What are Medicare Savings Programs?

What are Medicare Savings Programs? These state-funded programs can help finance what your health insurance won’t cover, including prescription drug costs.

Social Security Medicare Savings Programs (MSPs) cover premiums, deductibles, coinsurance, and copayments through your state’s Medicaid program. The top three types of Medicare Savings Programs for seniors are Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualifying Individual (QI) programs.

Have Medicare questions? Call (855) 634-0435 to get answers from a licensed insurance agent.

Certain income requirements apply, but there are many programs you could qualify for. Enter your ZIP code to start comparing Medicare insurance plans today.

Medicare vs. Medicare Savings Programs

Medicare provides health insurance coverage to seniors for free or at a reduced cost, but you’re still responsible for out-of-pocket costs like deductibles and copays. That’s where MSPs come in.

Before you sign up for Medicare coverage, compare how much Medicare insurance plans cost. For instance, Part A premiums are typically free, while Part C and Part D costs vary.

Medicare Costs by Plan Type

Once you know how much you need to pay, you can learn how to qualify for different types of Medicare Savings Programs for seniors. 

Types of Medicare Savings Programs

What do all Medicare Savings Programs do? Each MSP helps cover all or a portion of out-of-pocket Medicare costs. You might also want to compare the differences between Original Medicare and Medicare Advantage to find more ways to save.

What are the three types of Medicare savings programs? QMB, SLMB, and QI programs are the most common examples of Medicare Savings Programs.

Qualified Medicare Beneficiary (QMB) Program

QMB plans cover Part A and Part B premiums, deductibles, coinsurance, and copayments for Medicare-covered services. You may still receive a bill for Part D prescription copayments from Medicaid.

Specified Low-Income Medicare Beneficiary (SLMB) Program

SLMB plans cover Part B premiums and provide assistance with prescription drug costs, but you cost-share for many medical services. This MSP works best for individuals with very few healthcare needs beyond regular checkups. 

Qualifying Individual (QI) Program

The QI Medicare savings program is the most popular. It covers Part B premiums but requires a yearly application because it’s only offered on a first-come, first-served basis.

Medicaid vs. Medicare Savings Programs

Medicare Beneficiaries who qualify for or are already enrolled in Medicaid can receive additional benefits with these plans:

• Qualified Disabled Working Individual (QDWI) Program: Available to individuals who meet income and disability requirements to cover Part A premiums, but doesn’t provide full Medicaid benefits.
• Qualified Medicare Beneficiary Plus (QMB+) Program: Offers a higher level of coverage by including everything in QMB plans plus full Medicaid benefits.
• Specified Low-Income Medicare Beneficiary Plus (SLMB+) Program: Covers Part B premiums and provides full Medicaid benefits, with limited assistance from state Medicaid agencies for cost-shares.

Is the Medicare Savings Program the same as Medicaid? Both Medicare and Medicaid provide health insurance coverage, but Medicaid is partially funded by the state and available to low-income individuals of all ages. Get the full breakdown in our expert guide to Medicaid.

How to Qualify for Medicare Savings Programs

Medicare Savings Program eligibility depends on income and assets like property, retirement accounts, and other investments. The table below lists the federal requirements:

Medicare Savings Programs Monthly Income and Resource Limits by Policy Type

Some states don’t count certain types of income. Even if you earn more than what’s listed above, you could still qualify for savings depending on where you live. Compare health insurance plans and don’t hesitate to apply for savings anyway.

How to Apply for Medicare Savings Programs

Who qualifies for the Medicare savings program? Since MSPs are managed by state Medicaid programs, contact your local Medicaid office to apply. You can find the office nearest you at Medicaid.gov.

Follow these steps to prepare your application:

• Confirm Eligibility: Review the MSP income and resource limits.
• Complete Application: Get the application online or in person at the local office. Provide Social Security numbers, proof of residency, and proof of income.
• Submit Application: Submit the application online or in person. You may be required to scan or mail copies of your personal documents.

Follow up with the Medicaid office to ensure your application is being processed. Once approved, you will receive notification of your benefits, usually within 45 days. 

How to Save Money on Medicare

What are Medicare Savings Programs? MSPs are essential for managing healthcare costs, especially for those with limited income and resources. 

These state-funded programs pay for premiums, deductibles, coinsurance, and copayments. The three main types of Medicare Savings Programs are:

• Qualified Medicare Beneficiary (QMB)
• Specified Low-Income Medicare Beneficiary (SLMB)
• Qualifying Individual (QI)

Additionally, the Qualified Disabled Working Individual (QDWI) program supports disabled individuals with their Part A premiums. Exploring health insurance guides and savings programs online can also help you get cheaper healthcare.

To apply for MSPs, contact your local Medicaid office. The process involves confirming eligibility, gathering necessary documents, and submitting an application online or in person.

Call (855) 634-0435 to speak with a licensed insurance agent and compare Medicare plans near you.