UPDATED May 5, 2019. Public benefit programs (such as Medicaid), providing help with Medicare Costs, use the Federal Poverty Level (FPL) guidelines to determine who qualifies for coverage. The table below includes the current income and resource limits someone needs to meet to be eligible for Medicaid and Medicare Savings Programs in 2019.
For more details, see Medicare Savings Programs (MSP): Help with Medicare Expenses.
| Category | Description | 2019 Monthly Income Limit | 2019 Resource Limit |
| Healthy Horizons (QMB Plus) |
Full Medicaid coverage for individuals age 65 and older and persons with permanent disabilities |
$1,041 single $1,409 married |
$2,000 single $3,000 married |
| Qualified Medicare Beneficiary (QMB) |
Helps Medicare beneficiaries with Part A and B cost-sharing as well as the Part B premium |
$1,061 single $1,430 married |
$7,730 single $11,340 married |
| Specified Low-Income Medicare Beneficiary (SLMB) |
Helps Medicare beneficiaries pay the Part B premium |
$1,269 single $1,711 married |
$7,730 single $11,600 married |
| Qualified Individual (QI) |
Helps Medicare beneficiaries pay the Part B premium |
$1,426 single $1,923 married |
$7,730 single $11,600 married |
Table 1. Medicaid and Medicare Savings Programs – Eligibility
Help with Medicare Costs – Definition of Income
For eligibility purposes, all income that one receives from any source is counted. It may include employee wages, alimony payments, pension payments, Social Security Disability Income, Social Security Income, IRA withdrawals, and stock dividends. Make note, when only one spouse of a married couple is applying for Medicaid, the income of the applicant’s spouse is not counted, only the income of the applicant.
Help with Medicare Costs – Definition of Resources
Countable resources include stocks, bonds, investments, and savings and checking accounts. However, for Medicaid eligibility, many resources are considered exempt (non-countable). For instance, Pennsylvania allows an extra $6,000 exemption, which is in addition to the resources limits listed above. Other exceptions include personal belongings, household items, a vehicle, irrevocable burial trusts, and one’s primary home, given the Medicaid applicant or their spouse lives in the house, and the house is valued under $560,000. One exception for the house to be considered exempt remains; single applicants who do not live in their residence, but communicate an “intent” to return.
It’s important to be aware that Pennsylvania has a 5-year Medicaid Look-Back Period. In other words, within five years Medicaid checks to ensure no assets were sold or given away under fair market value to meet Medicaid’s asset limit. If one is found to violate of the look-back period, a period of Medicaid ineligibility will ensue.
US Government Sources
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