The Qualified Medicare Beneficiary (QMB) Program is designed to assist your mother by paying her:
- Medicare Part B premium;
- Medicare Part B premiums are based upon the income your mother reported on her taxes 2 years ago. Her premium can range from $144.60 to $491.60 per month (as of 2020), depending on her reported income.
- Medicare copayments and deductibles;
- Once your mother meets her deductible, she will be required to pay the coinsurance of 20% of the Medicare-approved amount charged by providers for her healthcare services.
In addition to the above assistance, your mother will automatically qualify for Medicare Part D “Extra Help.” The Extra Help program is estimated to be worth about $4,900 a year. If your mother does not qualify for the QMB program, she may want to apply for Extra Help for assistance.
The requirements for Extra Help are as follows (as of 2020):
- She must reside in the United States;
- Her resources must be limited to $14,610 for an individual and $29,160 for a married couple living together (resources follow the same rules that we have discussed throughout this book); and
- Her annual income must be limited to $19,344 for an individual or $26,100 for a married couple living together. If your mother makes more than this, she still might qualify. If you would like to apply your mother for this program, you can do so online at www.socialsecurity.gov/extrahelp or call Social Security at 1-800-772-1213.
The requirements to qualify for the QMB program are as follows (as of 2020):
- Your mother’s annual income is limited to $12,760 if she is single and $17,240 if she is married;
- Her resource limit is $7,730 if single and $11,600 if she is married.
Since the income requirements are so low, there is no transfer penalty to become eligible for this program. However, if your mother were to go into a nursing home or a Community-Based Alternative program alongside it, she would be subject to the penalty period. The income requirements are not as strict as Medicaid programs, in that you can receive help from other family members as long as they directly pay the provider.
To apply for this program, you can visit https://www.benefits.gov/benefits/benefit-details/6177. For any more information that you may need, please call 1-800-633-4227. It does not hurt to apply if you believe that you might qualify.