Is Any Help Available to Pay Medicare Costs If My Income and Assets Are a Bit Too High for Medicaid?

1 answer | Last updated: Oct 27, 2016
A fellow caregiver asked...

Is any help available to pay Medicare costs if my income and assets are a bit too high for Medicaid?


Expert Answers

If you have low countable income (which means that your actual income can be much higher) and few assets, not counting your home, a car, and other personal possessions, but your income or assets are slightly too high to qualify for Medicaid, you may still be eligible for another program that provides substantial financial help with medical costs left unpaid by Medicare. These other programs are called Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualifying Individual (QI).

These three programs have different eligibility requirements and pay different amounts of Medicare-related medical costs:

  • QMB: You may qualify as a QMB if your counted income is up to about $950 per month (this figure varies slightly from state to state). You may also have nonexempt assets of up to $4,000 ($6,000 for a couple). If you qualify as a QMB, your state pays all of your Medicare Part A and Medicare Part B premiums, deductibles, and coinsurance.

  • SLMB: You may qualify as a SLMB if your counted income is up to about $1,150 per month. You may also have nonexempt assets of up to $4,000 ($6,000 for a couple). If you qualify as an SLMB, the program pays your monthly Medicare Part B premium.

  • QI: You may qualify as a QI if your counted income is up to about $1,300 per month and your nonexempt assets are no more than $4,000 ($6,000 for a couple). If you qualify as a QI, the program pays your Medicare Part B monthly premium -- but each state's QI funds are limited and there's no guarantee of coverage even if you meet the qualifying standard.