Several financial assistance programs exist to help certain individuals obtain Medicare and Medicaid coverage: the Qualified Medicare Beneficiary (QMB) program; the Specified Low Income Medicare Beneficiary (SLMB) program; and the Qualifying Individuals (QI) programs. These programs are available to qualifying individuals who do not meet the income requirements for Medicaid.
Qualified Medicare Beneficiary (QMB) Program
The QMB program pays Medicare premiums, deductibles, and copayments for qualifying individuals. An applicant's income must fall below the federal poverty level. Additionally, the applicant must have very limited assets. QMB benefits are a federal entitlement; they are funded by a combination of state funds and matching federal funds.
Specified Low Income Medicare Beneficiary (SLMB) Program
The SLMB program pays the premium for Part B Medicare coverage for eligible individuals. The income of an eligible applicant cannot exceed 120% of the poverty level, and the applicant's assets must be very limited. Like the QMB program, the SLMB program is funded by both federal and state funds, and also like the QMB program, eligible applicants are entitled to SLMB benefits.
Qualifying Individuals (QI) Programs
The QI programs have more liberal income guidelines than either the QMB or the SLMB programs. The first QI program allows an applicant to earn up to 135% of the federal poverty level. Those individuals are eligible for payment of their full Medicare premiums. Eligible applicants for the second QI program may earn between 135 and 175% of the federal poverty level. If an applicant's premiums increased because of the transition of home health care benefits from Part A to Part B, he or she is eligible to have the premium increase paid. Because the QE programs are funded by federal block grants and are not entitlements, they are only available on a first-come, first-served basis.
Copyright 2013 LexisNexis, a division of Reed Elsevier Inc.