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: