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Medicaid/Medicare Buy-in Program ApplicationThe Medicaid/Medicare Buy-In Programs help people with a low income to pay their Medicare premium. Recipients can receive a substantial increase in spendable income when they no longer pay for their Medicare premium. There are three distinct Buy-in programs and each has different eligibility requirements: Qualified Medicare Beneficiary (QMB)
ApplicationsThe same application is used to apply for all three programs. It is much shorter than an application for other Medicaid programs. It is available as a paper application that can be completed and mailed to the local Department of Children and Families. Applications are available as pdf files by clicking on the links below for applications in English, Spanish or Creole or copies are available by calling The Senior Helpline Print and complete the application. Completed applications are mailed to the nearest office of the Department of Children and Families: Pasco County: New Port Richey Service Center |