Not all beneficiaries have the income and resources available to afford the entirety of their Medicare plan. That’s where Medicare Savings Programs (MSPs) can step in to help out.
MSPs — federally funded and administered by state Medicaid agencies — can assist in paying Medicare premiums, deductibles, coinsurance and copayments.
Although you may not know it, you could qualify for financial assistance through one of these programs. General requirements include:
Age 65+
Live in any of the 50 states or Washington, D.C.
Meet income and resource requirements (varies by program and state, see below)
Receive Social Security disability benefits
Have certain disabilities or permanent kidney failure
The 4 Medicare Savings Programs
There are four types of MSPs, and income and resource requirements vary for each of them.Â
When it comes to income limits, if you live in Alaska or Hawaii, your limits will be a bit higher than what’s listed below. It’s also important to note that you can still qualify for these programs if you’re currently working and your income is higher than what’s listed.
As for resource limits, these only include money in a checking or savings account, as well as any stocks and bonds you may hold. Other resources like your house, car, furniture or other common assets won’t be considered.
For full details on requirements and coverage, click here — but here’s a quick breakdown of each of the four MSPs:
Qualified Medicare Beneficiary (QMB) Program
The QMB program can help pay for premiums for Medicare parts A and B, as well as deductible, coinsurance and copayments for things covered by Medicare.
Individual monthly income limit: $1,094
Married couple monthly income limit: $1,472
Individual resource limit: $7,970
Married couple resource limit: $11,960
Specified Low-Income Medicare Beneficiary (SLMB) Program
The SLMB program is meant to help with Medicare Part B premiums only.
Individual monthly income limit: $1,308
Married couple monthly income limit: $1,308
Individual resource limit: $7,970
Married couple resource limit: $11,960
Qualifying Individual (QI) Program
The QI program covers only Part B premiums, as well, with some additional caveats. You’ll need to apply each year for the program, and you won’t receive QI benefits if you also qualify for Medicaid. Benefits for the QI program are granted on a first-come, first-served basis — and repeat recipients are given priority.
Individual monthly income limit: $1,469
Married couple monthly income limit: $1,980
Individual resource limit: $7,970
Married couple resource limit: $11,960
Qualified Disabled and Working Individuals (QDWI) Program
The QDWI only covers Medicare Part A premiums for those who are working with a disability and have lost prior benefits because of returning to work.
Individual monthly income limit: $4,379
Married couple monthly income limit: $5,892
Individual resource limit: $4,000
Married couple resource limit: $6,000
How To Apply for Medicare Savings Programs
If you have Medicare Part A or you’re eligible for it, you could already qualify for an MSP. Check out the income and resource limits listed above to determine whether yours are at or below the given amounts.
If you think you could qualify for Medicare savings with an MSP, you can contact your state's Medicaid program to begin the application process.
As a bonus: Once you’re enrolled in an MSP, you'll automatically get Part D Extra Help, which can help you pay prescription drug plan costs.
LEGAL DISCLAIMER: The above is meant to be strictly educational and not intended to provide medical advice or solicit the sales of an insurance product or service of any kind.
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