Are you enrolled in Medicare or soon-to-be Medicare eligible? If you’re also on a fixed income, you could qualify for financial assistance with the high cost of health care. A Medicare Savings Program (MSP) can help pay deductibles, coinsurance, and other expenses that Medicare usually doesn’t cover.
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We’re here to help you understand the types of Medicare Savings Programs. Below, we explain who is eligible for these programs and how to get the assistance you need to pay for your Medicare.
What is a Medicare Savings Program?
The Medicare Savings Program helps eligible Medicare recipients receive help from their state to pay the premiums for Medicare Part A and Part B. In addition to premiums, those who qualify may receive assistance with their coinsurance and copayments.
There are seven Medicare Savings Programs, and while applying, your state will determine which program(s) you are eligible for. Everyone is encouraged to apply, even if you do not believe that you might qualify for the programs.
The Seven Types of Medicare Savings Programs
Because different needs and circumstances can affect seniors, seven Medicare Savings Programs are available to help cover such scenarios.
- Qualified Medicare Beneficiary (QMB) Programs pay most out-of-pocket costs for Medicare, protecting beneficiaries from cost-sharing. These programs offer full coverage of Medicare Part B premiums. Your Medicare Part A premium will also receive coverage if you haven’t worked 40 quarters. Deductibles, copays, and coinsurance receive coverage contingent on the state in which the beneficiary resides. Those who qualify for the QMB income limits in 2022 are also automatically eligible for the Extra Help program for prescription drugs.
- QMB Plus (QMB+) refers to those who receive full Medicaid benefits and all the cost-sharing coverage QMB programs offer.
- Specified Low-Income Medicare Beneficiary (SLMB) Programs pay your Part B premium. Like QMBs, those who qualify as SLMBs are automatically eligible for Extra Help.
- SLMB Plus (SLMB+) eligibility entitles beneficiaries to pay their Medicare Part B premiums plus full Medicaid benefits. Protection for cost-sharing varies by state.
- Qualifying Individual (QI) Programs are also known as Additional Low-Income Medicare Beneficiary (ALMB) Programs. Like the SLMB programs, they offer Medicare Part B premium payment. Yet, you can qualify with a higher income. Those who qualify are also automatically eligible for Extra Help.
- Qualified Disabled and Working Individual (QDWI) Programs cover monthly Medicare Part A premiums for qualified individuals under 65 with disabilities who are currently working.
- Full Benefit Dual-Eligible (FBDE) refers to those eligible for Medicare and full Medicaid benefits. Depending on the state where they live, beneficiaries can receive up to the same full cost-sharing protection as with QMB+.
State-Specific Name Conventions for Medicare Savings Programs
If you live in any of the following states, please note the differences in program names:
- Alaska: QI is called SLMB Plus
- Connecticut: QI is called ALMB
- Maryland: QI is called SLMB II
- North Carolina: QMB, SLMB, and QI are called MQB, MQB-B, and MQB-E, respectively
- Nebraska: Federal QMB is replaced with full Medicaid; SLMB and QI are both referred to as QMB
- Oregon: SLMB and QI are called SMB and SMF, respectively
- Wisconsin: QI is called SLMB Plus
What Is the Income Limit for the Medicare Savings Program?
The income limit for your MSP in 2022 will vary based on the program you use and your marital status. So, who qualifies for Medicare Savings Program? To qualify for an MSP, you must be eligible for Medicare Part A. For those who don’t qualify for full Medicaid benefits, your monthly income must also be below the limits in the following chart.
| 2022 Monthly Income Limits for Medicare Savings Programs | ||
| Medicare Savings Program | Monthly Income Limits for Individual | Monthly Income Limits for Married Couple |
| QMB | $1,153 | $1,546 |
| SLMB | $1,379 | $1,851 |
| QI | $1,549 | $2,080 |
| QDWI | $4,249 | $5,722 |
| *Please note: the above income limits are subject to change in 2023 | ||
In addition to the income limits, you must have limited resources to qualify for an MSP.
What Are Countable Resources for Medicare Savings Programs?
Countable resources are monies in checking or savings accounts, stocks, and bonds included in your Medicare Savings Program resource limits. For seniors to qualify for the MSPs above, the dollar value of your countable resources must be below the limit for the type of assistance you’re looking to receive. See the chart below for the limit for each program.
