May 23, 2011
Medicare Savings Programs - Getting Help with Your Medicare Costs
The Medicare Savings Program (MSP) is administered by each state's Medicaid department. MSP helps you save with your out-of-pocket Medicare costs. At the very least, if you qualify, you will not have to pay your Medicare Part B premium. Other programs will help cover expenses such as your Medicare deductible, coinsurance and/or copayments.
To qualify for the Medicare Savings Program, you must:
- Be eligible for (not necessarily enrolled in) Medicare Part A (hospital insurance)
- Have an income at or near the federal poverty level
- Meet the maximum asset requirement
Medicaid is operated in each state separately so your requirements may differ. Below are the very least of qualifications you need to meet in order to be accepted. Even if you don't think you meet these minimal requirements, check your state's MSP website to see if your qualification criteria are different.
Four Different Programs
There are four different programs associated with MSP. Three of the programs help those who receive Social Security benefits keep more of their monthly check. Instead of the Social Security Administration deducting your Medicare Part B premium from your benefit check, your state Medicaid department will pay the premium for you.
Here are the four programs and what they offer:
- Qualified Medicare Beneficiary (QMB) program includes the Part B premium and also helps with other out-of-pocket medical expenses like your Medicare deductible, coinsurance and copayments. If you pay a premium for Medicare Part A (hospital insurance) QMB also covers this monthly expense.
- Specified Low-Income Medicare Beneficiary (SLMB) pays only the Medicare Part B premiums, but the maximum income requirements are higher because the program allows you to have an income from working.
- Qualified Individual Program (QI) pays the Medicare Part B premium and the maximum income requirements are even higher than SLMB.
- Qualified Disabled & Working Individuals (QDWI) pays Medicare Part A premiums only but has the highest qualifying income maximum. It's for under-age-65 people who are eligible for Medicare disability benefits but lost their Medicare Part A benefits because they went back to work. These individuals are also not receiving state Medicaid benefits.
Extra Help for Prescription Drug Costs
In addition to the four programs above, those who qualify for QMB, SLMB or QI also qualify for the Medicare Extra Help (Low-income Subsidy, or LIS) program to help pay their prescription drug expenses.
General requirements for the Medicare Savings Program
Remember to check your state's MSP website to see if your qualification criteria are different. For all programs, you must qualify for Medicare Part A, although enrollment is not necessary.
Income Limits*
- QMB - You may earn up to 100% of the federal poverty level (FPL). In 2011, the income limit was $928 per month for individuals or $1,246 per month for married couples.
- SLMB - You may earn between 100% and 120% of the federal poverty level (FPL). In 2011, the limit was $1,109 per month for individuals or $1,491 per month for married couples.
- QI - You may earn between 120% and 135% of the federal poverty level (FPL). In 2011, the limit was $1,246 per month for individuals or $1,675 per month for married couples.
- QDWI - The 2011 qualifying monthly income for individuals was $3,715 and for married couples was $4,989.
Asset Maximums*
For all 2011 Medicare Savings Programs, the asset maximum was $6,680 for individuals and $10,020 for married couples. This includes checking account balances, stocks and bonds. It does not include the value of other assets like cars, homes, household goods, burial plots, etc. You may deduct a $1,500 allowance per individual for burial expenses. Also not counted is $20/month ($240/year) of unearned income such as Social Security and pension.
*Please note that amounts for income and asset limits may change in 2012. These limits may also vary by state so be sure to check with your Medicaid office to get state specific requirements.
Applying for Medicare Savings Program
To apply for MSP or to see if you qualify, call your state Medicaid program. Visit www.medicare.gov/contacts to find out where to go.
