Crowe & Associates

QMB Program CT

QMB Program CT

QMB Program CT

QMB Program CT

The QMB Program CT is an essential program available to Medicare beneficiaries who meet the income requirements and reside in Connecticut.  The QMB program provides the highest level of financial help to those who qualify.  It assures that beneficiaries can receive the medical care they need.

In some instances, Medicare beneficiaries may face significant out-of-pocket costs for their healthcare services. When this occurs, the Medicare Qualified Medicare Beneficiary (QMB) program provides much needed assistance.

What is the Medicare QMB program:

The Medicare QMB program is a state-administered program that helps Medicare beneficiaries who have a limited income pay for things such as; Medicare premiums, deductibles, coinsurance, and copayments. QMB stands for “Qualified Medicare Beneficiary,” this refers to people who meet certain income and asset criteria.

How do you qualify for the Medicare QMB program:

A person must be enrolled in Medicare Part A and Part B and have limited income and resources. In 2023, the income limit for QMB eligibility in Connecticut is $2,564 per month for individuals and $3,468 per month for married couples. There is no asset limit to qualify for this program.

The Medicare QMB program in Connecticut covers the following:

  1. Medicare Part A premiums: Part A includes coverage for; inpatient hospital stays, skilled nursing facility care, hospice care, and home health care. The QMB program covers the monthly premium for Part A if either you or a spouse has not worked enough quarters to qualify for free Medicare Part A.
  2. Medicare Part B premiums: This portion of Medicare covers doctor visits, outpatient care, preventive services, and medical equipment.
  3. Deductibles, coinsurance, and copayments for covered services.
  4. Medicare Advantage premiums: The QMB program covers the monthly premium for Medicare Advantage plans.
  5. Part D prescription drug costs are covered by the QMB program.

There are 3 different levels of extra help available in CT:

As you will see, all three levels of MSP pay for the Medicare Part B premium.

  1.  QMB is the highest level of help in CT.  If your monthly income is either at or below $2,564 (single) or $3,468 (couple), you may qualify for this level of extra help.  QMB program covers; Part B premium, Medicare deductibles as well as co-insurance.
  2. SLMB is the next level of extra help in CT.  You may qualify for this level of help if your monthly income is either at or below $2,807 (single) or $3,797 (couple).  This level of help pays for your Part B premium only.
  3. ALMB is the last level of extra help available to CT Medicare residents.  To qualify for this level of help, your monthly income must be either at or below $2,989 (single) or $4,043 (couple).  This program pays for your Part B premium only and is subject to available funding.  People who receive Medicaid are not eligible for this program.

When you are accepted into any of the three levels of MSP, you are automatically enrolled into the LIS (Low Income Subsidy).

This program is also called “Extra Help”.  LIS pays the cost of a Medicare Part D (prescription coverage) benchmark plan, or part of a non-benchmark plan.  LIS also pays your Part D annual deductible, co-insurance, or co-pays on your prescription medications.  This applies even if you reach the coverage gap.  Another benefit if LIS enrollment is, you are allowed a Special election period to change your MA or Part D plan anytime during the first 3 quarters of the year

To sum it up; the QMB program CT is a valuable resource for those who qualify and are struggling to pay their Medical costs.

How to apply for the Medicare QMB or MSP help in Connecticut?

You can apply for the Medicare QMB program in Connecticut by contacting either the State of Connecticut Department of Social Services (DSS) or the Medicare Savings Programs (MSP) unit. There are a few ways to apply; online, by mail, or in person.

To apply online,  visit the DSS website and complete an application. To apply by mail, just download an application from the DSS website.  You can schedule an in-person meeting by calling the MSP unit 1-800-842-1508.  Important: you must provide documentation of your income and assets, as well as your Medicare information.

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