Are you having trouble loading this page? Click here to view a text-only version.

SHINE: Serving the Health Insurance Needs of Everyone

Medicare Buy-In Programs help save money

Lorraine York EdbergLorraine York-Edberg, Western Mass. Regional SHINE Program DirectorMedicare Buy-In Programs, also called Medicare Savings Programs, can assist low-income Medicare beneficiaries pay their share of the Medicare Part B premium, which is currently $121.80 monthly. Medicare beneficiaries may be eligible for different buy-in programs based on their income. The three programs are called QMB (Qualified Medicare Beneficiary), SLMB (Specified Low-Income Medicare Beneficiary), and QI-1 (Qualified Individuals).

Eligibility guidelines for these programs are as follows:

  • QMB is at 100% Federal Poverty Level (FPL) as follows for:
    • An individual: $1,010 monthly and less than $7,280 in assets
    • A couple: $1,355 monthly and less than $10,930 in assets
  • SLMB is at 120% FPL as follows for:
    • An individual: $1,208 monthly and less than $7,280 in assets
    • A couple: $1,622 monthly and less than $10,930 in assets
  • QI-1 is at 135% FPL as follows for:
    • An individual: $1,357 monthly and less than $7,280 in assets
    • A couple: $1,823 monthly and less than $10,930 in assets

These programs has not been subject to estate recovery since January of 2010, so the state will NOT place a lien on your property to recover benefits following your death.

And better still, if you qualify for any of the three Medicare Savings programs, you will also automatically qualify for a full subsidy under the Medicare Part D Low Income Subsidy (LIS), which is also known as "Extra Help." This program will pay the monthly premiums for your Part D plan, provided you are enrolled in a qualified plan. LIS will also assist with covering drugs during the Part D deductible and coverage gap.

If you are eligible for QMB, this program will pay for your Part A (hospital insurance) deductible and Part B annual deductible of $166 annually. Part B premium is currently $121.80 monthly, and the hospital deductible is $1,288 for each hospitalization.

If you are eligible for SLMB or Q I-1, these programs will pay for your Part B (medical insurance) premium which is currently $121.80 per month.

To apply, the easy, one-page application is simple to fill out. Contact MassHealth at 1-800-841-2900 and request the Medicare Buy-In application, and they can send it to you. We also have applications available here at the regional SHINE office upon request. If you need assistance filling it out, we are happy to help.

The SHINE program, (Serving Health Information Needs of Everyone… on Medicare), provides free, confidential and unbiased health insurance counseling for Medicare beneficiaries. To reach a trained and certified counselor in your area, contact the Regional Office at 1-800-498-4232 or 413-773-5555 or contact your local Council on Aging.