The programs that cover Medicare's out-of-pocket expenses provide limited Medicaid benefits to those who qualify. Through these programs, Medicaid will pay Medicare premiums, co-payments and deductibles within prescribed limits. There are two programs: Qualified Medicare Beneficiaries (QMB) and Special Low-Income Medicare Beneficiary (SLMB). The QMB program pays for the recipient's Medicare premiums (Parts A and B), Medicare deductibles and Medicare coinsurance within the prescribed limits. QMB recipients also automatically qualify for extra help with the Medicare Part D prescription drug plan costs. The income and asset caps are higher than the normal SSI/Medicaid qualification limits. (Resources must be at or below twice the standard allowed under the SSI program and income must be at or below 100 percent of the Federal Poverty Level.)
The SLMB program pays only for premiums for Part B Medicare benefits, although SLMB recipients also automatically qualify for extra help with Medicare Part D prescription drug plan costs. Again, the income and asset caps are higher than the normal SSI/Medicaid qualification limits. (Resources must be at or below twice the standard allowed under the SSI program and income can exceed the QMB level but must be less than 120 percent of the Federal Poverty Level.)
In my next post, I will discuss planning techniques for those that are dual eligible.