- The QI program is a Medicare savings program.
- The QI program helps pay your Part B premiums.
- Your individual or joint income and resources must meet a certain criteria to qualify.
The Medicare Qualifying Individuals (QI) program helps Medicare beneficiaries cover their Part B premium. Your premium is the monthly fee you pay for your Part B medical coverage.
The QI program is one of four Medicare savings programs. These programs help individuals with limited incomes cover their healthcare costs. To qualify, you need to meet the program’s income requirements, and you must reapply every year to keep your coverage.
Keep reading for more information about the Medicare QI program.
Assistance comes from each state and is based on your income and resources. As of 2021, there are four Medicare savings programs:
- QI program
- Qualified Medicare Beneficiary (QMB) program
- Qualified Disabled and Working Individuals (QDWI) program
- Specified Low-Income Medicare Beneficiary (SLMB) program
The program covers the cost of the Part B premium for people who qualify.
The QI program is for Medicare enrollees with Part A and Part B, and it’s intended to cover your Part B premiums. In 2021, the standard Part B monthly premium is $148.50. The QI program will pay this cost if you qualify.
The QI program won’t change your Part A costs — but most people don’t pay a premium for Part A anyway. So, if you have original Medicare with premium-free Part A and you qualify for the QI program, your total monthly premium would be $0.
Your eligibility for the Medicare QI program is based on your income. In 2021, the income limits for the QI program are $1,469 per month for individuals or $1,980 for married couples. The income limits are slightly higher in Alaska and Hawaii.
You’ll also need to be at or below the resource limit. In 2021, that means you’ll need less than $7,970 in resources as an individual or $11,960 as a married couple.
Resources include things like bank accounts or stocks. Medicare doesn’t consider high-value items like your car or home to be resources.
The income limits can change each year and are based on the federal poverty level (FPL). The FPL is calculated using data like the cost of living and the average salary in each state. Various programs use the FPL as a benchmark to qualify for programs like Medicare QI.
You aren’t eligible for QI benefits if you also qualify for Medicaid. But you can still apply for the program through your state Medicaid office. The office will determine which programs, if any, you qualify for.
Tips for finding help paying for Medicare
Medicare was created to offer healthcare services for people ages 65 and over as well as those with certain health conditions. But out-of-pocket costs like premiums, copayments, and deductibles can add up. If you’re having trouble paying for your share of Medicare costs, you can take several actions or look into programs that can help:
- Dual eligibility. If you have significant need or disability, you may qualify for both Medicare and Medicaid. This is called dual eligibility, and it could offer you additional health coverage and services.
- Extra Help. This program offers savings on prescription medication costs, but you have to be enrolled in a Medicare Part D prescription plan to participate. If you qualify for a QMB, you should also qualify for the Extra Help program.
- Medicare Advantage (Part C) plans. Medicare parts A and B cover inpatient and outpatient care, respectively. Medicare Part D is an optional program that covers prescription medications. Medicare Part C, or Medicare Advantage, allows you to tailor a Medicare plan that best suits your healthcare and financial needs. Bundling Medicare services through an Advantage plan may help you save money.
- Medicare savings programs. These programs — including the QMB — help cover a share of your Medicare costs. Participation is limited to particular needs and income limits.
- Sign up on time and plan ahead. A variety of penalties may be applied to your share of Medicare costs. Sign up for initial coverage on time. Add additional services you think you might need within designated time frames to avoid late fees and penalties.
- Update your income. A number of Medicare programs use income to determine eligibility. If your income drops, be sure to update Medicare.
- Ensure eligibility. Make sure you’re eligible for Medicare and enrolled in Part A.
- Contact your local office. Contact your state Medicare savings program office. They will have the application you need and can also provide instructions and assistance.
- Apply. Medicare encourages anyone who thinks they might be eligible for the QI program to apply. Medicare beneficiaries whose income is close to the qualifying line — and even if it goes slightly over — should apply, as there is no application cost.
- Reenroll each year. You’ll need to reenroll in the QI program each year. Applications for the QI program are approved on a first-come, first-served basis, so you’ll want to apply as early as possible. Priority is given to people who were enrolled in the QI program the previous year.
Documents you’ll need
You’ll likely need to provide some information about your finances with your application. This might include:
- your recent paystubs
- your most recent tax returns
- your checking and savings account statements
- statements from your pension or other retirement programs
- information on any stocks you own
- The Medicare QI program is one of four Medicare savings programs. It helps Medicare beneficiaries with limited incomes pay their Part B premiums.
- You’ll need to apply through your state and meet the income requirements to qualify.
- If you qualify for the QI program, you’ll also be automatically qualified for Part D Extra Help.