What is the Income Limit for Medicaid to Pay a Medicare Premium?

Medicaid provides health insurance to United States citizens and legal aliens meeting income and asset limits. Medicare offers health-care coverage to adults 65 or older, disabled individuals and people with end-stage and permanent renal disease. Individuals with income and assets below a specified amount may qualify for dual coverage from both programs. There are several eligibility groups and benefits --- including Medicare premium coverage --- depending on individual income and other qualifications.

QMB

• Qualified Medicare Beneficiary members may be entitled to Medicaid assistance with Medicare Part A and B deductibles, Medicare Part B premiums, co-insurance fees, possible Medicare Part A premiums and other health-care benefits. QMB candidates must be eligible for Medicare Part A. The income limit for QMB coverage is at or below 100 percent of the Federal Poverty Level (FPL).

SLMB

• Individuals eligible for the Specified Low-Income Medicare Beneficiary Program qualify for Medicare Part B premium assistance and other health-care coverage if they qualify for full Medicaid benefits under other eligibility requirements. Applicants must be eligible for Medicare Part A and have an income between 100 and 120 percent of the FPL.

Q-I

• The Qualifying Individual Program only covers Medicare Part B premium payments. Medicare Part A eligible individuals may qualify for Q-I benefits if their income is between 120 and 135 percent of the FPL and they are not eligible for Medicaid coverage under another program. The Q-I is limited by block grants each year and once the funds are depleted in a particular state, the program cannot accept new members until the following year.

QDWI

• The Qualified Disabled and Working Individual plan offers Medicare Part A premium coverage to disabled individuals who lose Medicare Part A due to employment and are required to pay for Medicare Part A enrollment. QDWI candidates must be ineligible for regular Medicaid benefits. The income limit for benefits is at or below 200 percent of the FPL.

Federal Poverty Level

• The Federal Poverty Level is a guideline issued by the United States Department of Health and Human Services each year. The guideline aids government agencies in determining eligibility for a range of assistance programs. As of 2011, the annual FPL for the contiguous 48 states is $10,890 for one person and $14,710 for couples. The 2011 annual FPL for Alaska residents is $13,600 for singles and $18,380 for couples. Hawaii guidelines are $12,540 for individuals and $16,930 for couples.