September 26, 2014
As a Medicare beneficiary, you may qualify for the Medicare Savings Program (MSP). The MSP, which is administered by each state's Medicaid department, is designed to help with your out-of-pocket Medicare costs. At the very least, if you qualify for the program, you will receive 100% coverage for your Medicare Part B premium. Other MSPs will help cover Medicare-related expenses such as your Medicare deductible, coinsurance, and copayments.
You must meet these conditions to qualify for the Medicare Savings Program:
- Be eligible or enrolled in Medicare Part A (hospital insurance).
- Have an income at or near the federal poverty level.
- Meet the maximum asset requirement.
Since Medicaid is operated separately in each state, your requirements may differ depending on your state of residence. Below are the very least of qualifications you need to meet to be accepted. Even if you don't think you meet these minimal requirements, check your state's MSP website to see if the qualification criteria are different in your state of residence.
What types of Medicare Savings Programs are available?
There are four different Medicare Savings Programs. Three of the programs are designed to help those who receive Social Security benefits keep a greater amount of their monthly check. Instead of the Social Security Administration deducting your Medicare Part B premium from your benefit check, your state Medicaid department will pay the premium for you.
Here are the four Medicare Savings Programs and an overview of the benefits they offer:
- Qualified Medicare Beneficiary (QMB): Covers the Medicare Part A and Medicare Part B premiums, deductibles, coinsurance, and copayments.
- Specified Low-Income Medicare Beneficiary (SLMB): Only covers the Medicare Part B premium. The SLMB program has higher maximum income requirements than QMB.
- Qualified Individual (QI): Covers the Medicare Part B premium, with maximum income requirements that are even higher than SLMB. Individuals who qualify for Medicaid cannot receive QI benefits.
- Qualified Disabled and Working Individuals (QDWI): Only covers the Medicare Part A premium, but has the highest qualifying income maximum. This Medicare Savings Program is for people
under 65 who are eligible for Medicare disability benefits, but lost their Medicare Part A benefits because they went back to work. These individuals cannot be receiving medical assistance from their state.
What are the income maximums?
To qualify for any of the four Medicare Savings Programs, your income must remain below certain limits. Here are each program's maximum monthly incomes for 2015:
- QMB: $993 for individuals and $1,331 for married couples
- SLMB: $1,187 for individuals and $1,593 for married couples
- QI: $1,333 for individuals and $1,790 for married couples
- QDWI: $3,975 for individuals and $5,329 for married couples
Remember to check your state's MSP website to see if your qualification criteria are different.
What are the asset maximums?
In 2015, the asset maximum is $7,160 for individuals and $10,750 for married couples for the QMB, SLMB, and QI Medicare Savings Programs. The asset maximum for the QDWI program is $4,000 for individuals and $6,000 for married couples. These maximum figures include checking account balances, stocks, and bonds, but they do not include the value of other assets like your home, furniture and household goods, burial plots, and one car. You may deduct a $1,500 allowance per individual for burial expenses.
Please note that amounts for income and asset limits may change each year. These limits may also vary by state, so be sure to check with your Medicaid office to get state-specific requirements.
How to apply for the Medicare Savings Program
To apply for the Medicare Savings Program, or to see if you qualify, call your state Medicaid program and visit www.medicare.gov/contacts .
Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies approved by Medicare and provide Medicare Part A and Part B coverage. Medicare prescription drug coverage is insurance run by an insurance company or other private company approved by Medicare. A Medicare Supplement plan is a health insurance plan provided by a private company that fills in the "gaps" in original Medicare coverage.
Medicare has neither reviewed nor endorsed this information.