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Medicare Savings Program: How Do I Apply?

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 the Medicare Savings Program?

The Medicare Savings Program aids the cost of Original Medicare for individuals who may not typically have enough to pay the full amount. There are four different types of Medicare Savings Programs, each with specific individual monthly income limits. In some instances, you may still qualify for one of the programs even if your income exceeds the income limit.

Qualified Medicare Beneficiary (QMB) Program

To potentially qualify for the QMB Program, you must meet the following:

  • 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

The QMB program helps pay for Part A premiums, Part B premiums, coinsurance, copayments, and deductibles.

Specified Low-Income Medicare Beneficiary (SLMB) Program

To potentially qualify for the SLMB Program, you must meet the following:

  • 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

The SLMB Program helps pay for Part B premiums only.

Qualifying Individual (QI) Program

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 potentially 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

The QI program only helps pay for Part B premiums.

Qualified Disabled and Working Individuals (QDWI) Program

To potentially qualify for the QDWI Program, you must meet the following:

  • You are 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

The QDWI Program helps pay for Part A premiums only.

How Does the Medicare Savings Program Work?

These Medicare Savings Programs work by helping to pay some of the costs associated with the costs that you would typically have to pay out-of-pocket. In some cases, depending on the Medicare Savings Program you qualify for, you might also automatically qualify for Medicare’s Extra Help Program. If you qualify for this program, you will also receive assistance for Part D prescription drug costs.

Medicare Savings Programs by State

Medicare Savings Programs might vary from state to state. Thankfully, Medicare organized a page with links to each state’s Medicare Savings Program website. You can find your state’s program here.

How to Apply for a Medicare Savings Program

You can call your state Medicaid program to see if you qualify for your state’s Medicare Savings program. You can do so if you have, or are eligible for Medicare Part A, if your income meets the required limits, and if you have limited resources below the required limits.

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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