Income Limits for Medicare

For low income persons, Medicare coverage may be at least partially covered by the state.

The basic requirements for Medicare coverage are that a person is 65 years of age or older, or that he has a disability or permanent kidney failure, and that he worked and paid taxes into the Medicare system for at least 10 years. If the income of a person covered by Medicare falls below a certain amount, he could qualify for one of four Medicare Savings Plans. The state of residency covers part of the costs associated with providing Medicare coverage in these programs.

The Medicare Savings Program

There are four available programs from Medicare that may help persons with low income and limited resources pay for part of the coverage premiums, deductibles and coinsurance. For all four programs, the resource limits for 2010 are $6,600 for a single person and $9,910 for a married couple. The applicant cannot have more than these amounts in savings.

The Four Programs

The Qualified Medicare Beneficiary program helps to cover the premiums for Parts A and B, plus deductibles, co-payments and co-insurance. The income limits for 2010 are $923 per month for an individual and $1,235 for a married couple. The Specified Low Income Medicare Beneficiary and Qualified Beneficiary programs only help pay Part B premiums. The income limits for these are $1,103 and $1,239 for a single person and $1,477 and $1,660 for married couples, respectively. Finally, the Qualified Disabled and Working Individuals program helps pay for Part A premiums only. The income limits imposed are $3,695 monthly for an individual and $4,942 monthly for a married couple.

Eligibility and Applying

For any of the four programs, a person must be eligible for Part A coverage. A person must apply every year to receive benefits from the Qualified Individual program. For the Qualified Disabled and Working Individuals program, a person must be disabled and working, and have lost her Medicare benefits because she went back to work. To apply, an individual should call her state Medicaid program.

Extra Help

Call your Social Security office to see if you qualify for the Extra Help program.

Persons who qualify for the Medicare Savings program may also qualify for Extra Help. This program helps to pay for some of the extra costs associated with prescription drug coverage. For 2010, the income limit is $16,245 for an individual with less than $12,510 in resources. For married couples, the income limit is $21,855 and less than $25,010 in resources.