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March 2014

How much does the Qualified Individual (QI) program matter to your state?

The Qualified Individual (QI) program covers the cost of Medicare Part B premiums for more than 500,000 low-income seniors and people with disabilities. Many more people are eligible for this program. However, the program’s future is in question. Currently, QI is authorized only through March 31, 2014. Since Congress is considering significant Medicare legislation this year, it has an excellent opportunity to improve QI by making it a permanent part of the Medicare program. (Read more.)

View sources and methodology.

QI Graphic

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Who’s covered? QI covers people with limited income and assets. In most states, individuals with incomes between 120 percent and 135 percent of the federal poverty level are eligible. In 2014, that’s an annual income of $14,004-$15,755 for a single person, or $18,876-$21,236 for a couple. In most states, a single person must have assets below $7,160, and a couple must have assets below $12,250, to qualify in 2014. In some states, however, the income and asset limits are more generous.

How much is it worth? In 2014, the regular Medicare Part B premium is $104.90 per month. (This amount is usually deducted from beneficiaries’ Social Security benefits.) QI covers this premium entirely. This essentially puts $104.90 per month, or $1,259 per year, back into the pockets of low-income seniors and people with disabilities. For someone living on $15,000 a year, that’s the same as an 8 percent boost in income. People with QI are also automatically enrolled in the Part D low-income subsidy, which qualifies them for low-cost prescription drug coverage. 

Sources: Families USA calculations based on Government Accountability Office, Medicaid: Enrollment and Expenditures for Qualified Individual and Transitional Medical Assistance Programs (Washington: GAO, December 2012), available online;  Medicare-Medicaid Coordination Office, Data Analysis Brief: Medicare-Medicaid Dual Enrollment from 2006-2011 (Washington: Centers for Medicare and Medicaid Services, February 2013), available online

Methodology: We took state enrollment data for QI as of 2009 published by the GAO and trended it forward to 2013. (The GAO did not report data for Tennessee.) The trend factor is the annual rate of growth in QI enrollment nationally from 2009-2011 reported by CMS. Growth in QI enrollment during this period averaged 8.77 percent per year. Our estimates do not account for any changes in state-specific eligibility rules, which could increase or decrease enrollment in a state compared to the national trend. The amount of premium savings is the number of estimated enrollees per state multiplied by the cost of the regular Medicare Part B premium for 2013.