Medicare Savings Programs

Apply for Medicare Savings Programs today to see if you qualify

Need help paying for Medicare? You may be able to qualify for Medicare Savings Programs that can help you with paying for some – or even all – of the Medicare expenses. Knowing what types of Medicare Savings Program are available, as well as how you may qualify, could end up saving you a great deal of money each year on your healthcare expenses.

What are Medicare Savings Programs and How Do They Work?

Medicare Savings Programs offer a path to get assistance from your state with paying your Medicare premiums. In addition, there are some Medicare Savings Programs that can also help pay charges, such as Medicare’s deductibles, copayments, and / or coinsurance costs.

Not everyone qualifies for Medicare Savings Programs, though. So, it is important to make sure that you meet the necessary requirements. These generally include the following:
Residing in one of the U.S. states or the District of Columbia;

  • Age 65 or older;
  • Enrolled in, or at least being eligible for, Medicare Part A;
  • Receiving Social Security disability benefits or being diagnosed with permanent kidney failure or other specific disabilities (even if you are under age 65);
  • Generating income that is below a set annual limit; and
  • Meeting the standard asset / resource requirements.

According to Medicare, “countable” financial resources include:

  • Money in checking and / or savings account(s)
  • Investments such as stocks and / or bonds

There are also some assets that are not considered as countable resources for eligibility in a Medicare Savings Program. These can include the following:

  • Your home
  • One vehicle
  • A burial plot
  • Up to $1,500 that is being saved for your burial expenses, and
  • Furniture and other household / personal items

Medicare Savings Programs

There are currently four Medicare Savings Programs available. These are the:

  • Qualified Medicare Beneficiary (QMB) Program
  • Specified Low Income Medicare Beneficiary (SLMB) Program
  • Qualifying Individual (QI) Program
  • Qualified Disabled and Working Individual (QDWI) Program

Each of these programs can differ somewhat in terms of what it helps you to pay for, as well as the amount of the monthly income and / or resource limit for qualification.

Qualified Medicare Beneficiary (QMB) Program

Through the Qualified Medicare Beneficiary, or QMB, program, Medicare enrollees can get assistance with paying premiums for Medicare Part A and / or Medicare Part B, as well as with the cost of other out-of-pocket cost responsibilities like deductibles, copayments, or coinsurance.

With this program, there is a monthly income limit for single individuals of $1,061 (in 2019), and $1,430 for married couples. Likewise, there is also an asset / resource upper limit of $7,730 for individuals, and $11,600 for married couples.

If you qualify for this program, it is important to let your healthcare provider know so you’re your healthcare charges can be billed accordingly. Typically, you show your healthcare professional your Medicare ID card as well as your QMB card. That way, you cannot be charged for Medicare deductibles, coinsurance, or copayments.

Specified Low Income Medicare Beneficiary (SLMB) Program

Through the Specified Low Income Medicare Beneficiary Program, or SLMB, you can receive assistance with the payment of Medicare Part B premiums. Here, the resource limits are the same as they are for the Qualified Medicare Beneficiary (QMB) program. However, the income limit differs.

In this case, the individual monthly income limit (for 2019) for the Specified Low Income Medicare Beneficiary program is $1,269 and the married couple monthly income limit is $1,711. Even if your income and / or resources are slightly higher, though, you may still want to apply for this program as some exceptions may be made.

Qualifying Individual (QI) Program

The Qualifying Individual (QI) program also provides assistance with the payment of Medicare Part B premiums only. In addition, even if you are already enrolled in the QI program, you will have to re-apply every year. The applications for this Medicare Savings Program are available on a first-come, first-served basis – with priority given to those who received these particular benefits in the previous year.

In this program, the individual and married couple resource limits are $7,730 and $11,600 respectively for 2019. The individual monthly income limit for the QI program is $1,426, and the monthly income limit for married couples is $1,923.

Qualified Disabled and Working Individuals (QDWI) Program

Through the Qualified Disabled and Working Individuals, or QDWI, program, you can receive assistance with paying for your Medicare Part A premium (if you do not qualify for premium-free Part A).
You may qualify for the QDWI program if one or more of the following criteria applies to you:

  • You are under age 65, disabled, and still working
  • You went back to work and you lost your premium-free Medicare Part A coverage
  • You are not already receiving medical assistance from your state, and / or
  • You have met the income and resource limits that are required by your state
  • In 2019, the resource limit for married couples in the QDWI program is $5,722 and $4,000 for single individuals. The monthly income limit for individuals to qualify for QDWI is $4,249 and it is $5,722 for married couples.

How to Apply for a Medicare Savings Program

In order to determine whether or not you are eligible for a Medicare Savings Program, as well as to apply for a program if you are qualified, you should first contact the Medicaid office or the State Health Insurance Assistance Program (SHIP) in your state. That is because only your state can determine whether you qualify for a Medicare Savings Program – and generally, different states will require different eligibility criteria to be met.

Once you do know which of the MSP programs you are eligible for (if any), you can apply online by going to the Medicare Benefits page on the Social Security website. This page can be accessed by going to:

Additional Medicare-Related Cost-Saving Benefits

By being enrolled in a Medicare Savings Program, it is possible that you could also receive additional cost-saving benefits. For example, if you qualify for the QMB, QI, or SLMB program, you will also automatically qualify for receive Extra Help in paying for your Medicare Part D prescription drug coverage.

Extra Help is a federal program that assists Medicare-eligible individuals with paying for some – or even most – of their out-of-pocket costs that are related to Medicare’s prescription drug coverage. This program is also oftentimes referred to as the Medicare Part D Low Income Subsidy, or LIS.

Got a Medicare question? We love questions. Contact us.
Author Bio: Ben started Prepare for Medicare in 2014 to help people help people get objective answers to questions about Medicare. He’s held leadership roles at numerous Fortune 500 Medicare health insurers in product development, sales, marketing and strategy for over 20 years.

Sources: Medicare Savings Programs.