How to Stop Medicare Taking $202.90 From Your Parent's Social Security in Hawaii
If Medicare is deducting $202.90 from your parent's Social Security check every month, Hawaii can pay that premium instead — through the Medicare Savings Programs administered by Med-QUEST. The application packet includes Form DHS 1100 and the DHS 1100B supplement for Medicare applicants. Med-QUEST must decide non-disability applications within 45 calendar days; after approval, the deduction can take another 60 to 90 days to stop. For a senior living on $1,400/month, getting that $202.90 back is the difference between covering groceries and falling short.
The catch is that nobody at Social Security can stop the deduction directly. It is not their decision. The premium stops only when Hawaii's Med-QUEST Division approves your parent for QMB, SLMB, or QI and sends a state buy-in transaction to CMS, which then notifies the Social Security Administration to remove the deduction. Three agencies, one result — and the guide to navigate it is the application your parent files with Med-QUEST.
The Problem: Why the Deduction Exists
Medicare Part B coverage is not free. In 2026, the standard premium is $202.90/month, and for most beneficiaries it is deducted automatically from their Social Security benefit before the money hits the bank. Your parent's Social Security statement shows a gross benefit — say $1,400 — but the actual deposit is $1,197.10 after the Part B premium.
For high-income beneficiaries, the premium can be even higher through IRMAA surcharges. But for low-income seniors in Hawaii, the issue is the opposite: they are paying a premium they may not need to pay at all.
The Solution: Hawaii Medicare Savings Programs
Hawaii's Medicare Savings Programs pay the Part B premium on behalf of qualifying seniors. Three of the four tiers — QMB, SLMB, and QI — cover the Part B premium:
- QMB (income up to $1,530/mo individual): pays Part B premium, Part A premium, deductibles, copays, and coinsurance. Also provides balance billing protection.
- SLMB (income up to $1,836/mo individual): pays Part B premium only.
- QI (income up to $2,066/mo individual): pays Part B premium only.
All three achieve the same outcome for the Social Security deduction: it stops. The difference is that QMB also covers out-of-pocket costs at the doctor and pharmacy, while SLMB and QI address only the premium.
Hawaii's income limits are higher than the mainland's because the state uses its own Federal Poverty Level guidelines, set roughly 15% above the contiguous-states level. A senior earning $1,500/month qualifies for QMB in Hawaii but would not on the mainland.
Step by Step: How the Deduction Actually Stops
1. Apply Through Med-QUEST
File Form DHS 1100 and the DHS 1100B supplement required for Medicare applicants — either through the KOLEA portal at medical.mybenefits.hawaii.gov, at a Med-QUEST eligibility office on your parent's island, or by mail/fax. The application covers all MSP tiers; Med-QUEST evaluates which one your parent qualifies for.
Documents needed: Social Security award letter (showing the gross benefit amount, not the net deposit), Medicare card or SSA Benefit Verification Letter showing Part A and/or Part B enrollment, recent bank statements for every account, and any pension or annuity records.
If you are applying from the mainland on your parent's behalf, you need to set up authorized representative status using Form DHS 1127 (Appointment of Authorized Representative). This lets Med-QUEST discuss the case with you and accept documents you submit.
2. Med-QUEST Approves Coverage
Med-QUEST must issue a determination within 45 calendar days for non-disability applications, or within 90 days when a new disability determination is needed. When approved, your parent receives a notice specifying the MSP tier and the effective date. For QMB, coverage starts the first day of the month after approval — no retroactive coverage. For SLMB and QI, up to three months of retroactive coverage before the application month is possible, meaning the state may reimburse premiums already deducted.
3. The Three-Agency Handoff
After Med-QUEST approves your parent, the state sends a buy-in transaction to CMS (the federal Medicare agency). CMS processes the transaction and notifies the Social Security Administration to stop the Part B premium deduction. This handoff can take an additional 60 to 90 days.
During this gap, your parent's Social Security check still shows the $202.90 deduction. This does not mean the application failed — it means the inter-agency process has not completed. If the deduction continues more than 90 days after approval, call Med-QUEST at 1-800-316-8005 to confirm the buy-in was transmitted.
4. The Deduction Stops and Retroactive Adjustments Arrive
Once SSA processes the buy-in, the Part B deduction disappears from the next Social Security deposit. If SLMB or QI coverage was approved with retroactive months, SSA also issues a one-time retroactive adjustment for premiums already deducted during the covered retroactive period.
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What Happens to the Extra Help for Prescriptions
Every QMB, SLMB, or QI approval automatically triggers eligibility for 100% Full Extra Help (the Part D Low-Income Subsidy). Your parent does not need to file a separate application. Full Extra Help caps copayments at $12.65 per covered drug in 2026 and provides a $0 premium in a basic benchmark Part D plan.
