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Eligibility Income Guidelines for Medicare Savings Programs and "Extra Help" Program 

Last updated April 2015

Program Name Eligibility Guidelines Benefits

QMB (Qualified Medicare Beneficiary)

On Medicare:

Monthly Income: $1,001 (individual) / $1,348 (couple)

Resources: $7,280 (individual) / $10,930 (couple)

excludes home, car, and $1,500 for burial

  •  Part A & Part B premiums, deductibles and copays
  • Extra Help Full Subsidy

SLMB (Specified Low-Income Medicare Beneficiary)

On Medicare:

Monthly Income: $1,197 (individual) / $1,613 (couple)

Resources: same as QMB

  • Part B premium
  • Extra Help Full Subsidy

Qualifying Individual (QI)

 

On Medicare:

Monthly Income: $1,345 (individual) / $1,813 (couple)

Resources:same as QMB

  • Part B premium
  • Extra Help Full Subsidy

Medicare Part D (Prescription Drug Program) Extra Help Full Subsidy

On Medicare:

Monthly Income: $1,344 (individual) / $1,812 (couple)

Resources: $8,780 (individual) / $13,930 (couple)

excludes home, car, and $1,500 for burial

  • Low or $0 premium
  • $0 deductible
  • $2.65-$6.60 copay
  • NO "donut hole" GAP!

Medicare Part D (Prescription Drug Program) Extra Help Partial Subsidy

On Medicare:

Monthly Income: $1,491 (individual) / $2,011 (couple)

Resources: $13,640 (individual) / $27,250 (couple)

excludes home, car, and $1,500 for burial

  • 25-75% premium reduction
  • $66 annual deductible
  • 15% copay
  • NO "donut hole" GAP!