Medicare Savings Programs

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Medicare Savings Programs

Compared to the premiums for private health plans, Medicare can seem like a bargain. But even Medicare's out-of-pocket costs can add up, especially if you are on a fixed income. Fortunately, there are Medicare Savings Programs that help cover certain out-of-pocket costs associated with Medicare.

Depending on your income and other financial resources, you may be eligible for these programs, which can pay all or part of your Part A and Part B premiums, deductibles, copayments, and coinsurance amounts. You may also qualify for help with your Part D prescription drug costs.

Here's a look at the different Medicare Savings Programs and how they can help pay for your health care.

What are the different Medicare Savings Programs?

There are four options to qualify for a Medicare Savings Program:

  • Qualified Medicare Beneficiary (QMB). QMB pays all of your Part A premiums (if you have them). It also pays for your Part B premiums, deductibles, copayments, and coinsurance amounts. You also automatically qualify for the Extra Help program to help with your Part D prescription drug costs.
  • Specified Low-Income Medicare Beneficiary (SLMB). SLMB covers your monthly Part B premium. You also automatically qualify for Extra Help.
  • Qualified Individual (QI). QI covers your monthly Part B premium but has a slightly higher income limit to qualify. If you qualify, you also automatically get Extra Help with Part D.
  • Qualified Disabled and Working Individual (QDWI). QDWI covers the Part A premium for people who do not qualify for premium-free Part A. This sometimes occurs because they have either returned to work or are disabled and currently working.

Medicare Savings Programs eligibility

Eligibility is based on both your monthly income and your financial assets, which include cash in checking and savings accounts, stocks, bonds, and individual retirement accounts. Other financial assets, such as your home, furnishings, and personal items, your car, a burial plot, and up to $1,500 in burial expenses, do not count against your allowable assets.

What are the Medicare Savings Programs income limits?

The table below shows the eligibility requirements in 2020 and may change from year to year. Keep in mind that these programs are administered at the state level, so each state may have different guidelines for calculating your income and assets—even if your income and resources are slightly above the limits listed above, you should contact your state's Medicaid office or State Health Insurance Assistance Program (SHIP) for details about how to qualify.

Income limits for Medicare chart

How to Apply for Medicare Savings Programs

To find out more about Medicare Savings Programs administered in your state, contact your local Medicaid Office or SHIP Counselor. Contact the KIPDA SHIP Program at (502) 266-5571.