October 6, 2016
As a Medicare beneficiary, in certain situations you might qualify for the Medicare Savings Program (MSP). The MSP, which is administered by each state’s Medicaid department, is designed to help with your out-of-pocket Medicare costs. In some cases, MSPs may also help pay Medicare Part A and Medicare Part B premiums, deductible, coinsurance, and copayments if you meet certain conditions.
You must meet these conditions to qualify for the Medicare Savings Program:
- Be eligible or enrolled in Medicare Part A (hospital insurance).
- Have an income at or near the federal poverty level.
- Meet the maximum asset requirement.
Since Medicaid is operated separately in each state, your requirements may differ depending on your state of residence. The minimum qualifications you need to meet to be accepted are listed below. Even if you don’t think you meet these minimal requirements, check your state’s MSP website to see if the qualification criteria are different in your state of residence.
What types of Medicare Savings Programs are available?
There are four different Medicare Savings Programs. Three of the programs are designed to help those who receive Social Security benefits keep a greater amount 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.
Listed below are the four Medicare Savings Programs and an overview of the benefits they offer:
- Qualified Medicare Beneficiary (QMB): Covers the Medicare Part A and Medicare Part B premiums, deductibles, coinsurance, and copayments.
- Specified Low-Income Medicare Beneficiary (SLMB): Covers only the Medicare Part B premium. The SLMB program has higher maximum income requirements than QMB.
- Qualified Individual (QI): Covers the Medicare Part B premium, with maximum income requirements that are even higher than SLMB. Individuals who qualify for Medicaid cannot receive QI benefits.
- Qualified Disabled and Working Individuals (QDWI): Covers only the Medicare Part A premium, but has the highest qualifying income maximum. You qualify for this Medicare Savings Program if: you’re a working disabled person under 65; you lost your Medicare premium-free Part A benefits because you went back to work; and you aren’t getting medical assistance from the state.
What are the income maximums?
To qualify for any of the four Medicare Savings Programs, your income must remain below certain limits. Here are each program’s maximum monthly incomes for 2016:
- QMB: $ 1,010 for individuals and $ 1,355 for married couples
- SLMB: $ 1,208 for individuals and $ 1,622 for married couples
- QI: $ 1,357 for individuals and $ 1,823 for married couples
- QDWI: $ 4,045 for individuals and $ 5,425 for married couples
Remember to check your state’s MSP website to see if your qualification criteria are different. Also please note that these income limits may increase in 2017.
What are the asset maximums?
In 2016, the asset maximum was $7,280 for individuals and $10,930 for married couples for the QMB, SLMB, and QI Medicare Savings Programs. The asset maximum for the QDWI program is $4,000 for individuals and $6,000 for married couples. These maximum figures include checking account balances, stocks, and bonds, but they do not include the value of other assets like your home, furniture and household goods, burial plots, and one car. You may deduct a $1,500 allowance per individual for burial expenses.
Please note that income and asset limits may change each year. These limits may also vary by state, so be sure to check with your Medicaid office to get state-specific requirements.
How to apply for the Medicare Savings Program
To apply for the Medicare Savings Program, or to see if you qualify, call your state Medicaid program or visit www.medicare.gov/contacts.