Qualified Medicare Beneficiaries
Yes, New Jersey Medicaid can pay for Medicare premiums for individuals with very low income, such as less than $1,215 per month, ($15,650 per year.) Medicaid programs in all states, including New Jersey, are required to assist low-income Medicare beneficiaries with Medicare cost sharing, which includes premiums, deductibles, and coinsurance, especially for those below the Federal Poverty Level (FPL).
People with income below the FPL in 2025 and thereafter indexed for inflation, and who otherwise qualify can have all Medicare cost sharing – including premiums – paid by Medicaid through programs like the Qualified Medicare Beneficiary (QMB) program. With income less than $1,215/month (which is well below the FPL), you would likely qualify for this assistance in New Jersey.
Specified Low-Income Medicare Beneficiary (SLMB) and Qualified Individual-1 (QI-1)
For those with slightly higher incomes (up to 135% of FPG), these programs pay only the Medicare Part B premium. If you qualify, New Jersey pays your Medicare premium directly, and the amount is added back to your Social Security benefit. Asset limits apply, but they are higher than regular Medicaid limits.
For Medicare Savings Programs (MSPs), which help pay Medicare premiums, the 2025 asset limit is $9,090 for an individual. This limit includes countable assets like cash, bank accounts, stocks, and non-resident real estate, but exempts personal belongings, a primary residence, one vehicle, and certain burial funds.
For regular Medicaid (not MSPs), thee asset limit is lower: $2,000 for an individual and $3,000 for a couple with both spouses applying.
What happens if an individual’s assets exceed the Medicaid limit in New Jersey?
If an individual’s assets exceed the Medicaid limit in New Jersey, they are not eligible for Medicaid coverage – including programs that pay Medicare premiums – until their assets are reduced to within the allowable limit.
To discuss your NJ elder care matter, please contact Fredrick P. Niemann, Esq. at (732) 863-9900 or email him at fniemann@hnlawfirm.com. Please ask us about our video conferencing or telephone consultations if you are unable to come to our office.
By Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright, a Freehold Township, Monmouth County, NJ Elder Care Attorney