MEDICARE SAVINGS PROGRAMS
 

Medicare Savings Programs are federal programs that help low-income individuals with some
of the out-of-pocket costs for Medicare, including Medicare Part A and Part B premiums,
deductibles, copayments, and coinsurance.


There are four types of Medicare Savings Programs: Qualified Medicare Beneficiary (QMB)
Program, Specified Low-Income Medicare Beneficiary (SLMB) Program, Qualifying
Individual (QI) Program, and Qualified Disabled and Working Individuals (QDWI)
Program.
Benefits vary for each program, but all of them, with the exception of the QDWI
Program, help pay for Medicare Part B premiums.


To qualify, you must have or be eligible for Medicare Part A and have income and resources
below a certain threshold. The income and resource requirements are different for each of the
four Medicare Savings Programs and may change from year to year.


If you qualify for a QMB, SLMB, or QI program, you automatically qualify to get Extra Help
paying for Medicare prescription drug coverage. With Extra Help, aka Low Income Subsidy
(LIS), the most you will pay for covered prescriptions is $3.35 for generics and $8.35 for brand
names.


Qualified Medicare Beneficiary (QMB) Program
QMB income & resource limits in 2019:
Individual monthly income limit:
  $1,041
Married couple monthly income limit:  $1,410
Individual resource limit:  $7,730
Married couple resource limit:  $11,600

 

Program helps pay for:
Part A premiums
Part B premiums
Deductibles, coinsurance, and copayments

 

Medicare providers aren’t allowed to bill you for Medicare deductibles, coinsurance, and
copayments when you get services and items Medicare covers, except outpatient prescription
drugs.

Pharmacists may charge you up to a limited amount (no more than $3.70 in 2018) for prescription drugs covered by Medicare Part D

 

Specified Low Income Medicare Beneficiary (SLMB) Program
SLMB income & resource limits in 2019:
Individual monthly income limit:  $1,249

Married couple monthly income limit:  $1,691
Individual resource limit:  $7,730
Married couple resource limit:  $11,600


Program helps pay for:
Part B premiums only


Qualifying Individual (QI) Program
You must apply every year for QI benefits. QI applications are granted on a first-come, first-served basis, with priority given to people who got QI benefits the previous year. (You can't get
QI benefits if you qualify for Medicaid).

 

QI income & resource limits in 2019:
Individual monthly income limit:  $1,406

Married couple monthly income limit:  $1,903
Individual resource limit:  $7,730
Married couple resource limit:  $11,600


Program helps pay for:
Part B premiums only

 

Qualified Disabled and Working Individuals (QDWI) Program
The QDWI program helps pay the Part A premium. You may qualify if any of these apply to
you:

  • You're a working disabled person under 65

  • You lost your premium-free Part A when you went back to work

  • You aren't getting medical assistance from your state

  • You meet the income and resource limits required by your state

QDWI income & resource limits in 2019:
Individual monthly income limit:  $4,249
Married couple monthly income limit:  $$5,722
Individual resource limit:  $4,000
Married couple resource limit:  $6,000

Program helps pay for:
Part A premiums only

We wish to thank Captain George Ahrend, a former Borough of Spotswood resident and police officer, for sharing his artistic talent in contributing to the design of the Borough of Spotswood's seal. We thank Mr. Thomas Sullivan, a former Borough of Spotswood resident and sanitation employee, for sharing his artistic talent in contributing to the design of the Borough of Spotswood's seal.