Medicare Beneficiaries (QMB) Program
Qualified Medicare Beneficiaries (QMB) program is for people
who receive Part A Medicare and whose income is below 100%
of poverty. This program pays Medicare co-payments and co-insurance
amounts for medical services covered by Medicare, including
the co-payments for Medicare-approved skilled nursing home
care. It also pays the Medicare Part B premiums for eligible
clients. This program does NOT pay for any services
NOT covered by Medicare. The income limit,
after allowable deductions, is 100% of the Federal Poverty
Level, which is typically adjusted annually. The
Federal Poverty Level is available on the Internet at http://aspe.hhs.gov/poverty
Eligibility Limits in Monthly Amounts
(as of July 2010)
Size *Monthly Income
. . . . . . . . . . . $
2 . . . . . . . . . . . .
Countable Income is gross income
minus exemptions, allowable disregards, deductions, and
earned income expenses. The disregards and deductions are
different for each Medicaid program. This means that the
“countable income” to decide eligibility for
one program will be different than the “countable
income” used to decide eligibility for another program.
In general, you may deduct $20.00 general income exclusion;
$65.00 and 1/2 of the remaining gross earned income;
Health and accident premiums, and impairment-related work
expenses. Income too high? Consider the
Special Low-Income Medicare Beneficiary Program.
Also, see NOTE at bottom of page.
is NOT allowed.
person - $6,600
2 persons - $9,910
NOT cover Medicare premiums nor medical costs prior to the month of application.
Federally Qualified Health Centers are clinics that offer
low-cost medical care. It does not matter whether
the person qualifies for Medicaid or has health insurance.
The cost of care is based on income. There is a list
of health centers in the brochure "Exploring Medicaid".
The brochure comes in two versions depending on where a
person lives. One version of Exploring
Medicaid is for people living in the Wasatch Front
(Salt Lake, Utah, Davis,
Weber, and Morgan Counties). The other version of
is for people who live in other areas of the state. In either
version, look for telephone numbers for Federally Qualified
Health Centers in the Resource section of the brochure.