Loveland Bike Trail
 

Medicare Savings Programs

  • If you are on Medicare Part A you may be eligible for one of the programs that help pay for your Medicare Part B premium.
  • If you are eligible for SSI and are entitled to Medicare, you may be eligible for payment of your Medicare Part A premium, Medicare Part B premium, and any Medicare coinsurance and deductibles.

You can be eligible with monthly income up to $1,239 for an individual or $1,660 for a couple. Your assets will need to be below $8,100 for an individual and $12,910 for a couple.

Medicare savings programs include:

QMB (Qualified Medicare Beneficiary)

QI-1 (Qualified Individual-Level 1)

SLIM-B (Special Low Income Beneficiaries)


QMB

State Medicaid programs now pay Medicare premiums, deductibles and co-insurance for Medicare recipients with limited income and resources. These individuals are called Qualified Medicare Beneficiaries (QMB)

Medicaid will pay:

  • Monthly premiums for Medicare coverage.
  • Medicare deductibles (the yearly deductible for Part B Medicare services such as office visits, lab, x-ray services and Part A deductible if you are hospitalized)
  • Medicare co-insurance (the 20% per service charge which you have to pay for most medical services)

Medicaid will only pay for medical services that are benefits of Medicare. Prescriptions are not a benefit of the QMB program. The QMB recipient must show the medical provider his/her Medicare card and his/her Medicaid card. Medicaid and Medicare combined will automatically pay for monthly premiums, co-insurance and deductibles.

The QMB recipient only pays a small fee for certain medical expenses, known as Medicaid co-payment. Call the hotline at (800) 221-3943 for more information.

Note: When you are approved for QMB, it will take about 90 days for Colorado's payments to be made to Medicare on your behalf. You will be reimbursed for any Medicare premiums you paid during that period.

QMB eligibility requirements

  • Be currently eligible for Medicare hospital insurance (PART A).
  • Meet income limits. (Income is anything, which can be used to purchase food, clothing, or shelter. Some examples include wages, Social Security, pensions, child support and unemployment benefits.)
  • Meet resource limits. (Resources are whatever money remains unspent from a prior month. Some examples include cash, checking and savings accounts, stocks, bonds, some insurance policies and secondary property.) The home, a car, personal belongings, household goods, some burial policies, and some life insurance policies are not counted as part of your resources, but these items must be reported on the application.
  • Be a U.S. Citizen or permanent legal alien.
  • Be a resident of Colorado.


QI-1/SLIM-B

State Medicaid now pays the Medicare Part B premium for Medicare recipients with limited income and resources. These individuals are called Special Low Income Medicare Beneficiaries (SLIMB)

Medicaid will pay

Monthly premiums for Medicare Part B coverage. This can help you by having Medicare pay for most of the cost of your doctor, medical supply, lab, x-ray, and ambulance services.

  • Payment of Medicare Part B Premiums is the only benefit available under Medicaid for QI-1 / SLIM-B.
  • Call the hotline at (800) 221-3943 for more information
  • Medicaid coverage will begin the month your application is received. Coverage can be made retroactive three months prior to the application upon request and if eligible.

Note: QI-1 and SLIM-B recipients are not eligible for help with Medicare co-payments.

QI-1/SLIM-B eligibility requirements

  • Be currently eligible for Medicare "hospital insurance" (PART A)
  • Meet income limits. (Income is anything, which can be used to purchase food, clothing, or shelter. Some examples include wages, Social Security, pensions, child support and unemployment benefits.)
  • Meet resource limits. (Resources are whatever money remains unspent from a prior month. Some examples include cash, checking and savings accounts, stocks, bonds, some insurance policies and secondary property.) The home, a car, personal belongings, household goods, some burial policies, and some life insurance policies are not counted as part of your resources, but these items must be reported on the application.
  • Be a U.S. Citizen or permanent legal alien.
  • Be a resident of Colorado.
  • Not be eligible for Medicaid coverage under another program like TANF, SSI, OAP, LTC, etc.

How to Apply

To apply for these programs,you must complete an application packet. Please call (970) 498-6300 if you would like a packet mailed to you. Applications cannot be processed until all forms within the packet are completed and returned to our office. You can expect processing of a new application to take up to 45 days.

You will need several documents to verify information and you may need to come in for a face-to-face interview. If you do not have all of your required paperwork in order before the interview, you can gather it after.

If you need assistance filling out the application, contact Catholic Charities Northern at (970) 484-5010. Home visits may be available if needed.

Background Image: Loveland Bike Trail by Sharon Veit. All rights reserved.