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| 2022 Resource Limits for Medicare Savings Programs | ||
| Medicare Savings Program | Resource Limits for Individual | Resource Limits for Married Couple |
| QMB | $8,400 | $12,600 |
| SLMB | $8,400 | $12,600 |
| QI | $8,400 | $12,600 |
| QDWI | $4,000 | $6,000 |
| *Please note: the above income limits are subject to change in 2023 | ||
Countable resources mean any money in bank accounts (checking or savings), stocks, and bonds. Your home, one car, a burial plot, up to $1,500 already saved for burial expenses, and personal belongings aren’t included when countable resources are considered.
How to Apply for a Medicare Savings Program
Visit Medicare.gov or call your local Medicaid office to determine if you’re eligible for an MSP in your state. You can also call 1-800-MEDICARE to ask about financial assistance with your Medicare premiums. They can also provide you with the phone number for the Medicaid office in your state, and you can determine whether you’re dual-eligible.
If your income and/or resources exceed those listed above, but you think you could still qualify, filling out an application is recommended. The limits are subject to increase each year.
When applying for an MSP, you’ll need documentation. The list of what’s required varies by state, but you’ll want to make sure to furnish recent bank statements to substantiate your need for the program. Be sure to speak with a Medicare agent or fill out one of our online rate forms to apply for your coverage.
How To Renew Medicare Savings Program
Seniors approved for a Medicare Savings Program must renew (recertify) yearly. You should receive a notice through the mail when it is time to renew your MSP. If you do not, contacting your local Medicaid office and following the process they lay out will be your course of action to continue receiving benefits the following year.
Is Medicare Savings Program the Same as Medicaid?
While MSPs are administered by and use the same funding as Medicaid, they are programs for covering Medicare expenses. Your Medicare Savings Program can help you cover a range of out-of-pocket Medicare expenses, including your coinsurance, deductibles, or premiums.
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How to Get Additional Medicare Coverage with Your Medicare Savings Program
If you qualify for a Medicare Savings Program and/or Extra Help, you can save money on your out-of-pocket Medicare costs. To save even more, you can add supplemental coverage to your Medicare.
Pairing a Medicare Advantage plan with your MSP is an excellent way to protect yourself from high medical bills because of a chronic condition, unexpected illness, or accident. This can also give you additional benefits for an affordable price.
Also, those that qualify for a Medicare Savings Program may not be subject to a Medicare Part D or Part B penalty. Although, this depends on your level of Extra Help and the state in which you reside.
Call the number above today to get rate quotes for your area and explore coverage options that fit with your Medicare Savings Program. You can also fill out our compare rates form, and an agent will contact you with premium rate quotes from top carriers in your area.
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Hi medicarefaq.com administrator, Your posts are always well-written and easy to understand.
What are the qualifications to be designated as FBDE
Hi Tommie,
To be qualified as FBDE, you must meet the income requirements set by your state to enroll in Medicaid, but you do not meet the federal income limits to qualify for QMB or SLMB.
my wife and i are on medicare and Medicaid and have the QMB program with the state of Illinois with the cola raise is a joke as every thing has gone to the moon cost of living i am 70 and my wife is 67 when she got on QMB when she turned 65 we where a little over the income limit and the case worker was able to adjust it so we both stayed qualified for 2022 are social security together will be 1572 we are worried we will get knocked off QMB we told them we would get a divorce to stay qualified and to they pay for are part B this has been very helpful as my wife has COPD and i have had 8 bladder surgery’s since 2018 for non aggressive cancer i am working with are local federal legislatorsc congress woman to give 2022 QMB a better income raise for 2022 as we see the income limit for single person is better and for sure we would stay qualified , you is really responsible for raising the income limits federal or state or is it both of them ! us married seniors get a screw job just like on taxes ! are rent is going up January 2022 will this also help us on QMB
Phil, we understand your frustrations. Unfortunately the QMB amounts for 2022 have not been released yet by CMS. As soon as this information is available we will be updating this article.
I am now 67 years of age. In 2021 my SSA Retirement was $1,008 and I have QMB.
On Jan 03, 2022 my SSA Retirement will be $1,067.
On I don’t remember which website I so, that in 2022 earnings limit will be $1,060 (in 2021 it was $1,084). Is it possible? That income limit will be less with this inflation and rising prices on EVERYTHING? Is it possible that over $7 I will lose QMB?
Yefim, as of today, Medicare has not released their 2022 income limits for the Medicare Savings programs. It is possible that $7 could push you over the limit, however, your best option may be getting in contact with your state Medicare and medicaid offices.
hi Jagger,
Do you know when the new income/asset limits are expected to be released by CMS. Do you know when they were released last year?
Thanks.
