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Qualified Individuals (QI) program

What is a Qualified Individuals (QI) program?

The Qualified Individuals (QI) program is a Medicare Savings Program (MSP) that pays for an enrollee’s Medicare Part B premiums. MSPs are federal programs that are administered by Medicaid in each state.

As of 2020, most Medicare beneficiaries pay $144.90 a month for Part B. QI enrollees no longer have this amount deducted from their Social Security benefit – amounting to an annual increase of over $1,738.

Enrollees who have been approved for QI will receive up to three months of retroactive coverage, although some states limit this retroactive coverage to the current calendar year.

It can take two to three months from when an individual is approved for the MSP for Part B premiums to no longer be deducted from their Social Security income. Enrollees will receive a one-time deposit for the premiums that were withheld after they were approved for the MSP, along with a payment for any retroactive benefits.

Unlike the Qualified Medicare Beneficiary (QMB) program, QI does not pay for Parts A and B cost sharing (e.g. deductibles, co-pays and coinsurance) or for Part A premiums (if an enrollee owes them).

QI benefits had been based on discrete funding allotments in each state, and individuals who applied for QI after this funding was allocated were unable to receive any benefits. The Medicare Access and CHIP Reauthorization Act of 2015 changed this – by authorizing federal funding for QI on a permanent basis.

QI enrollees automatically receive Extra Help – a federal program that lowers prescription drug costs under Part D.

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