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Medicare Savings Programs

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 You Can Save the Cost of Your Medicare Premium Every Month.

The Medicare Savings Programs consist of:   QMB, SLMB, AND ALMB PROGRAMS:

The Qualified Medicare Beneficiary program (QMB), Specified Low-Income Medicare Beneficiary program (SLMB), and Additional Low Income Beneficiary program (ALMB), help eligible Medicare beneficiaries pay all or some of Medicare’s cost sharing amounts (ie. premiums, deductibles and co-payments). To qualify an individual must be eligible for Medicare and must meet certain income guidelines which change annually.

 

QMB (Qualified Medicare Beneficiary Program)

The QMB program provides the following benefits:

  • Payment of Medicare Part A monthly premiums (when applicable)
  • Payment of Medicare Part B monthly premiums and annual deductible
  • Payment of co-insurance and deductible amounts for services covered under both Medicare Parts A and B if the medical provider is a Medicare and Medicaid provider.
  • Automatic enrollment in the low income  subsidy for those on Medicare Part D.

Eligibility criteria for this program:

  • The individual must be eligible for Medicare Part A insurance (even if not currently enrolled)
  • The monthly income must be at or below $2,120.55/month for a single person and $2,854.83/month for a married couple
  • There is  no asset test

SLMB (Specified Low-Income Medicare Beneficiary Program)

The SLMB program provides the following benefits:

  • Payment of the Medicare Part B monthly premium
  • Automatic enrollment in the low income subsidy for Part D drug coverage

Eligibility criteria for this program:

  • The individual must be eligible for Medicare Part A insurance (even if not currently enrolled)
  • The monthly income must at or below $2,321.55/month for single person and $3,125.43/month for married couples
  • No asset test

 

ALMB (Additional Low-Income Beneficiary Program) – Limited Expansion of SLMB 

The Balanced Budget Act of 1997 expanded the SLMB program for certain “qualified individuals” by increasing the income guidelines, but Congress only appropriated a limited amount of funds to each state to pay for this expansion. Once a state’s appropriated money is gone, even eligible individuals will not be able to get into the program.

ALMB  Program Benefits:

  • Part B premium paid in full
  • Automatically enrolled in LIS under Medicare Part D.

 

Program Eligibility:

  • Income at or below $2,472.30/month for single person and $3,328.38/month for married couples
  • No asset limit
  • Individuals must apply every year for these benefits
  • It is important to apply early to have a better chance of obtaining these benefits. Applications from those meeting the eligibility requirements will be granted on a first come first served basis.
  • Priority for the following year will be given to those who received the benefits during the previous calendar year
  • These benefits are not available to those who qualify for any other kind of Medicaid (T19)

Do these programs help with prescription drug coverage?

Enrollment in any of the above three programs, automatically grants the beneficiary enrollment in the Low Income Subisdy (LIS) under Medicare Part D.  This is very beneficial for the for the individual because:

  • their Part D plan’s premium will be paid in part or in full by the federal government (depending on what Part D plan you are enrolled in)
  • the co-pays for formulary drugs will be between $2.95 – $7.40 per prescription
  • coverage will continue through the “donut hole” so the individual will not have to pay the full cost of their formulary drugs.
  • LIS qualifies you for special enrollment periods throughout the year which means you can change your Part D plan as often as you wish.

MSP Frequently Asked Questions 

How do you obtain QMB, SLMB or ALMB benefits?

The above programs are administered by the State Department of Social Services (DSS). To apply for any of these programs, follow this link to download application.

Medicare Savings Application – English

Medicare Savings Application – Spanish

Medicare Savings Brochure – English

Medicare Savings Brochure – Spanish

Applications should be mailed to:

DSS ConneCT Scanning Center
P. O. Box 1320
Manchester, CT 06045-1320
 

If you need additional information or assistance, call CHOICES at 1-800-994-9422.

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