Medicare Savings Programs (MSPs) are financial assistance programs that help you pay for your Medicare premiums and, in some situations, some of your out-of-pocket expenses such as Part A and Part B deductibles, coinsurance, copayments, and prescription medicines. Medicare Buy-In Systems or Medicare Premium Payment Programs are other names for these programs.
Medicare Savings Programs are divided into four categories. You may be eligible for one or more of the following programs, depending on your specific circumstances. But first, let's take a short look at the three general questions you must answer "Yes" to before you can even consider a Medicare Savings Program.
If all of the following apply to you, you can contact your state's Medicaid office to apply for a Medicare Savings Program.
You don't go beyond the limit of your limited resources (see table below)
You do not earn more than the maximum amount allowed (see table below)
You have Medicare Part A or are eligible for it.
Let's take a look at the four different types of Medicare Savings Programs, what they pay for, and the financial eligibility requirements for each.
Assists with premiums, deductibles, coinsurance, and copayments for Medicare Part A and Medicare Part B.
Except for outpatient prescription medicines, you cannot be billed for services and commodities covered by Medicare under this program.
Only apply if your income and resources are within the program's limits (see table below)
If you meet the income and resource limits (see table below) and have Part A, you can apply for this program.
A state-funded program that assists with the payment of Part B premiums.
People who are eligible for Medicaid may not be eligible for QI benefits.
If you meet the income and resource limits (see table below) and have Part A, you can apply for this program.
A state-funded program that assists with the payment of Part B premiums.
You must apply for QI benefits every year, and they are given out on a first-come, first-served basis.
To be eligible for this program, you must:
You meet your state's income and resource requirements.
You're a disabled worker under the age of 65.
When you returned to work, you lost your premium-free Part A.
Your state does not provide medical assistance to you.
You automatically qualify for Medicare Extra Help paying for Medicare prescription drug coverage if you qualify for one of the first three programs (QMB, SLMB, or QI). Important Information if you are eligible for the QMB, SLMB, or QI programs
You automatically qualify for Extra Help paying for Medicare prescription drug coverage if you qualify for one of the first three programs (QMB, SLMB, or QI).
Only pays for Medicare Part A premiums.
You are eligible for this program if you fulfill the income and resource limits (see table below) and if you match any of the following criteria:
Your state does not provide medical aid to you.
Your income and resource limits are both met (see table below)
You're a disabled worker under the age of 65.
When you returned to work, you lost your premium-free Part A.
For each of the four Medicare Savings Programs, the table below displays the varied income and resource limits for individuals and married couples in 2021.
2021 Income and Resource Limits | Qualified Medicare Beneficiary (QMB) Program | Specified Low-Income Medicare Beneficiary (SLMB) Program | Qualifying Individual (QI) Program | Qualified Disabled and Working Individuals (QDWI) Program |
---|---|---|---|---|
Individual Monthly Income |
$1,084 |
$1,296 |
$1,456 |
$4,339 |
Married Couple monthly income |
$1,457* |
$1,744* |
$1,960* |
$5,833 |
Individual Resources |
$7,860 |
$7,860 |
$7,860 |
$4,000 |
Married Couple Resources |
$11,800 |
$11,800 |
$11,800 | $6,000 |
Income is rather straightforward, but for information on how your resources are valued, read the list below for what is and is not “countable.”
Resources that can be counted include:
Shares/Stocks
Investments in bonds
Cash in a bank account or a savings account
The following items are not countable resources:
Up to $1,500 for burial costs if you have set up that amount.
Home furnishings
Other personal and home goods
Your home
A single-car, motorcycle, or motorhome (additional vehicles count as assets)
Burial plot
It's not a bad idea to apply even if you don't think you'll qualify or satisfy the requirements. The program will notify you if you are accepted or not, but income and resource constraints can alter at any time.
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