Medicare Savings Programs (MSPs) offer financial assistance to individuals enrolled in Medicare or those who will soon be eligible. These programs help cover the high costs of healthcare, including deductibles, coinsurance, and other expenses not typically covered by Medicare. This blog post provides an overview of MSPs, eligibility criteria, and application process.
What is the Medicare Savings Program?
The Medicare Savings Program assists eligible Medicare recipients in paying for premiums associated with Medicare Part A and Part B. In addition to premium coverage, qualified individuals may receive assistance with coinsurance and copayments. Applying for MSPs is recommended for everyone, even if they believe they may not qualify.
The Seven Types of Medicare Savings Programs:
- Qualified Medicare Beneficiary (QMB) Program:
- Full coverage of Medicare Part B premiums
- Coverage of Medicare Part A premiums if eligibility requirements are met
- Protection from cost-sharing expenses such as deductibles, copays, and coinsurance
- Automatic eligibility for Extra Help program for prescription drugs
- QMB Plus (QMB+):
- Full Medicaid benefits along with the cost-sharing coverage provided by QMB programs
- Specified Low-Income Medicare Beneficiary (SLMB) Program:
- Payment of Medicare Part B premiums
- Automatic eligibility for Extra Help program
- Protection from cost-sharing expenses based on state regulations
- SLMB Plus (SLMB+):
- Payment of Medicare Part B premiums
- Full Medicaid benefits
- Cost-sharing protection varies by state
- Qualifying Individual (QI) Program:
- Payment of Medicare Part B premiums
- Qualification possible with a higher income
- Automatic eligibility for Extra Help program
- Qualified Disabled and Working Individual (QDWI) Program:
- Coverage of monthly Medicare Part A premiums for individuals with disabilities under 65 who are currently working
- Full Benefit Dual-Eligible (FBDE):
- Eligibility for both Medicare and full Medicaid benefits
- Potential for similar full cost-sharing protection as QMB+
Income and Resource Limits: Income and resource limits determine eligibility for MSPs. For monthly income and resource limits in 2023, refer to the following charts:
2023 Monthly Income Limits for Medicare Savings Programs:
| 2023 Monthly Income Limits for Medicare Savings Programs | ||
| Medicare Savings Program | Monthly Income Limits for Individual | Monthly Income Limits for Married Couple |
| QMB | $1,235 | $1,663 |
| SLMB | $1,478 | $1,992 |
| QI | $1,660 | $2,239 |
| QDWI | $4,945 | $6,659 |
Countable Resources for Medicare Savings Programs – Countable resources include money in checking or savings accounts, stocks, and bonds. Certain assets, such as your home, one car, burial plot, up to $1,500 for burial expenses, and personal belongings, are not considered countable resources. Refer to the chart below for the 2023 resource limits:
2023 Resource Limits for Medicare Savings Programs:
| 2023 Resource Limits for Medicare Savings Programs | ||
| Medicare Savings Program | Resource Limits for Individual | Resource Limits for Married Couple |
| QMB | $9,090 | $13,630 |
| SLMB | $9,090 | $13,630 |
| QI | $9,090 | $13,630 |
| QDWI | $4,000 | $6,000 |
How to Apply for a Medicare Savings Program: MSPs are administered by each state. To apply in Virginia, contact the State of Virginia Common Help. Even if your income and/or resources exceed the limits, it is recommended to submit an application as the limits may change annually. Prepare the necessary documentation, including recent bank statements, to support your application.
Renewing Your Medicare Savings Program: If approved for an MSP, you must renew (recertify) your enrollment yearly. You should receive a renewal notice by mail. If not, contact your local Medicaid office for guidance on continuing to receive benefits in the following year.
Difference between Medicare Savings Program and Medicaid: While MSPs are funded and administered by Medicaid, they specifically assist with Medicare-related expenses. MSPs help cover out-of-pocket costs like coinsurance, deductibles, and premiums associated with Medicare.
Additional Medicare Coverage with Medicare Savings Program: If eligible for an MSP and Extra Help, you can save more on Medicare expenses.
Medicare Savings Programs offer valuable financial assistance to Medicare beneficiaries. By understanding the eligibility criteria and application process, you can access the support you need to manage healthcare expenses.