Medicare Savings Program: Get Help with Medicare Part A and B Costs, If You Qualify

If you or a loved one need help to pay for Medicare — but don’t qualify for Medicaid — a Medicare Savings Program (MSP) may be able to help cover many of your costs. MSPs are federally funded programs that pay some or all of the Original Medicare costs for older Americans with limited income and resources. If you qualify, Medicare Savings Programs can help pay the following Medicare costs:

• Monthly premiums

• Deductibles

• Copayments

• Coinsurance

MSPs are run by the states and provide an essential financial safety net for many older Americans. To see if an MSP can help you, you’ll need to know what they are, who qualifies, and how to sign up. Curious whether you are eligible for a Medicare Savings Program? Here’s what to know.

There are four Medicare Savings Programs, and each is designed to help adults with different levels of income and resources. If you have Original Medicare (Parts A and B) and have trouble paying your medical bills, one of these four programs may be able to help you:

Qualified Medicare Beneficiary (QMB) Program: A QMB can help pay for Part A and B premiums, deductibles, copays and coinsurance. This Medicare Savings Program has the lowest income and resource limits and qualifies you for the Part D Extra Help program to help cover prescription costs.

Specified Low-Income Medicare Beneficiary (SLMB) Program: SLMB is a state-based Medicare Savings Program that helps pay for Part B premiums. You can have a higher income than with QMB, but you must be enrolled in Medicare Part A. Like the QMB, you’ll automatically get help with prescription drugs.

Qualifying Individual (QI) Program: The QI will help pay your Part B premium if you qualify. The QI is similar to the SLMB but has higher income limits. QI recipients are required to reapply each year. QI recipients are also enrolled in Part D Extra Help.

Qualified Disabled and Working Individuals (QDWI) Program: The QDWI helps pay Part A premiums for eligible people for one of several reasons. These include:

• You’re working, disabled and under 65
• You returned to work and lost your premium-free Part A and Social Security disability benefits
• You meet your state’s income and resource limits
• You are not getting medical assistance from your state

Each MSP was created to help different groups of people pay for their Medicare costs. Because of this, each Medicare Savings Program has different income and resource limits you’ll need to meet to qualify. These limits get adjusted each year. For 2021, the Medicare Savings Program income and resource limits are: ^[1]

Qualified Medicare Beneficiary (QMB) Program

• 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

• Individual monthly income limit: $1,308
• Married couple monthly income limit: $1,762
• Individual resource limit: $7,970
• Married couple resource limit: $11,960

Qualifying Individual (QI) Program

• 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

• Individual monthly income limit: $4,379
• Married couple monthly income limit: $5,892
• Individual resource limit: $4,000
• Married couple resource limit: $6,000

Remember, what is Medicare Savings Program built to do? MSPs are designed to help people with limited incomes and resources afford Medicare health coverage. Because each MSP is administered at the state level, there may be different qualifying factors based on where you live. Even if you don’t meet the income or resource requirements above, you may qualify for a Medicare Savings Program. To find out, you can either contact your local Medicaid office or give GoHealth a call. Our licensed insurance agents will walk through your income and resources to see what kinds of financial assistance you may qualify for.

What items are not counted as resources?

As you read above, each MSP has resource limits you can’t exceed. Resources typically refer to the money you have in the bank, stocks and bonds. Because MSPs are state-run programs, these limits may vary based on where you live. But despite the differences between states, there are a few personal items that do not count as resources, no matter where you live:

• Your primary home

• One of your cars

• burial spaces and burial funds up to $1,500

• life insurance with a cash value of less than $1,500

• Furniture

To find out if you meet your MSP’s resource limits, give your local Medicaid office a call.

To apply for a Medicare Savings Program, you’ll need to contact your State Health Insurance Assistance Program (SHIP). These state-run organizations receive federal funding to help provide financial assistance through MSPs and Part D Extra Help. You can also contact a licensed insurance agent, like the ones at GoHealth. They can look at your income and resources and examine which Medicare Savings Programs you may qualify for.

Money in bank accounts is considered a resource when determining whether you’re eligible for a Medicare Savings Plan. This amount changes depending on which Medicare Savings Program you qualify for. Just like with income limits, your state may accept your application if your resources are higher than the limits allowed. To see if you are eligible, contact your local SHIP.