Qualified Medicare Beneficiaries (QMB): The QMB Program provides limited assistance to help pay your Medicare Part A (hospital insurance) and Part B (supplemental insurance) premiums, premium penalties for late enrollment, Medicare deductibles and Medicare coinsurance expenses. To be eligible for assistance under QMB (in addition to meeting the General and Financial Requirements listed below), you must be entitled to and enrolled in Medicare Part A insurance as verified by the Social Security Administration (SSA). QMB assistance is determined without regard to eligibility for any other public assistance program, including Medicaid.
Specified Low-Income Beneficiaries (SLMB or SLMB135): The Specified Low-Income Medicare Beneficiaries programs provide limited assistance to help pay your Medicare Part B (supplemental insurance) premium and premium penalties for late enrollment.
To be eligible for assistance under SLMB or SLMB135 (in addition to meeting the General and Financial Requirements listed below), you must be entitled to Medicare Part B insurance as verified by the Social Security Administration (SSA). SLMB assistance is determined without regard to eligibility for any other public assistance program. SLMB135 assistance recipients may not be otherwise eligible for Medicaid, including Medicaid In and Out.
Qualified Disabled and Working Individuals (QDWI): The QDWI program provides limited assistance that pays the Medicare Part A (hospital insurance) premium of disabled working individuals who have lost Medicare due to earnings. To be eligible for assistance under QDWI (in addition to meeting the General and Financial Requirements listed below), you:
- must be entitled to enroll in Medicare Part A;
- must be disabled and working and have lost Medicare coverage due to earnings; and cannot be eligible for benefits from any other medical assistance program.
Citizenship Status/Immigration: You must be either a US citizen or an eligible qualified alien.
Residency: You must be a current resident of NH, but you do not need to live in NH for any specified length of time.
Social Security Number: The law requires that you furnish a Social Security Number or verification of an application for a Social Security Number if one has never been issued or you cannot provide the number.
Potential Income: You must be prepared to explore and develop all potential sources of income to which you may be entitled. For example, if you are potentially eligible for any of the following (or additional benefits not listed), you must apply for them (we can help you do this):
- Social Security Benefits
- Retirement Benefits or Pensions
- Unemployment or Worker's Compensation
- Third-party Medical Coverage
- VA Benefits (including Aid and Attendance)
- Disability Benefits or Pensions
- Contributions from any Liable Third Party
Financial requirements are broken into two components, income and resources. You are considered eligible for the QMB, SLMB/SLMB135 or QDWI Programs if both income and resource requirements are met.
Income: All available income for you and your spouse, if living together, is counted when we determine your eligibility for the QMB, SLMB/SLMB135 or QDWI Programs. However, we subtract certain expenses from that total. If, after subtracting your expenses, your total net income equals or falls below the monthly net income limits for your living arrangement and the program for which you are applying, you are considered income-eligible.
Resources: All resources that you and, if applicable, your spouse own are considered when determining eligibility. Examples of resources are cash, bank accounts, stocks, bonds, some life insurance, permanently unoccupied real estate and some trusts. We do not count certain resources such as the home you are living in, vehicles or burial plots for yourself. You are considered resource-eligible if, after counting or excluding your household's resources, your total countable resources equal or fall below:
- For the QMB, SLMB, and SLMB135 programs: $7,280 for one person, or $10,930 for two or more persons.
- For the QDWI program: $4,000 for one person, or $6,000 for two or more persons.
What Happens Now?
If you meet the requirements above and think your income and resources are close to the figures provided and you wish to apply for assistance, you must:
- Get all the information you need to apply for assistance on our Web site; or
- Contact your local District Office and speak with a DHHS worker who will assist you through the application process.
Right to an Administrative Appeal Hearing
If you disagree with any decision the Division of Family Assistance makes on your case, you may request an Administrative Appeals hearing.