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Qualified Medicare Beneficiaries (QMB)

This program may help pay your Medicare Part "B" Premiums. Healthy Connections will make a QMB determination for a Medicaid-eligible individual in any full benefits category if that individual is covered under Medicare Part A.

Eligibility: 

To be eligible as a QMB, an individual must be entitled to Medicare Part A and:

  • Be aged 65 or over or
  • Blind or
  • Disabled
Income Limit: 

FAMILY SIZE

MONTHLY INCOME

(Effective 3/1/2015)

ANNUAL INCOME

(Effective 3/1/2015)

RESOURCES

(Effective 3/1/2015)

1

2

$ 981

$ 1,328

                  $ 11,770

                  $ 15,930

$ 7,280

$ 10,930

Benefits: 

QMB coverage offers payment of Medicare premiums, co-pays and deductibles.

To Apply: 

Apply online and submit this supplemental form to your local county officeAdditional Information for Select Medicaid ProgramsIf you elect to file a hardcopy application, you may complete the following forms and submit them to your local county office

Section 303 of the Medicare Catastrophic Coverage Act of 1988 (MCCA) required the State Medicaid program to pay the premiums (Part A and/or B) and cost sharing for individuals/couples with limited resources and incomes at or below 100% of the Federal Poverty Level.