How to apply for Qualifying Individual (QI)

Who it's for

QI is the top income tier of the Medicare Savings Programs. Like SLMB, it pays the Medicare Part B premium (around $202.90/month, roughly $2,435/year) — but for households whose income is too high for SLMB. Eligibility falls between 120% and 135% of the federal poverty level. QI funding is a federal block grant awarded on a first-come, first-served basis each calendar year, and enrollment must be renewed every year. QI is mutually exclusive with full Medicaid — anyone already receiving Medicaid benefits is not eligible for QI, but Medicaid typically covers the Part B premium directly instead.

What you'll need

• Proof of identity (driver's license or state ID)
• Proof of state residency
• Social Security card
• Medicare card
• Last month's bank statements
• Proof of income (Social Security award letter, pay stubs, pension statements)

Where to apply

What to say when you call

"Hello, I'm calling to ask about Qualifying Individual (QI). I'd like to know whether I may qualify, what documents I need, and whether I can apply online, by mail, by phone, or in person. I understand I may need proof of identity (driver's license or state ID), proof of state residency, social Security card — is anything else required? What is the best next step?"

Tip: have a pen ready, ask for the person's name, and write down any case or reference number they give you.

Step by step

1. Confirm you are not currently enrolled in full Medicaid benefits, since QI eligibility requires that you are not already receiving Medicaid.
2. Gather your required documents: a driver's license or state ID, proof of state residency, your Social Security card, your Medicare card, last month's bank statements, and proof of income (such as a Social Security award letter, pay stubs, or pension statements).
3. Apply online through your state Medicaid agency's application portal, or call 1-800-MEDICARE (Kentucky residents call (855) 459-6328) to apply by phone.
4. Answer all questions on the application honestly and completely, and submit your documents as requested.
5. Keep a copy of your completed application and any confirmation number or reference information you receive after submitting.
6. Renew your QI enrollment every year to keep your benefits active — your state Medicaid agency will notify you when it is time to renew.

What to expect: After submitting your application, your state Medicaid agency will review your information and documents. Because QI is funded through a federal block grant awarded on a first-come, first-served basis each calendar year, applying as early as possible is important — slots can run out. Processing times vary, so contact your state Medicaid agency or call the number you used to apply for an estimate. If approved, QI will cover your Medicare Part B premium. Because enrollment must be renewed every year, watch for renewal notices from your state agency and respond promptly to avoid a gap in coverage.

Renewals

annual

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