Benefit Bulletin: December 2018

Benefit Bulletin: December 2018

If You Can’t Afford Your Medicare Part B Costs, Apply for a Medicare Savings Program

The Medicare Part B premium for doctors and hospital outpatient care is one of the most misunderstood expenses that retirees have.  Every month, the Social Security Administration automatically deducts the Part B premium from the benefits of retirees. The premium of people with incomes below $85,000 (individual) and $170,000 (couple) will be $135.50 per month in 2019.  New retirees are frequently surprised to see how much that deduction takes from their Social Security benefits.  Frequently the deduction is responsible for keeping Social Security benefits flat, and failing to keep up with other costs due to weak growth in COLAs.  From 2000 through 2018, Medicare Part B premiums have increased, on average, an astonishing 11% per year.

In recent months, I’ve heard from a few retirees who haven’t enrolled in Medicare Part B at all, saying they can’t afford the cost.  Every state, however, has programs that can help to pay Medicare premiums.  In some cases, the programs may also pay Medicare Part B deductibles, coinsurance, and co-payments for individuals who meet certain qualifications.

If you have trouble affording the Part B premium, you should apply.  The specific names of these “Medicare Savings Programs,” and how they work, vary from state to state.  There are three main programs:

  • Qualified Medicare Beneficiary (QMB):  This program pays for Medicare Part A and B premiums.  For those who qualify, this program will cover most out-of-pocket costs for Medicare-covered services from Medicare providers, or providers in your Medicare Advantage plan’s network.
  • Specified Low-income Medicare Beneficiary (SLMB): Pays for Medicare Part B premium.
  • Qualifying Individual (QI) Program: Pays for Medicare Part B premium. You must apply every year for this program, and applications are granted on a first-come, first served basis.

To qualify, the programs have income and asset limits, and states use different rules to count your income and assets to determine if you are eligible.  Monthly income limits typically are as high as $1,234 (individual) and $1,666 (married couples).  Asset limits are $7,560 (individual) and $11,340 (married couples).  Certain resources are never counted as assets.  These include your primary house, one car, household goods and wedding/engagement rings, burial spaces and burial funds up to $1,500 per person, and life insurance with a cash value of less than $1,500.  Some state may exclude other assets as well.

Going without any Medicare Part B coverage is not a good option.  Ignoring regular medical care can worsen chronic health conditions more quickly.  Just one overnight stay in the hospital could lead to bankrupting bills.  For more information about Medicare Savings Programs, find contacts and information:
Contact your State Medicare Program, to learn if you qualify and to apply.


Source:  “Medicare Savings Program Basics,”, Medicare Rights Center, accessed on 10/08/18.