What Is the Qualified Medicare Beneficiary (QMB) Program?
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The Qualified Medicare Beneficiary (QMB) program pays for your Medicare costs if you meet certain requirements for the income you make and assets you own. It will pay your Medicare Part A and B monthly rates and your Medicare Part B deductible, copays and coinsurance.
The QMB program income limits for 2024 are $15,300 per year for a single person and $31,440 per year for a family of four. In addition, some states have a separate limit for assets that you have to meet to qualify for QMB assistance.
What is QMB?
The Qualified Medicare Beneficiary (QMB) program is a Medicare Savings Program that pays for your Medicare Part A and B monthly rates and the costs you have to pay when you visit the doctor. You must meet certain income requirements to enroll in QMB.
Many states also have an asset limit. Your house and one car don't count toward the QMB asset requirement. However, the money in your bank account, investments, second homes and your retirement account all count toward this asset requirement.
Medicare is a type of low-cost health insurance that's run by the government. Most people become eligible for Medicare when they turn 65, although it's also possible to qualify for Medicare regardless of your age if you have kidney failure (end-stage renal disease) or ALS (Lou Gehrig's disease). Original Medicare is made up of two parts:
- Medicare Part A: Hospital insurance
- Medicare Part B: Medical insurance
In addition, you can buy Medicare Part D, which covers prescription drugs. Keep in mind that QMB will not pay the cost of a Part D plan. However, a separate government-run program called Extra Help, which you're automatically enrolled in when you sign up for QMB, can drastically lower the cost you pay for prescription drug coverage.
About 99% of people don't pay a monthly premium for Medicare Part A. As long as you've paid Medicare taxes as part of working for at least 10 years (40 quarters), it will be free. However, if you belong to the 1% of Medicare enrollees who have to pay for Part A, you could be looking at paying up to $518 per month.
Medicare Part B enrollees have to pay $185 per month in 2025. You also must pay a $257 deductible before Part B coverage starts. Finally, both Medicare Part A and B come with out-of-pocket costs that you're responsible for once you've met your deductible, known as copays and coinsurance. These can add up to thousands of dollars or more per year.
2024 Medicare premiums
Monthly cost | |
|---|---|
| Medicare Part B | $185 |
Medicare Part A (10+ yrs) | $0 |
Medicare Part A (7.5-10 yrs) | $285 |
Medicare Part A (less than 7.5 yrs) | $518 |
Who is eligible for the Qualified Medicare Beneficiary program?
To qualify for QMB in most states, you must earn no more than the federal poverty level (FPL) plus $240 per year. This amounts to $15,300 per year for a single person and $31,440 per year for a family of four in 2024.
The federal poverty level changes every year, which means the income requirements to enroll in the QMB program change annually as well.
Some states such as Alaska, Hawaii, Maine, Connecticut and Washington, D.C., have higher income requirements.
In addition, many states have separate caps on the value of assets you own. In 2024, you cannot qualify for QMB in most states if you have assets worth more than $15,720 as a single person or $31,360 as a married couple.
Keep in mind that certain items such as your primary residence, your car, household goods, wedding rings and burial plots don't count toward your limit. However, money sitting in your bank account or a second house or car is included when calculating your assets.
In addition, some states have higher asset limits or no asset limits. For example, California eliminated its asset limit on Jan. 1, 2024.
You can still enroll in QMB even if you have a Medicare Advantage plan. Your Medicare Advantage plan cannot bill you for services that are covered under Original Medicare (Parts A and B).
How is QMB different from other Medicare Savings Programs?
The Qualified Medicare Beneficiary program is just one of four programs run by the government that help you pay for Medicare. These programs are collectively known as the Medicare Savings Programs.
Of the four programs, QMB offers the most help. It pays for your Medicare Part A and B monthly rates and what you'll pay when you go to the doctor or have a procedure done, called your Medicare Part B out-of-pocket costs. These include your deductible, copays and coinsurance.
The other three programs pay for either your Medicare Part A or Part B monthly rate, but not both. These other programs also won't pay for your out-of-pocket costs.
Medicare Savings Programs (MSPs)
- Qualified Medicare Beneficiary (QMB) program: Pays for your Medicare Part A and B monthly rates and your Part B deductible, copays and coinsurance. You'll also automatically enroll in Extra Help, which offers subsidized prescription drug coverage.
- Specified Low-Income Medicare Beneficiary (SLMB) program: Pays for your Medicare Part B rates, and you'll automatically enroll in Extra Help.
- Qualifying Individual (QI) program: Offers the same assistance as the Specified Low-Income Medicare Beneficiary program. However, it has higher income limits, and you must reapply for the program each year.
- Qualified Disabled & Working Individual (QDWI) program: Pays for your Medicare Part A monthly rates if you're working, you're disabled and you lost your premium-free Medicare Part A coverage and Social Security disability benefits because you started working again.
Although these other programs offer less help compared to QMB, the other Medicare Savings Programs have higher income limits. If you're not eligible for QMB, your state may help you enroll in a program with lower eligibility requirements.
Frequently asked questions
What is the Qualified Medicare Beneficiary (QMB) program?
The Qualified Medicare Beneficiary program helps people who earn a low income pay for Medicare. It covers your monthly Medicare costs and the portion of your medical bill that you're responsible for paying.
Can I get Medicare Part B for free?
Yes, you can get Medicare Part B for free if you're eligible for the Qualified Medicare Beneficiary (QMB) program. Other Medicare Savings Programs, such as Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI), pay for your Medicare Part B monthly rate, although you're still responsible for your Part B deductible, copay and coinsurance.
Can you enroll in the Qualified Medicare Beneficiary program if you have Medicaid?
Yes, you can qualify for QMB even if you're dual enrolled in both Medicare and Medicaid.
You'll probably still have to pay for some medical costs even if you have both Medicare and Medicaid. Enrolling in a Qualified Medicare Beneficiary program can reduce or eliminate those remaining bills.
Sources and methodology
Information about Medicare Savings Programs and Medicare income requirements came from the Centers for Medicare & Medicaid Services (CMS). Federal poverty level limits are from the Social Security Administration.
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