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Medicare Savings Programs

What Are The Medicare Savings Programs?

They are Medical Assistance (MA) benefit programs to assist you in paying Medicare premiums, deductible, and coinsurance if you have limited income and resources.

Must I Be Eligible For MA To Receive These Benefits?

No, you are allowed to have higher income and resources than is allowed under the Medical Assistance program.

How Do I Qualify For These Benefits?

You must be entitled to receive Medicare Part A (“entitled” means you are eligible for Part A benefits even if you do not receive them).

Have countable resources (DHS Policy Manual 510-05-06-20) which do not exceed $7,970 for an individual or $11,960 for a couple.

Have countable monthly income (DHS Policy Manual 510-05-85-40) (after certain deductions) of less than:

Program                   Individual                      Couple

  QMB                               $1.074                           $1,452
  SLMB                              $1,288                           $1,742
  QI-1                                $1,449                           $1,960

The first $20 of all income per month is disregarded.  You can add $20 to amounts above.

What Resources Are Exempt Or Not Counted?

  • A residence occupied by you, your spouse, or your dependent relative.
     
  • One motor vehicle, household goods and personal effects.
     
  • Property which is essential to earning a livelihood, property essential to self support, and property up for sale, but not sold.
     
  • Indian trust land, per capita and judgment funds.
     
  • A burial plot (grave site, crypt or mausoleum) for each family member (eligible or ineligible) is excluded.
  • Lump sum payments of Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits are excluded for nine consecutive months following the month you receive them.

  • Along with the burial plot an individual is allowed either the SSI burial OR ND burial provision.

SSI burial provision:
Burial funds of up to one thousand five hundred dollars each, plus earnings on excluded burial funds held for the individual and the individual's spouse are excluded from the date of application. Burial funds may consist of revocable burial accounts, revocable burial trusts, other revocable burial arrangements including the value of installment sales contracts for burial spaces, cash, financial accounts such as savings or checking accounts, or other financial instruments with definite cash value, such as stocks, bonds, the cash surrender value of life insurance not excluded under subsection 3a below, or certificates of deposit. The fund must be unencumbered and available for conversion to cash on very short notice. The fund may not be commingled with nonburial-related assets and must be identified as a burial fund by title of account or by the or recipient's statement.

  • The value of any irrevocable burial must be designated toward the burial fund exclusion.
  •  Life or burial insurance excluded under this subsection (total face value is $1,500 or less), must be considered at face value toward meeting the burial fund exclusion.

North Dakota Burial Provision
Any pre-need funeral service contracts, prepayments or deposits to a fund which are placed in an irrevocable itemized funeral contract designated by an applicant or recipient for the applicant's or recipient's burial. An applicant or recipient designates a prepayment of deposit for his or her burial by providing funds that must be used for that purpose. Only those prepayments paid by members of the Medicaid unit are considered as burial prepayments.

What Do These Programs Cover?

Qualified Medicare Beneficiary (QMB) covers:

  • Medicare Part B premiums
  • Medicare Part A & B deductibles
  • Medicare Part A & B coinsurance
  • Medicare Part A & B copayments

May be eligible for other Medicaid benefits.

Special Low-Income Medicare Beneficiary (SLMB) covers:

  • Medicare Part B premiums

May be eligible for other Medicaid benefits.

Qualified Individuals (QI)  pay only the Medicare Part B premium.

Where Do I Apply For The Programs?

Contact your local County Social Service Office for an application. You have the right to complete an application.

What If I Am Denied?

You can appeal. The appeal is a request for a hearing and must be in writing. You have 30 days from the date of the notice to appeal.

DISCLAIMER: This information is not legal advice. If you have a legal problem, you should talk to a lawyer and ask for advice about your options.

October 2019

N.D.A.C. 75-02-02.1

Prepared by Legal Services of North Dakota in cooperation with the Department of Aging Services