Medicare Savings Programs

The Medicare Savings Programs provide special limited Medicaid coverage to assist with certain costs for Medicare beneficiaries with low income and few assets. In North Dakota, these programs include the following.

The Qualified Medicare Beneficiaries (QMB) program pays for Medicare premiums, deductibles, and coinsurance payments. The income level (maximum income) for QMB eligibility is equal to 100 percent of the poverty level applicable to a family of the size involved. For 2009/2010, the monthly income level is $903 for a one-person unit and $1,215 for a two-person unit.

The Specified Low-Income Medicare Beneficiaries (SLMB) program pays only the Medicare Part B premiums for the beneficiaries. Individuals who have SLMB coverage may also have coverage under another Medicaid program, such as the Workers with Disabilities Medicaid buy-in program, if they meet the eligibility criteria for the other Medicaid program. The income level for SLMB is equal to 120 percent of the applicable poverty level. For 2009/2010, the monthly income level is $1,083 for a one-person unit and $1,457 for a two-person unit.

The Qualifying Individuals (QI) program pays only the Medicare Part B premiums for the beneficiaries. However, unlike SLMB coverage, QI coverage is not available to beneficiaries who are in receipt of any other Medicaid benefits for the same period. The income level for QI is equal to 135 percent of the applicable poverty level. For 2009/2010, the monthly income level is $1,219 for a one-person unit and $1,640 for a two-person unit.

Effective January 2010, the asset limits for the Medicare Savings Programs are: $6,600 for a one-person unit ($4,000 in 2009); or $9,910 for a two-person unit ($6,000 in 2009).

Individuals who are covered by one of the Medicare Savings Programs are automatically entitled to extra help (the low-income subsidy) in paying for Medicare prescription drug coverage (Medicare Part D).

Sources: Medicaid Program Policy Manual 510-05-60 (Medicare Savings Programs) and 510-05-85-40 (Income Levels); Medicare and You 2010, page 79.

Any questions may be directed to: rsi5@srt.com