Medicare Savings Programs help people pay for their Medicare costs, like premiums and cost-sharing expenses.  

Medicare Savings Programs, often called MSPs, are federally-funded assistance programs administered by the Medicaid programs of individual states. They help people with limited income and resources by paying some or all of their Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) costs, such as premiums, deductibles, co-payments, and coinsurance. Eligibility for certain MSPs also qualifies you for the Extra Help program, which helps with the cost of prescription drugs.

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Do I Qualify for a Medicare Savings Program

To be eligible, you must:

  • Be age 65 or older
  • Receive Social Security disability benefits 
  • Have certain disabilities or permanent kidney failure (even if under age 65)
  • Meet standard income and resource requirements. 

What are the types of Medicare Savings Programs?

There are four types of Medicare Savings Programs, each with different benefits and different income and resource limits. 

Benefits vary for each program, but all of them, except for the QDWI Program, help pay for Medicare Part B premiums.

The income/resource limit amounts, which vary between plans, may increase each year, so if your income and resources are slightly higher than the limit or if you think you might be eligible for MSP enrollment, you should still apply. These income and resource limits are generally structured around the “federal poverty level. Some states may choose to increase these federal guideline amounts or eliminate the resource test altogether. Contact someone from your state to get clarification on your local eligibility rules.

1. Qualified Medicare Beneficiary (QMB) Program

These programs help pay for Medicare Part A premiums, Part B premiums, deductibles, coinsurance, and co-pays. In 2020, the QMB income and resource limits were:

  • Individual monthly income limit*: $1,084
    Married couple monthly income limit*: $1,457
  • Individual resource limit: $7,860
    Married couple resource limit: $11,800

2. Specified Low-Income Medicare Beneficiary (SLMB) Program

Those who earn a little more than the maximum QMB income requirement may qualify as a Specified Low-Income Medicare Beneficiary (SLMB). This state program helps pay only the Medicare Part B premiums for people who have Part A and limited income/resources.

In 2020, the SLMB income and resource limits were:

  • Individual monthly income limit*: $1,296
    Married couple monthly income limit*: $1,744
  • Individual resource limit: $7,860
    Married couple resource limit: $11,800

3. Qualifying Individual (QI or QI-1) Program

This state program helps pay Part B premiums only for people who have Part A and limited income and resources. You must apply every year for QI benefits. Funding is limited, and QI applications are granted on a first-come, first-served basis. And priority goes to people who got QI benefits the previous year. Note that you cannot get QI benefits if you qualify for Medicaid.

In 2020, the QI income and resource limits were:

  • Individual monthly income limit*: $1,456
    Married couple monthly income limit*: $1,960
  • Individual resource limit: $7,860
    Married couple resource limit: $11,800

4. Qualified Disabled & Working Individuals (QDWI) Program

Unlike other MSPs, this program helps qualified individuals pay only the Medicare Part A Premium

You may qualify for a QDWI program if:

  • You are a working disabled person under 65.
  • You lost your premium-free Part A when you went back to work.
  • You are not getting medical assistance from your state.
  • You meet the income and resource limits required by your state.

In 2020, the QDWI income and resource limits were:

  • Individual monthly income limit*: $4,339
    Married couple monthly income limit: $5,833
  • Individual resource limit: $4,000
    Married couple resource limit: $6,000

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Important Notes About These Plans

  • The income/resource limits above are federal guidelines. Some states may choose to increase these federal guideline amounts or eliminate the resource test altogether. Refer to your state eligibility rules.
  • Income limits are slightly higher in Alaska and Hawaii.
  • If you have income from working, you may qualify for benefits even if your income is higher than the limits listed.
  • If you qualify for the QMB program, SLMB, or QI program, you automatically qualify to get Extra Help paying for Medicare Part D prescription drug coverage.

What counts as income and resources for Medicare Savings Programs?

If you have income from working, you might still meet eligibility requirements for an MSP program even if your income is higher than the income limits listed for each program. Countable resources include money in checking or savings accounts, stocks, and bonds. They do not include your home, one car, one burial plot, up to $1,500 in burial expenses if you’ve set that side, furniture, and household/personal items. 

How Do I Enroll in an MSP?

Call your State Medicaid Program to see if you qualify for a Medicare Savings Program in your state.

It’s important to call or fill out an application if you think you could possibly qualify for savings—even if your income or resources are higher than the amounts listed here.

To get help in your local area, go to Medicare.gov and use the “Find Someone to Talk To” tool on the right side of the page. 

For the most up-to-date requirements, you can also contact Medicare for more information at 1 (800) MEDICARE or 1(800) 633-4227, 24 hours a day, seven days a week; for TTY assistance, call 1 (877) 486-2048.

Your local State Health Insurance Assistance Program (SHIPs) can also help. SHIPs are federally funded to provide free, objective assistance to people with Medicare and their families and can help you apply for the Medicare Savings Programs and Part D Low-Income Subsidy/Extra Help. Find your SHIP by visiting www.shiptacenter.org or calling 1 (877) 839-2675.

Learn More: What (and When) Is Medicare Open Enrollment?

FAQ: Medicare Savings Programs

How do I renew a Medicare Savings Program?

You will need to renew (recertify) your MSP every year. If you do not receive a notice in the mail to recertify, contact your local Medicaid office and ask what you need to do to make sure you receive your MSP benefits in the following year.

What is the difference between Medicare Savings Programs and Medicaid?

Medicare Savings Programs are assistance programs run by state Medicaid programs. 

What Is the Extra Help Program?

Enrollment into MSPs automatically qualifies a person to receive the Medicare Part D Low-Income Subsidy (LIS/Extra Help). This benefit helps pay for prescription drugs and is estimated by the Social Security Administration to have an annual value of $4,900. Furthermore, if a senior/adult with disabilities is not already enrolled in Part D, they will have no late enrollment penalty if they receive Extra Help.

Some Medicare beneficiaries are automatically eligible for Extra Help and do not need to apply. These beneficiaries are deemed eligible as long as they: 

  • Are entitled to Medicare Part A, Medicare Part B, or both; and 
  • Receive Supplemental Security Income (SSI), including 1619 
  • Receive full Medicaid; or 
  • Are Qualified Medicare Beneficiaries (QMB), Specified Low-Income Medicare Beneficiaries (SLMB), or Qualifying Individuals (QI). 

Medicare beneficiaries who do not meet the criteria may still be eligible for the Extra Help based on their resources, income, and household size. These beneficiaries must file an application for Extra Help to see if they qualify. The best way for Medicare beneficiaries to file for Extra Help is online at www.socialsecurity.gov/extrahelp. The online application, known as the i1020, is available in English and Spanish. 

Learn More: The 20 Most Asked Medicare Questions

Conclusion: You Might Be Eligible for Help with Your Medicare Costs

A Medicare Savings Program may help you lower your out-of-pocket healthcare costs. It’s important to call or fill out an application if you think you could qualify for savings—even if your income or resources are higher than the amounts listed here.

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Updated January 23, 2021

mal profeta is a writer, editor, educator, and public health advocate. They serve as the communications director of an NIH-funded clinical and translational science research center that focuses on addressing health disparities in Appalachia. A former Fulbright recipient, they are completing an MFA in poetry at New York University. More at malprofeta.xyz.