Medicare beneficiaries who cannot afford to pay their Medicare premiums and other medical costs may be able to get help from their state. There are four different Medicare Savings Programs (MSPs) that help pay some or all of a senior’s Medicare premiums and may also pay Medicare deductibles, copayments and coinsurance.
The key qualification for all of these programs is currently having (or at least being eligible for) Medicare Part A. From there, each program sets its own monthly income and resource limits, and additional eligibility requirements may apply. When it comes to financial resources, only certain assets count toward the limit. This includes money in checking and savings accounts and investments like stocks and bonds. Resources that are not counted include one home, one car, a burial plot, up to $1,500 put aside for burial expenses, furniture, and personal items.
Each program is described in further detail below. Keep in mind that the income and resource limits may vary slightly from state to state. If you believe you may be eligible, it is worth applying even if your income and resources are slightly higher than the cutoff.
Medicare Savings Programs
- Qualified Medicare Beneficiary Program (QMB)
This program is the most comprehensive and helps beneficiaries pay for Medicare Part A and Part B premiums as well as coinsurance, deductibles and copayments. To qualify, the income and resource limits for an individual are $1,025 per month and $7,390, respectively. For a couple, the income and resource limits are $1,374 per month and $11,090, respectively.
- Specified Low-Income Medicare Beneficiary Program (SLMB)
The SLMB program only helps beneficiaries pay their Part B premiums. To qualify, the income and resource limits for an individual are $1,226 per month and $7,390, respectively. For a couple, the income and resource limits are $1,644 per month and $11,090, respectively.
- Qualifying Individual Program (QI)
This program only helps cover beneficiaries’ Part B premiums. It is not open to people who qualify for Medicaid. To qualify for the QI program, the income and resource limits for an individual are $1,377 per month and $7,390, respectively. For a couple, the income and resource limits are $1,847 per month and $11,090, respectively.
Medicare beneficiaries must re-apply for the QI program each year, and help is granted on a first-come, first-served basis. Individuals who already receive QI benefits are given priority over those who apply for the first time.
- Qualified Disabled Working Individuals Program (QDWI)
The QDWI program is more complex and less common than the others. It only provides assistance with paying for Medicare Part A premiums. A beneficiary may be eligible if they are under age 65, have a disabling impairment, lost their free Medicare Part A when they successfully returned to work and do not qualify for Medicaid. Eligible individuals must also meet income and resource requirements. The income and resource limits for an individual are $4,105 per month and $4,000, respectively. For a couple, the income and resource limits are $5,499 per month and $6,000, respectively.
Medicare beneficiaries who are eligible for the QMB, SLMB and QI programs also qualify automatically for another program called Extra Help. Extra Help provides assistance with the costs of Medicare prescription drug coverage (Part D).
You can go online to get more information about these programs. Visit the Centers for Medicare & Medicaid Services (CMS) website for information regarding Medicare Savings Programs (MSPs) and the Social Security Administration’s website for addition information on the Extra Help program. You can also contact your local Area Agency on Aging and Social Security office for information and assistance with applications.