Health & Benefits

Medicare is a federal health insurance program with multiple parts, including Parts A, B, C, and D. There are costs that Medicare participants may have to pay. Medicare Savings Programs help people pay for some Medicare costs. Medicare Savings Programs include: 

• Qualified Medicare Beneficiary A person that gets property or money from someone when they die (QMB),
• Special Low-Income Medicare Beneficiaries (SLMB),
• Qualified Individual (QI-1) program, and
• Qualified Disabled and Working Individual (QDWI).

To qualify for these programs, you must have Medicare Part A and meet other requirements, such as showing proof of your citizenship and residency. Eligibility for these programs is based on your income and assets Anything a person owns that has financial value . If you have lower income and assets, more assistance will be available to you. 

Income eligibility changes every year. Be sure to look at the current income guidelines. 

A person who qualifies for any Medicare Savings Program should also be eligible for "Extra Help." Extra Help assists with the costs of prescription medicine. 

These programs are run by the Illinois Department of Human Services (IDHS). You can also call the Illinois Department on Aging at (800) 252-8966 for assistance.

You can apply for these programs at your local IDHS office. You can also go to the Application for Benefits Eligibility website. If you are denied, you can appeal A request to change a court's decision through your local IDHS office.

Qualified Medicare Beneficiary Program (QMB)

QMB Programs generally offer the broadest financial assistance. QMB eligibility entitles you to have the State pay your Medicare-related charges. This includes:

• Medicare Part A and Part B premiums Money that must be paid every month, such as for health insurance . 
• Medicare Part A and Part B deductibles.
• Coinsurance charges. These are typically 20% of approved Part B costs not paid by Medicare. This is often your out-of-pocket expenses under Medicare.
• Coinsurance for extended hospital stays and skilled nursing facilities. This is usually your out-of-pocket expenses under Medicare.

You may be approved for both Medicaid and QMB, known as "dual coverage." You can get QMB help and additional cash or medical benefits if you have dual coverage.

If you receive Medical Savings Program benefits after 2010, those benefits cannot be recovered from your estate. But if you receive Medicaid, those benefits may be open to recovery from your estate. Learn more about Medicaid Estate Recovery from the Illinois Department of Healthcare and Family Services.     

There are income and resource limits for QMB. Learn more about eligibility for QMB.

Specified Low-Income Medicare Beneficiary (SLMB)

Your income may be too high for QMB. If so, you may be eligible for the SLMB program instead.

SLMB benefits are more limited than QMB. They only cover Medicare Part B premiums.

Learn more about the SLMB program and eligibility on Medicare.gov.

Qualified Individuals Program (QI-1)

If your income is too high for QMB, you might qualify for QI-1. Like SLMB, QI-1 only helps with costs associated with Medicare Part B.

QI-1 is a limited program that requires an annual application. QI-1 is awarded on a first-come, first-served basis.

Learn about the QI-1 program and eligibility on Medicare.gov.

Qualified Disabled and Working Individuals (QDWI)

An individual with a disability A substantial impairment that functionally limits a person in carrying out major life activities, such as walking, lifting, seeing, or learning. who lost their Social Security Disability A federal program that gives money to people who cannot work because of a disability benefits when they returned to work can apply for QDWI. 

Learn about the QDWI program and eligibility on Medicare.gov.