Many seniors think the only way to get $0 Medicare is by signing up for a Medicare Advantage plan. We hear it all the time, people call us needing care, but their plan does not cover the advanced wound treatments we provide. These are patients who want to heal, but their insurance rules stand in the way.
There is another option most people do not know about. The QMB program can cover your Medicare costs including premiums, deductibles, and copays while letting you keep the freedom and coverage of Traditional Medicare. This post explains what QMB is, who qualifies, and why it could be a better choice than Medicare Advantage for many people in our community.
We’ve all seen the commercials. “Get Medicare coverage for $0 a month!” It sounds great, but there’s a catch. Those ads are usually for Medicare Advantage plans, which are run by private insurance companies.
What they don’t tell you is that “free” can come with hidden costs:
- Limited doctor networks
- Delays in care due to prior authorization
- Rules that can change every year
The good news? You can have Traditional Medicare, keep your choice of doctors, avoid the red tape, and still pay $0 for premiums, deductibles, and most copays if you qualify for a program called QMB.
What is QMB and How Does It Work?
The Qualified Medicare Beneficiary (QMB) program is run by your state’s Medicaid program, but you don’t have to be on full Medicaid to qualify. Even if you’ve never had Medicaid before, you might still get QMB to help pay your Medicare costs.
If you qualify, QMB will:
- Pay your Medicare Part A premium (if you have one, most people don’t)
- Pay your Medicare Part B premium
- Cover all Medicare deductibles, copays, and coinsurance so you don’t pay the usual 20% out-of-pocket
And here’s the big bonus: If you also qualify for Extra Help (which many QMB recipients do automatically), your Part D prescription drug premiums, deductibles, and most copays are also covered.
Medicare Advantage “Free” vs. Traditional Medicare + QMB
| Feature | Medicare Advantage “$0 Plan” | Traditional Medicare + QMB |
|---|---|---|
| Doctor choice | Limited to plan’s network | Any doctor that takes Medicare |
| Prior authorization | Often required | Rarely required |
| Annual plan changes | Yes | No, Medicare rules stay the same |
| Out-of-pocket costs | Copays, coinsurance, and deductibles | $0 for covered services |
| Prescription coverage | Included, but may have restrictions | Covered with Part D + Extra Help |
Why This Matters for Seniors in El Paso
In our community, many older adults are convinced to join Medicare Advantage because of the $0 price tag without realizing they might lose access to their doctors or face delays in care.
QMB offers a different path: you keep Traditional Medicare’s flexibility and still pay nothing for most services. That means:
- No surprise bills for covered care
- No fighting with insurance over prior authorizations
- Freedom to choose your doctor or specialist
How to See if You Qualify
- Call Texas Health and Human Services at 2-1-1 and ask about the QMB program.
- Visit the Texas HHS Medicare Savings Programs page to apply.
- If you’re not sure where to start, call us at Integrity Wound Care. We can help point you in the right direction.
Bottom line: You don’t need Medicare Advantage to get $0 Medicare coverage. With QMB, you can have all the benefits of Traditional Medicare, keep your doctors, and avoid the headaches of private insurance.
Don’t settle for “free” with strings attached, go for free with freedom.