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Medicare Buy-In Programs Help Save Money

Lorraine York-EdbergLorraine York-Edberg

To apply, fill out a simple one-page application.

Medicare buy-in programs, also called Medicare Savings Programs, can help low-income Medicare beneficiaries pay their share of the standard Medicare Part B premium, which is currently $135.50 monthly. Medicare beneficiaries may be eligible for different buy-in programs based on their income and assets.  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 as follows for an
    • Individual $1,041 monthly and less than $7,730 in assets
    • Couple $1,410 monthly and less than $11,600 in assets
  • SLMB is at 120% Federal Poverty Level as follows for an
    • Individual $1,249 monthly and less than $7,730 in assets
    • Couple $1,691 monthly and less than $11,600 in assets
  • QI-1 is at 135% Federal Poverty Level as follows for an
    • Individual $1,406 monthly and less than $7,730 in assets
    • Couple $1,872 monthly and less than $11,600 in assets

These programs are not 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.  The LIS will also assist with covering drugs during the Part D deductible and coverage gap.

If you are eligible as a Qualified Medicare Beneficiary (QMB), this program will pay for your Part A (hospital insurance) deductible and Part B annual deductible of $185 annually.  The 2019 Part B standard premium is currently $135.50 monthly, and the hospital deductible is $1,364 for each hospitalization.

If you are eligible as a Specified Low Income Medicare Beneficiary (SLMB) or the Qualified Individual Medicare Beneficiary (Q I-1), this program will pay for your Part B (medical insurance) premium.

To apply, it is a one-page application, and simple to fill out.  To get this application, you can 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 assist.

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 LifePath at 1-800-498-4232 or 413-773-5555, or contact your local Council on Aging.