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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

  1. Be currently eligible for Medicare hospital insurance (PART A).
  2. 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.)
  3. 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.
  4. Be a U.S. Citizen or permanent legal alien.
  5. 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

  1. Be currently eligible for Medicare "hospital insurance" (PART A)
  2. 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.)
  3. 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.
  4. Be a U.S. Citizen or permanent legal alien.
  5. Be a resident of Colorado.
  6. Not be eligible for Medicaid coverage under another program like TANF, SSI, OAP, LTC, etc.


To apply for these programs, you must complete a packet of information. Please call 498-6300 if you would like a packet mailed to you. Applications cannot be processed until all forms 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 (listed below) to verify information. And you may need to come in for a face to face interview.

Please include the following with the COLORADO DEPT OF HUMAN SERVICES, APPLICATION FOR ASSISTANCE:

  • Proof of Medicare "Part A or B" eligibility
  • Social Security numbers (or proof of application) for everyone requesting benefits
  • If you are not a U.S. Citizen, proof of status in this country, such as
    • Visa
    • Legal Permanent Resident Card
    • Employment authorization card for everyone you are applying for
  • Proof of Colorado residency, such as
    • State of Colorado photo ID with your current address
    • Utility receipts with your current address
    • Lease agreement with your current address
    • Bank statements with your current address
  • Proof of your gross income and your spouse's gross income, such as
    • Current wages or income (pay stubs, employer letter)
    • Verification of Social Security or SSI
    • Proof of other income or checks you receive (child support, alimony, self-employment, financial aid)
  • Proof of resources (assets), such as
    • Bank statements
    • Value of motor vehicles
    • Property tax statements for United States real estate property
    • Value of property owned outside of the United States
    • Life insurance letter showing current face and cash value
    • Burial funds or policies
      • Verification/proof of any other resources you have (stocks, bonds, CD's, mineral rights, retirement accounts, etc.)

Depending on your individual circumstances, the State may require more supporting documents.