Do you qualify for a Medicare Cost Sharing Program?
Friday, March 28th, 2014
Medicare Cost Sharing Programs
Qualifying Individuals (QI 1)
Brief Description
Cost sharing assistance for low income Medicare beneficiaries. You must meet criteria for one of the other Medicaid categories in order to get TennCare Medicaid.
Monthly Income Limit
Between 120% and 135% poverty
$1,149 – $1,293 (1)
$1,551 – $1,745(2)
Resource Limit
$7,080 (1)
$10,620 (2)
Comments
This is a mandatory Medicaid eligibility category. State is required to pay Medicare Part B premiums for these individuals as long as federal funds are available. They are not eligible for TennCare unless they meet the criteria for one of the other eligibility categories. Eligibility for this program is determined by TennCare.
Qualified Disabled Working Individuals (QDWI)
Brief Description
Low income disabled working individuals under age 65 who are entitled to Medicare Part A. You must meet criteria for one of the other Medicaid categories in order to get TennCare Medicaid.
Monthly Income Limit
200% poverty
$1,915 (1)
$2,585 (2)
$3,255 (3)
Resource Limit
$4,000 (1)
$6,000 (2)
Comments
This is a mandatory Medicaid eligibility category. State is required to pay Medicare Part A premiums for these individuals. They are not eligible for TennCare unless they meet the criteria for one of the other eligibility categories. Eligibility for this program is determined by TennCare.
Qualified Medicare Beneficiaries (QMB)
Brief Description
Low income persons eligible for Medicare Part A. You must meet criteria for one of the other Medicaid categories in order to get TennCare Medicaid.
Monthly Income Limit
100% poverty
$958 (1)
$1,293 (2)
Resource Limit
$7,080 (1)
$10,620 (2)
Comments
This is a mandatory Medicaid eligibility category. State is required to pay Medicare premiums, deductibles, and coinsurance for these individuals. They are not eligible for TennCare unless they meet the criteria for one of the other eligibility categories. Eligibility for this program is determined by TennCare.
Special Low Income Medicare Beneficiaries (SLMB)
Brief Description
Low income Medicare beneficiaries. You must meet criteria for one of the other Medicaid categories in order to get TennCare Medicaid.
Monthly Income Limit
Between 100% and 120% poverty
$958 – $1,149 (1)
$1,293 – $1,551 (2)
Resource Limit
$7,080 (1)
$10,620 (2)
Comments
This is a mandatory Medicaid eligibility category. State is required to pay Medicare Part B premiums for these individuals. They are not eligible for TennCare unless they meet the criteria for one of the other eligibility categories. Eligibility for this program is determined by TennCare.
We will help you apply for Medicare Cost Sharing Programs:
Independent Insurance Consultants- Medicare insurance division
865-691-5571 Toll Free 1-866-691-5571
clientservices@medicareinsurance-advisors.com
Direct link: https://www.tn.gov/tenncare