If you are entitled to Medicare benefits and have a low income, DMMA may pay your Medicare premiums and, in some cases, other “out-of-pocket” expenses such as deductibles and coinsurance through Qualified Medicare Beneficiary Programs.

You must be entitled to Medicare Part A to qualify for any of these programs. Recipients under these programs do not receive regular Medicaid services.

Qualified Medicare Beneficiary Program (QMB)

Under this program, Medicaid pays for the following:

• The Medicare Part A hospital premium. Most Medicare recipients receive this coverage free.
• The Medicare Part B premium.
• The Medicare Part A hospital deductible.
• The annual Part B deductible.
• The 20% coinsurance (for services such as physician visits and lab work).

Your gross monthly income cannot exceed 100% of the Federal Poverty Level (see our Federal Poverty Level charts). Your assets are not considered.

Specified Low Income Medicare Beneficiary (SLMB) Program

Under this program, Medicaid pays the Medicare Part B premium only. Your gross monthly income cannot exceed 120% of the Federal Poverty Level.

Qualified Individual – 1 Program

Under this program, Medicaid pays the Medicare Part B premium only. Your gross monthly income cannot exceed 135% of the Federal Poverty Level.