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Medicare Savings Program: How Do I Apply & Get Help with Medicare Costs?

At times, the cost of Medicare may seem high. In addition, the prices sometimes increase each year. Thankfully, Medicare provides a state-by-state Medicare Savings Program that helps lower-income individuals pay parts of the out-of-pocket Medicare costs. These costs might include any premiums, deductibles, coinsurance, and copayments from Original Medicare Parts A and B.

What is Medicare Savings Program?

There are several types of Medicare Savings Programs (MSPs). They differ based on the assistance they offer and their eligibility requirements. MSPs are funded at a state level, and can help you cover some of the out-of-pocket costs in Original Medicare (Medicare Part A, your inpatient services, and Part B, your outpatient services). Depending on the program, these costs may include Medicare Part A and Part B copays, coinsurance, premiums, and deductibles. These benefits can make your healthcare more affordable, without having to sacrifice your coverage.

How Does the Medicare Savings Program Work?

Medicare Savings Programs are funded at a state level, so there may be some variation state-to-state. You can find your state’s program on Medicare’s Helpful Contacts page. In some cases, depending on the Medicare Savings Program you’re enrolled in, you might also automatically qualify for Medicare’s Extra Help Program. This program can help you with your Medicare Part D prescription medication costs.

How Do I Apply for a Medicare Savings Program?

If you meet the guidelines for any of the programs below, you can call your State Medicaid Program to apply. In some instances, you may still qualify even if your income or resources slightly exceeds the listed limits, so you may want to submit an application if you’re close.

The different types of Medicare Savings Programs are:

Qualified Medicare Beneficiary (QMB) Program

The QMB program helps pay for Part A and Part B premiums, coinsurance, copayments, and deductibles. To be eligible for QMB, you’ll need to meet the following requirements:

  • Individual monthly income limit of $1,032 (limits may be higher in Alaska or Hawaii)
  • Married couple monthly income limit of $1,392 (limits may be higher in Alaska or Hawaii)
  • Individual resource limit of $7,560
  • Married couple resource limit of $11,340

Specified Low-Income Medicare Beneficiary (SLMB) Program

The SLMB program helps pay for Part B premiums only. The eligibility guidelines for SLMB assistance are:

  • Individual monthly income limit of $1,234 (limits may be higher in Alaska or Hawaii)
  • Married couple monthly income limit of $1,666 (limits may be higher in Alaska or Hawaii)
  • Individual resource limit of $7,560
  • Married couple resource limit of $11,340

Qualifying Individual (QI) Program

The QI program only helps pay for Part B premiums, but unlike the other savings programs, Medicare requires you to apply for QI benefits every year. These applications are processed on a first-come, first-served basis, and priority is given to those who got QI benefits in past years. To qualify for the QI program, you must meet the following:

  • Individual monthly income limit of $1,386 (limits may be higher in Alaska or Hawaii)
  • Married couple monthly income limit of $1,872 (limits may be higher in Alaska or Hawaii)
  • Individual resource limit of $7,560
  • Married couple resource limit of $11,340

Qualified Disabled and Working Individuals (QDWI) Program

The QDWI program helps pay for Part A premiums only. To be eligible for the QDWI program, you must meet the following:

  • You’re a working disabled person under 65
  • Your premium-free Part A was lost when you returned to work
  • Your state isn’t helping you with medical assistance
  • You meet your state’s income and resource limits
  • Individual monthly income limit of $4,132 (limits may be higher in Alaska or Hawaii)
  • Married couple monthly income limit of $5,572 (limits may be higher in Alaska or Hawaii)
  • Individual resource limit of $4,000
  • Married couple resource limit of $6,000

Medicare Savings Programs are designed to help people afford their healthcare. If you meet the eligibility requirements for any of the programs, you can apply for assistance. The benefits they offer can give you more room in your budget, without having to compromise your health insurance.  

Nothing on this website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

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