After Med-QUEST shares MSP enrollment data with CMS, CMS deems the beneficiary eligible for Extra Help. The Part B deduction can continue for 60 to 90 days after state approval while SSA updates its payment system.
Common Obstacles and What to Do
The KOLEA portal stalls or gives an error. The online system has known technical issues, particularly with account linking. If the portal will not accept the application, submit Forms DHS 1100 and 1100B by fax or in person at the nearest Med-QUEST office. Oahu has offices in Honolulu, Kapolei, and Waipahu; neighbor islands have section offices in Hilo, Kona, Wailuku, Lihue, Kaunakakai, and Lanai City.
The denial letter says "over income" but does not mention SLMB or QI. Med-QUEST should evaluate all tiers on one application, but some denial notices reference only the QMB income threshold. If your parent's income is above $1,530 but below $2,066, call Med-QUEST to confirm that SLMB and QI eligibility was assessed.
The deduction continues more than 90 days after approval. Contact Med-QUEST to verify that it transmitted the buy-in, and call SSA at 1-800-772-1213 to confirm the buy-in record exists on their end.
Your parent does not have premium-free Part A. If they lack 40 work credits, they may be paying a Part A premium of up to $505/month. QMB can pay this premium through a conditional enrollment process — they do not need to wait for a General Enrollment Period. This is called a Part A buy-in, and it goes through SSA with the QMB approval as the qualifying event.
Who This Is For
- Adult children who see a $202.90 deduction on a parent's Social Security statement and want it removed
- Seniors whose net Social Security deposit is significantly less than their gross benefit because of the Part B premium
- Families who called Social Security and were told they cannot stop the deduction — because Social Security is not the agency that makes this decision
- Anyone in Hawaii whose parent earns under $2,066/month and is still paying the full Part B premium out of pocket
Who This Is NOT For
- Seniors with income above $2,066/month (individual) or $2,801/month (couple) — these are above the QMB, SLMB, and QI limits for Part B premium help; eligible under-65 disabled workers may separately qualify for QDWI Part A help, and Extra Help through SSA may still apply
- Anyone looking to reduce an IRMAA surcharge — that is determined by IRS tax data and is not related to the Medicare Savings Programs
- Families needing full Medicaid long-term care coverage — MSP is a separate program that only covers Medicare costs
The Full Process in One Place
The Hawaii Medicare Savings Programs & Extra Help Guide covers the complete path: checking eligibility against Hawaii's FPL thresholds, assembling documents in the order Med-QUEST asks for them, submitting through KOLEA or a local office, tracking the three-agency handoff that stops the deduction, handling a denial or renewal, and using QMB balance billing protections when a provider sends a bill they should not. It includes printable tools — an eligibility worksheet, document checklist, application tracker, renewal calendar, billing dispute log, and agency communication log — built for this specific process.
Frequently Asked Questions
Can I call Social Security to stop the Medicare premium deduction?
No. The Social Security Administration deducts the Part B premium because CMS instructs it to. Only a state buy-in — where Hawaii agrees to pay the premium — triggers CMS to notify SSA to stop the deduction. The process starts with a Med-QUEST application, not a call to SSA.
How much money will my parent save?
If approved for any MSP tier that covers Part B, the savings are $202.90/month — $2,434.80/year. QMB also covers deductibles, copays, and coinsurance, which can save thousands more depending on how much care your parent receives. Extra Help adds additional savings on prescription drugs.
What if my parent already paid premiums for months they were eligible?
SLMB and QI allow up to three months of retroactive coverage before the application month. If your parent was eligible during those months, SSA will issue a one-time retroactive adjustment. QMB has no retroactive coverage — it starts the first of the month after approval.
Can my parent keep their current doctor?
Yes. MSP does not change your parent's Medicare coverage. They keep Original Medicare or their Medicare Advantage plan. QMB adds balance billing protection, which means their providers must accept Medicare's payment as full and cannot send additional bills. SLMB and QI do not affect the provider relationship at all — they only eliminate the premium deduction.
How long does the whole process take from application to the deduction actually stopping?
Med-QUEST must issue a determination within 45 calendar days for non-disability applications, or within 90 days when a new disability determination is needed. The CMS-to-SSA handoff can take another 60–90 days after approval. SLMB and QI retroactive coverage can recover some premiums paid during the waiting period.
What if my parent lives on a neighbor island with no nearby Med-QUEST office?
Neighbor island residents can submit Forms DHS 1100 and 1100B by mail or fax to the section office serving their island (Hilo, Kona, Wailuku, Lihue, Kaunakakai, or Lanai City). The KOLEA portal also works from anywhere. Phone support is available at 1-800-316-8005, though hold times can be long.
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