Medicare Savings Programs
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What Are Medicare Savings Programs?Medicare Savings Programs are federally funded programs managed by each state. These programs help people with limited income and assets pay for some (or all) of their Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) premiums, deductibles, copayments, and coinsurance. Older adults and individuals with disabilities who may not be eligible for full Medicaid may still have the option to enroll in a Medicare Savings Program.1
The 4 Types of Medicare Savings ProgramsThere are four kinds of Medicare Savings Programs, each with its own specific benefits. The names of these programs and how they work may vary from state to state. Unfortunately, Medicare Savings Programs aren’t available in Puerto Rico or the U.S. Virgin Islands.2
- Qualified Medicare Beneficiary (QMB) Program
- Specified Low-Income Medicare Beneficiary (SLMB) Program
- Qualifying Individual (QI) Program
- Qualified Disabled and Working Individuals (QDWI) Program
Money-Saving Tip: If you qualify for a QMB, SLMB, or QI Program, you’re automatically eligible for the Extra Help benefit. This benefit helps pay some of your Medicare Part D prescription drug costs.
Qualified Medicare Beneficiary ProgramOver 7 million people participate in the Qualified Medicare Beneficiary (QMB) Program.3 The QMB Program provides Medicaid coverage of Medicare Part A and Part B premiums to low-income Medicare beneficiaries. QMB enrollees will not be billed for services and items Medicare covers, including coinsurance, deductibles, and copayments.
Specified Low-Income Medicare Beneficiary ProgramThe Specified Low-Income Medicare Beneficiary (SLMB) Program helps cover your Medicare Part B premiums. These premiums go toward medically necessary care, including outpatient care, home health services, durable medical equipment (DME), and preventive services.
Qualifying Individual ProgramThe Qualifying Individual (QI) Program pays your Medicare Part B premiums. This program is offered on a first-come, first-serve basis. Recipients must reapply each year, and those who received QI benefits during the previous year are prioritized.
FYI: If you qualify for Medicaid benefits, you are not eligible for the SLMB or QI Program.
Qualified Disabled and Working Individuals ProgramThe Qualified Disabled and Working Individuals (QDWI) Program helps pay for Medicare Part A premiums. You may qualify for the QDWI Medicare Savings Program if:
- You are currently a disabled individual under the age of 65 who is working.
- You lost your premium-free Medicare Part A benefit when you returned to work.
- You meet your state’s income and resource limits.
- You aren’t receiving medical assistance in your state.
Medicare Savings Program Income and Resource LimitsEach year, income and resources limits are set for all four Medicare Savings Programs.4
|Medicare Savings Program||Individual monthly income limit*||Married couple monthly income limit*||Individual resource limit||Married couple resource limit|
|Qualified Medicare Beneficiary (QMB)||$1,094||$1,472||$7,970||$11,960|
|Specified Low-Income Medicare Beneficiary (SLMB)||$1,308||$1,762||$7,970||$11,960|
|Qualifying Individual (QI)||$1,469||$1,980||$7,970||$11,960|
|Qualified Disabled and Working Individuals (QDWI)||$4,379||$5,892||$4,000||$6,000|
What Counts Toward the Medicare Savings Program Resource and Income Limits?
Medicare Savings Program Countable Resources LimitCountable resources (also known as assets) include:
- Money in a checking or savings account
- Money market accounts
- Mutual funds
- Certificates of deposit (CDs)
- Individual retirement accounts (IRAs)
- Your home
- One car
- Other household and personal items
- A burial plot
- Up to $1,500 for burial expenses if you have put that money aside
Medicare Savings Program Income LimitCalculated income includes:
- Social Security benefits
- Supplemental Security Income (SSI)
- Railroad benefits
- Veterans benefits
- Public assistance
- Unemployment insurance
- Workers’ compensation
- Alimony payment
- Dividends and interest
- Rental income
Did You Know: Even if individuals or couples are slightly over the Medicare Savings Program income or resource limit, they still may qualify. States have some flexibility in excluding some income and resources.5
Who Is Eligible for a Medicare Savings Program?You must be eligible for or receiving Medicare Part A. Your income and resources must be at or below the limits for one or more of the Medicare Savings Programs.
Expert Tip: Enrolling in Medicare Part A for the first time? Check out our comprehensive Medicare enrollment guide.
From the Pros: Medicare Savings Programs are administered by Medicaid. Head over to our Medicare and Medicaid health insurance guide to learn about the important insurance differences.