Medicare’s General Enrollment Period Provides Important Opportunity for QMB and Part D Extra Help Coverage

Medicare’s General Enrollment Period Provides Important Opportunity for QMB and Part D Extra Help Coverage

Medicare’s General Enrollment Period (GEP) for Parts A and B is from January 1st – March 31. This is a particularly important time for Californian’s with low-incomes who are eligible and not yet enrolled in Medicare Part A. During this time, these individuals can apply for Medicare Parts A and/or B and the Qualified Medicare Beneficiary (QMB) program. QMB pays one’s Medicare Part A premium (if they do not qualify for premium-free Part A – which is $437 per month in 2019), Part B premium ($135.50 per month in 2019), and one’s Medicare deductibles and coinsurance. In addition, qualifying for and applying for QMB will automatically trigger a beneficiary’s entitlement to the full Part D Low-Income Subsidy (LIS), also referred to as Extra Help.

California does not have a Medicare Part A Buy-In Agreement that allows individuals to enroll in Medicare Part A at any time during the year in order to become eligible for Medicare cost-sharing benefits under QMB. Therefore, beneficiaries who don’t currently have Medicare Part A, must enroll in Part A before March 31, 2019 in order to be entitled to QMB benefits in 2019.

For those applying for Medicare Part A and QMB who aren’t eligible for premium-free Part A, and, cannot afford the Part A premium if they don’t qualify for QMB, a ‘conditional application’ process is available – see our website section,  How to Apply.  This means that these beneficiaries will only be enrolled in Medicare Part A if they are also confirmed eligible  for QMB and the state then pays their Part A premiums.

People who already have both Medicare Parts A and B can apply for QMB and other Medicare Savings Programs (MSPs) at any time of the year. Visit or contact your local Department of Health Care Services (DHCS) to apply for these  Medicare Savings Programs and/or for Medi-Cal.

See Low-Income Help for more information on MSPs and Medi-Cal.
Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.