What is the Qualified Medicare Beneficiary Program?

The Qualified Medicare Beneficiary (QMB) Program is a Medicaid benefit that helps low-income Medicare beneficiaries with Medicare costs. The program pays Medicare Part A and Part B premiums, deductibles, coinsurance, and copayments for eligible individuals, effectively functioning as a Medicare Savings Program for those with limited financial resources.

Why is the Qualified Medicare Beneficiary Program important?

• Cost reduction: Eliminates most out-of-pocket Medicare expenses.
• Access improvement: Makes healthcare more affordable for low-income seniors and disabled individuals.
• Financial protection: Preserves limited income for other essential needs.

Eligibility criteria for the QMB Program

• Medicare Part A eligibility.
• Income limitations (typically around 100% of the Federal Poverty Level).
• Resource limitations with certain exemptions.

How Solace can help

A Solace advocate can help you determine if you qualify for the QMB Program, assist with the application process, gather necessary documentation, and address issues if providers inappropriately bill you for Medicare cost-sharing. They can also help you understand how QMB status affects your healthcare costs and identify additional assistance programs you might qualify for.