Need Help With Medicare Expenses? Check Out the QMB and SLMB Programs
The State of Iowa offers the QMB (Qualified Medicare Beneficiary) and SLMB (Specified Low-Income Medicare Beneficiary) programs to help pay for certain Medicare related expenses.
For example, both QMB and SLMB pay your Medicare Part B premium. The payment of the Medicare premium is a major cost savings for many retirees. This premium is ordinarily deducted directly from your social security. It is one of those expenses that you never really see, and so don’t often think about – kind of like the money an employer withholds from a paycheck. You pay this premium in order to receive Medicare Part B healthcare benefits, which pay, among other things, 80% of the cost to visit your doctor’s office.
To be eligible for QMB and SLMB, you must receive Medicare and meet certain income and resource guidelines.
The resource guidelines are the same for both QMB and SLMB. In 2021, you can have resources of up to $7,970 for an individual and $11,860 for a couple. Resources include any cash, savings, investments, extra vehicles, real estate other than your home and various other kinds of property. Resources do not include your home, one car and household possessions. Some burial funds or set asides are also not included. For example, a prepaid burial arrangement is not included if it meets Iowa Department of Human Services guidelines. Alternatively, an individual can earmark savings or other funds for burial expenses in an amount up to $1,500.
While the resource guidelines for QMB and SLMB are the same, the income guidelines are different:
For the Qualified Medicare Beneficiary (QMB) program, the maximum monthly income in 2021 is $1,074 for one person or $1,452 for a couple. These income limits are $20 higher if you have income other than Social Security. Income includes Social Security benefits, pensions, wages and interest.
As explained above, the QMB program pays the monthly Medicare Part B premium. It also pays the hospital deductible, daily coinsurance for extended hospitalizations and skilled nursing care, the Part B deductible and the 20% coinsurance for Part B expenses. Thus, the QMB program generally pays all of the expenses that a Medicare Supplement insurance policy would pay, plus the Medicare Part B premium.
For the Specified Low-income Medicare Beneficiary (SLMB) and Expanded SLMB (E-SLMB) programs, the maximum monthly income is $1,449 for one person and $1,960 for a couple. These income limits are $20 higher if you have income other than Social Security. These programs pay only the monthly Part B premium, a major cost saving for many retirees and others on Medicare.
If you think you are eligible for either of the above programs, you should apply at your local Department of Human Services office. You can find the address and phone number in your phone book. If you have any questions about the QMB or SLMB programs, please contact the Legal Hotline for Older Iowans or the Department of Human Services.
Iowa Legal Aid provides help to low-income Iowans.
To apply for help from Iowa Legal Aid:
Iowans age 60 and over, call 800-992-8161.
Apply online at iowalegalaid.org
If Iowa Legal Aid cannot help, look for an attorney on “Find A Lawyer.” A private attorney there can talk with you for a fee of $25 for 30 minutes of legal advice.
*As you read this information, remember this article is not a substitute for legal advice.