Medicare Savings Program

You can get help from your state paying your Medicare premiums. In some cases, Medicare Savings Programs may also pay Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) deductibles, coinsurance, and copayments if you meet certain conditions. These conditions are listed below under "How do I apply for Medicare Savings Programs?"

 

4 kinds of Medicare Savings Programs

Qualified Medicare Beneficiary (QMB) Program

The QMB Program is a state program that helps pay Part A premiums, Part B premiums, deductibles, coinsurance, and copays.

 

QMB income & resource limits in 2021:

 

Individual monthly income limit: $1,094
Individual resource limit: $7,970

 

Married couple monthly income limit: $1,472
Married couple resource limit: $11,960

 

Note:
If you’re eligible, the QMB Program helps pay for Part A and/or Part B premiums. Medicare providers aren’t allowed to bill you for services and items Medicare covers, including deductibles, coinsurance, and copayments, except outpatient prescription drugs. Pharmacists may charge you up to a limited amount (no more than $4.00 in 2021) for prescription drugs covered by Medicare Part D.

If you get a bill for these charges, tell your provider or the debt collector that you’re in the QMB Program and can’t be charged for Medicare deductibles, coinsurance, and copayments. If you’ve already made payments on a bill for services and items Medicare covers, you have the right to a refund. If you’re enrolled in a Medicare Advantage Plan, you should also contact the plan to ask them to stop the charges.

 

Specified Low-Income Medicare Beneficiary (SLMB)

The SLMB Program is a state program that helps pay Part B premiums for people who have Part A and limited income and resources.

 

SLMB income & resource limits in 2021:

Individual monthly income limit: $1,308
Individual resource limit: $7,970

 

Married couple monthly income limit: $1,762
Married couple resource limit: $11,960

 

Qualifying Individual (QI) Program

The QI Program is a state program that helps pay Part B premiums for people who have Part A and limited income and resources. You must apply every year for QI benefits. QI applications are granted on a first-come, first-served basis, with priority given to people who got QI benefits the previous year. (You can't get QI benefits if you qualify for Medicaid).

 

QI income & resource limits in 2021:

Individual monthly income limit: $1,469
Individual resource limit: $7,970

 

Married couple monthly income limit: $1.980
Married couple resource limit: $11,960

 

Qualified Disabled and Working Individuals (QDWI) Program

The QDWI program helps pay the Part A premium. You may qualify if any of these apply to you:

  • You're a working disabled person under 65
  • You lost your Social Security disability benefits and premium-free Part A because you returned to work
  • You aren't getting medical assistance from your state
  • You meet the income and resource limits required by your state

QDWI income & resource limits in 2021:

Individual monthly income limit: $4,379
Individual resource limit: $4,000

 

Married couple monthly income limit: $5,892
Married couple individual resource limit: $6,000

 

If you qualify for the QMB program, SLMB, or QI program, you automatically qualify to get Extra Help paying for Medicare drug coverage.

 

Note: These amounts may increase each year. If your income and resources are slightly higher, you should still apply.

What items are included in the Medicare Savings Program resource limits?

Countable resources include:

  • Money in a checking or savings account
  • Stocks
  • Bonds

Countable resources don't include:

  • Your home
  • One car
  • Burial plot
  • Up to $1,500 for burial expenses if you have put that money aside
  • Furniture
  • Other household and personal items

How do I apply for Medicare Savings Programs?

If you answer yes to these 3 questions, call your State Medicaid Program to see if you qualify for a Medicare Savings Program in your state:

 

  1. Do you have, or are you eligible for, Part A?
  2. Is your income for 2021 at, or below, the income limits listed for any of the programs above?
  3. Do you have limited resources, below the limits above?

It's important to call or fill out an application if you think you could qualify for savings—even if your income or resources are higher than the amounts listed here.