Applying to Medicare Savings Programs (MSPs) can significantly affect your healthcare costs. These programs are designed to help those with limited income and resources by paying for some expenses that Medicare doesn’t cover. Whether you’re just turning 65 or you’ve been on Medicare for a while, it’s worth looking into these programs to see if you qualify. This article will walk you through Medicare Savings Programs, who qualifies, and how to apply.



What Are Medicare Savings Programs?

Medicare Savings Programs are state-run programs that help pay for Medicare premiums, deductibles, co-insurance, and co-payments. If you qualify for an MSP, you will also get Extra Help, a Medicare program for people with limited income and resources that helps lower Medicare drug plan costs, such as premiums, deductibles, and co-insurance. Learn more about Medicare Savings Programs on Medicare.gov.

There are four types of MSPs:

  • Qualified Medicare Beneficiary (QMB) Program: This program helps pay for Part A and Part B premiums and may also cover deductibles, co-insurance, and co-payments.
  • Specified Low-Income Medicare Beneficiary (SLMB) Program: The SLMB program pays for Part B premiums for individuals with slightly higher incomes than those who qualify for QMB.
  • Qualifying Individual (QI) Program: This program also covers Part B premiums but is available on a first-come, first-served basis.
  • Qualified Disabled and Working Individuals (QDWI) Program: This program helps pay for Part A premiums for certain disabled individuals who have returned to work.

Who Is Eligible?

Eligibility for these programs is based on income and resource limits that are set by each state. Generally, to qualify, you need to have a limited income and few resources, such as savings, investments, or property (other than the home you live in). The income limits vary by state and change each year, so it's essential to check the current limits for your state.

Here’s a general idea of the income and resource limits for 2024:

  • Income: Typically, your monthly income needs to be at or below 135% of the Federal Poverty Level (FPL), but this can vary depending on the program.
  • Resources: Resources usually include savings, stocks, and bonds, and there are limits on how much you can have. For example, in 2024, the resource limit for QMB, SLMB, and QI is $9,560 for an individual and $14,340 for a couple.

Keep in mind that not all income or resources count towards these limits, so it’s crucial to get an accurate assessment. You can check specific eligibility requirements at your state Medicaid office.



How to Apply

Applying for an MSP is a straightforward process, but it does require some preparation. Here’s a step-by-step guide:

  • Check Your Eligibility: Before applying, verify if you meet your state’s income and resource requirements. You can find this information on your state's Medicaid website or by contacting your local Medicaid office.
  • Gather Necessary Documents: You’ll need to provide documentation, such as proof of income (like Social Security benefits or pension statements), proof of resources (like bank statements), and proof of identity (like a birth certificate or driver’s license).
  • Complete the Application: The application process varies by state, but you can typically apply online, by mail, or in person at your local Medicaid office. Some states may require you to fill out a paper application, while others have an online system.
  • Submit Your Application: After completing your application, submit it along with all required documents. Make sure to keep a copy of everything for your records.
  • Follow Up: After submitting your application, follow up with your Medicaid office to ensure they received everything and to check the status of your application. This is also a good time to ask any questions you might have.





What Happens Next?

Once your application is approved, you’ll start receiving assistance with your Medicare costs. The benefits will vary depending on which program you qualify for, but in most cases, you’ll notice a reduction in your Medicare premiums and other out-of-pocket costs.

If your application is denied, don’t give up. You may be able to appeal the decision or find other programs that can assist with your healthcare costs. Find more details on how Extra Help with Medicare prescription costs works.