DO I  Qualify for Medicare Benefits (QMB)

You may be able to get extra help to pay for the monthly premiums, annual deductibles, and co-payments related to the Medicare Prescription Drug program. However, you must be enrolled in a Medicare Prescription Drug plan to get this extra help.

If you are entitled to Medicare Part A coverage and have limited income and resources, you may be eligible for Medicaid and the QMB program. If you are eligible, your state’s Medicaid and QMB program may pay for your Medicare Part B premium, Part A and Part B deductibles, and coinsurance requirements.

To qualify for extra help with Medicare prescription drug plan costs in 2018, your annual income must be limited to $18,210 for an individual ($24,690 for a married couple living together). Also see: 2018 Federal Poverty Level Guidelines (FPL):2018 LIS Qualifications and Benefits.

Although the rules may vary from state to state, in general, you must meet the following requirements in order to be eligible for both programs:

  • You must be entitled to Medicare Part A
  • Your income must be at or below the national poverty level ( limits generally change annually)
  • Excluding certain exempt property, you may not have resources that exceed a certain value (resource limits generally change annually). Some things, such as your home, one car , and certain other personal items, usually do not count as resources

How to Apply for Medicaid and QMB

Call your local Medicaid office to ask how to submit your application. Many states allow you to submit your application online, through the mail, or through community health centers. A few states will require that you schedule an in person appointment at the Medicaid office.

If you indeed qualify for Medicaid, and receive Medicare benefits (A & B), there are also a number of plans available that TSS can assist you with, to cover most health of your health care costs and needs.

See if you qualify for the QMB program?  Give one our Specialists a call:


 or schedule an appointment click here!

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