Medicare Savings Programs Keep Costs Down

Find out if you qualify for one of these cost-cutting programs

Medicare Savings Programs Extra Help
Medicare may throw you a lifeline if you have low income. Stockbyte/DigitalVision/Getty Images

Even though costs are lower with Medicare than with many private insurance plans, many seniors may still find it difficult to afford. For many, incomes may be limited to Social Security benefits and retirement savings, if they have any at all.

Medicare throws a lifeline. For those with limited incomes and assets, there are Medicare Savings Programs (MSP) that can help to decrease the cost of annual deductibles, coinsurance, copayments and monthly premiums for Part A, Part B, and Part D.

You can be eligible for these programs if you are on Original Medicare but not if you are on a Medicare Advantage plan.

What Medicare Savings Programs Are Available

There are five Medicare Savings Programs. They are listed here starting with the programs that have the strictest financial eligibility requirements.

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

People who qualify for QMB, QI or SLMB automatically qualify for Extra Help. People on Medicaid do not qualify for QI or QDWI. QDWI also requires that applicants be younger than 65 years old and be working with a disabling impairment.

These programs can cover a wide range of costs including premiums, deductibles, coinsurance and copayments for Part A, Part B, and Part D. People may qualify for more than one of these programs.

 

What Each Medicare Savings Program Covers
Medicare Savings ProgramPart APart BPart D
QMB

Premiums

Deductibles

Coinsurance

Copayments

Premiums

Deductible

Coinsurance

Copayments

 
SLMB Premiums 
Extra Help  

Deductible

Premiums

Coinsurance

Copayments

QI Premiums 
QDWIPremiums  

Qualifying for a Medicare Savings Program

In order to qualify for these programs, your monthly income and assets must fall into a certain range.

Your assets include bank accounts, bonds, secondary cars, real estate other than your primary residence and stocks. Your assets do not include burial plots, burial expenses up to $1,500, furniture and personal items, life insurance valued less than $1,500, your primary car or your primary residence.

The federal government sets baseline limits for income and assets for these Medicare Savings Programs based on the federal poverty level (FPL). The QMB is set at 100 percent of the FPL, SLMB at 120 percent and QI as high as 135 percent.

However, in the end, your state has the final say. Most states use the following limits but some may allow higher income and asset ranges for you to be eligible. Alaska, Connecticut, the District of Columbia, Hawaii and Maine had higher limits in 2016. Other states, including Alabama, Arizona, Connecticut, Delaware, District of Columbia, Maine, Mississippi, New York and Vermont, did not set asset limits.

2016 Medicare Savings Program Eligibility Criteria for Individuals
Medicare Savings ProgramMonthly IncomeAssets
QMB$1,010$7,280
SLMB$1,208$7,280
Extra Help$1,356$8,780
QI$1,357$7,280
QDWI$4,045$4,000
2016 Medicare Savings Program Eligibility for Married Couples
Medicare Savings ProgramMonthly IncomeAssets
QMB$1,355$10,930
SLMB$1,622$10,930
Extra Help$1,822$13,930
QI$1,823$10,930
QDWI$5,425$6,000

How to Apply for a Medicare Savings Program

Check with your state Medicaid office to find out if you are eligible for a Medicare Savings Program. The office will let you know how to proceed with an application.

Continue Reading