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Medicare Part B is very rarely “free”, there are monthly premiums most people have to pay for their Medicare Part B coverage
There are several programs that can help to reduce the cost of your Medicare Part B premium and even cover the cost entirely
The three cost reduction programs are the Qualified Medicare Beneficiary (QMB), the Specified Low-Income Medicare Beneficiary(SLMB), and Qualifying Individual (QI)
The standard Part B premium for 2015 was $121.80, although it can be higher based on your income or other factors
Although most people have to pay a premium to be eligible to receive Medicare Part B benefits, there are programs that can help reduce or cover the cost depending on your circumstances.
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The first program that can help reduce your costs is the Qualified Medicare Beneficiary (QMB). There are two requirements to be eligible for this program, which include the income limit and asset limit. If you meet both of these requirements and are eligible for the program, your state should pay your premiums, deductibles, and copay for both Medicare Part A and B.
Your income must be no more than the federal poverty level to be eligible for this program, which was an annual income of $12,760 for a single person and an annual income of $17,240 for a married couple in 2020.
Certain income from working may not be counted in this estimate, as the Qualified Medicare Beneficiary program uses the supplemental security income guidelines for calculating countable income, so up to half of your working income may not be included.
If you apply these adjustments to your income and find that it is near the required amount, it can be in your best interest to apply for the program.
In addition to the income limit, there is an asset limit you must meet in order to be eligible for the QMB program. The asset limit is approximately $7000 for an individual and $11,000 for a couple that is married.
Some of your assets may not be counted, such as your house, car, or other household items, because this stipulation also follows the supplemental security income guidelines for countable assets.
If your income is too high to be eligible for the Qualified Medicare Beneficiary program, there are two other programs you may want to consider applying for. These are the Specified Low-Income Medicare Beneficiary(SLMB)and Qualifying Individual(QI) programs.
Although the asset limits are similar to the QMB, the income limit can be up to 80 percent higher depending on the program. If your monthly income, after adjust for countable income, is less than $1,296 for a single person or less than $1,744 for a couple, there is a strong possibility you will be eligible for some financial help through the SLMB program.
The QI program has a higher income limit and those who have a single income of less than $1,456 or a joint income that is less than $1,960 should apply for support from QI.
Since these programs allow applicants to have slightly higher monthly incomes, they do not offer as much support as QMB and are not technically considered free. You will still be responsible for paying your deductibles and copayments, although QI and SLMB will pay the monthly premium.
These programs require you to file a separate application than your general Medicare application, usually with your local Department of Social Services. You will need to bring documentation that prove your income which can include your income tax returns, Social Security benefits information, or pay stubs.
Additionally, it can be helpful to bring any documentation that proves your financial assets, your car registration if applicable, your social security card, your spouse’s financial information, if applicable, and any medical bills that may be relevant. The employee that handles your case may request additional paperwork from you.
If your request for assistance and enrollment in these programs gets denied, it may be possible to file an appeal. You may be granted a hearing where you can show proof of your income and explain why you believe the denial decision was wrong and should be reversed.
The standard premium amount for Medicare Part B is $144.60. You may pay a higher premium amount if your income is higher than $85,000 as an individual and $170,000 as a couple. Your premium may also be different if you’re enrolling in Medicare Part B for the first time, you do not get Social Security benefits, or you are billed directly for your premium.
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