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June 23, 2021
Who Qualifies for Free Medicare?

Who Qualifies for Free Medicare?

Have your Medicare premiums and copays been breaking the bank? If so, it may be time to talk to us about financial assistance options.

Luckily, there are quite a few, so it’s likely that you will find a solution that's right for you.  

Is Medicare ever free?

By and large, Medicare is not considered free. Because you have been contributing to your Medicare services through taxes throughout your life, you will have contributed money to Medicare regardless of the current cost of your copayments or premiums.  

However, it's possible to receive assistance for your Medicare Part A and Part B premiums, copays, and other fees. This is called a Medicare Savings Program, which is state-funded help with paying your premiums.

In some situations, Part A and Part B deductibles, coinsurance, and copayments may be paid as well.  

If you receive Social Security benefits, it may feel like Medicare is free because your Part B premiums can be automatically deducted from your benefit checks, but you are still paying for your coverage.

Though this doesn’t necessarily make Medicare free, it's definitely worthwhile to check out the Medicare Savings Program if you need financial assistance.  

Read more: Is Medicare Coverage Free at Age 65?  

Is Medicare Part B based on income?

Yes, Medicare Part B pricing is based on income. However, coverage is federally regulated, which means that Medicare Part A is usually a $0 premium, but Part B requires a monthly premium that is based on your tax filings.

The most common monthly Part B premium is $148.50. If you have a high income, you'll pay more.

In 2021, the Medicare Part B deductible is $203. After you reach this deductible, you pay 20% of the Medicare-approved amount for most care.

What is the difference between Extra Help and the Medicare Savings Program?  

When investigating affordable Medicare options, you've likely come across the names Extra Help and Medicare Savings Progam.

Though Extra Help is a great resource, it is only going to help with Medicare Part D prescription drug costs.

If you're looking for help with your Original Medicare-related costs, look for a Medicare Savings Program. There are four kinds:  

  • Qualified Medicare Beneficiary (QMB) program
  • Specified Low-income Medicare Beneficiary (SLMB) program  
  • Qualifying Individual (QI) program  
  • Qualified Disabled and Working Individuals (QDWI) program  

Bonus Tip: If you qualify for the QMB program, SLMB program, or QI program, you automatically qualify for Extra Help to assist with your Medicare prescription drug coverage costs.  

How do I qualify for Medicare financial assistance?

Income limits change every year, so if you aren’t sure about your qualification, don’t count yourself out yet!

Each type of Medicare Savings Program has a different monthly income limit that varies based on marital status. Here are this year’s limits to qualify for all the different programs*:  

  • QMB program: $1,094/month (individual income) and $1,472/month (married couple income)
  • SLMB program: $1,308/month (individual income) and $1,762/month (married couple income)
  • QI program: $1,469/month (individual income) and $1,980/month (married couple income)
  • QDWI program: $4,379/month (individual income) and $5,892/month (married couple income)

*Income limits can be slightly higher in Alaska and Hawaii, so be sure to talk to a trusted agent to learn more about your specific qualifications.  

Aside from income, there are also resource limits to qualify for Medicare Savings Programs. Countable resources include:  

  • Money in checking or savings accounts
  • Stocks
  • Bonds  

However, the following resources are exempt:  

  • One home
  • One car
  • Burial plot
  • Up to $1,500 in set-aside burial expenses  
  • Furniture  
  • Any other household and personal items  

All of these programs have personal qualifications, from age to disability status, so be sure to check with your agent or our team here at Medicare Allies to learn more about the best program for you.  

What do Medicare Savings Programs pay for?  

Because each program is different, they all pay for different things.

  • A QMB program helps pay for Part A premiums and/or Part B premiums, deductibles, coinsurance and copayments except outpatient prescription drugs.  
  • A SLBM program helps pay for Part B premiums only.
  • A QI program helps pay for Part B premiums and is allocated on a first-come, first-serve basis. You also can’t qualify for QI if you qualify for Medicaid.  
  • A QDWI program helps pay for Part A premiums only.  

Conclusion 

Want help determining your Medicare costs?

Call us for help with your Medicare plan, including what programs you may qualify for and what health coverage may be the best fit for your needs and budget. There is truly something for everyone, regardless of your budget constraints.

Luke Hockaday
By
Luke Hockaday
Luke Hockaday is a Customer Success Rep here at Medicare Allies. Luke has been helping Medicare-eligible clients with their insurance and retirement-planning needs since 2011. Luke is passionate about 3 things, and 3 things only: senior insurance, football, and food!

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