Alex
Al, at this time the income limits have not been released by Medicare. We are checking back each day and will have this updated as soon as we receive the information.
i have humana advantage and medicaid in ga. 1,186.00 is ss ck monthly review is in april will i loose qmb
Diane, the best way to be sure is to contact your local Medicaid office. They will have the most accurate information as this is decided on a state by state basis.
Thank you for providing information. I rejected auto enroll in Medicare part B, by return mailing my card before coverage commenced – but by social security account shows a scheduled part B premium deduction (SS deduction scheduled in the month before coverage begins)- will Social Security refund the deduction? Also, may I change and enroll in part B within 3 months following my 65th birthday if I initially rejected part B?
Charles, it’s best to contact your local Social Security office to ensure they received the card you mailed back to them rejecting Part B enrollment. If you wish to enroll in Part B three months following your 65th birthday, you can do so as you are still within your initial enrollment period. However, if you do not enroll during your IEP, you must provide proof of credible coverage to avoid any penalties when enrolling in the future.
Hi Lindsay Thank you for the transparent information. I live in PR and before deductibles receive 1,190 after I’m charged
Medicare Part B it’s 1042. I signed up for Medicaid a few months ago and I was told it would cover Part B but my checks are still deducted. Is it because I receive too much before deductibles? I’m agoraphobic so it’s hard for me to leave my house to go to the post office to get mail on this or to talk to someone in person. Unfortunately since I moved here a year ago I haven’t been able to find any kind of social worker and would be grateful for any help! I want to call my insurance company but I’m not trying to have anything go wrong with what I’m already getting. Customer service and bureaucracy is difficult here. Thank you!
Do you know which Medicare Savings Program you enrolled in?
Very useful information given in a very clear and simple method .
Thank you .
Thank you for the positive feedback!
I have applied for PAAD and EXTRA help. Two months passed no reply. I would like to apply for MSP also. How can you help me.
Hi Santosh – you should contact your local Medicaid office to see if you are eligible for an MSP in your state.
I’m 75, I live in Illinois, I retired 2 months ago. I have Medicare part A, part B and Cigna Supplement insurance as Part G. Presently I’m applying for QMB Medicare Saving Program.
Will QMB Medicare program work as Cigna supplement insurance covering medical expenses? Can I cancel Cigna because it costs me more than $170 a month? Thanks
Hi Alex! Yes, you can cancel your Medicare Supplement Plan G since you have QMB. Don’t forget to apply for Extra Help since you will be automatically eligible.
Hi, I’m confused and can’t seem to get a straight answer from our local medicaid office. My husband is on Medicare, I am not because I am not eligible for a few more years. But he qualifies for the MSP. The question is which one. Does he fall into the category for an “individual” or for “married couple”? Do I also have to be on Medicare for him to qualify for the income for “married couple” or is he considered “individual” because I’m not on Medicare? I have researched and asked time and time again, and nobody can tell me, but they still put him in the SLMB bracket when I believe as a married couple, he qualifies for the QMB. Also, I don’t see where it specifically states the spouse has to be on Medicare also. Please help. Thanks!!
Hi Kim! The income category will be based on how you file your taxes. If you file jointly, then it will fall into the married couple category. I hope this helps!
I am having this same exact issue. My husband is 31 and I am 33. He collects SSDI because he is paralyzed. I am unable to work because I care for him 24/7. We filed our taxes as married jointly. With the social security increase in January, it is now putting my husband over the limit for the QMB program as an individual. If he is considered married then he is safe. I just don’t understand which category he falls into. This is so confusing.
Laiken, If you are filing jointly, he should fall in the Married category, however, it’s always best to reach out to your state Medicaid and Medicare offices to confirm.
Hi Lindsay and thanks for this site! I live in Virginia and have full Medicaid since 1/2019 and am now considering enrolling in Medicare too because I turned 65 last February. Seems I missed the initial enrollment period and might have to pay a penalty on Part B premiums? I am low-income, self-employed and have yet to receive my first SSA retirement check. Which Medicare Plan would work best for someone in my situation? I think I might meet “Special Needs” Medicare Advantage criteria or possibly, a “Medicare Savings Program.” Do I even NEED Medicare if I already have Medicaid? If I enroll in both, am I “dual eligible?” So confusing! Thanks again.
Hi Rosy! Any penalties you incurred will be eliminated if you’re eligible for Medicaid and enroll in a Medicare Savings Program. If you qualify for QMB, then yes you should enroll in Medicare since all our costs will be covered by Medicaid. Being dual-eligible for Medicare & Medicaid & enrolling in both is a better combination than Medicare Advantage alone.
I’m curious about something: I qualify for and receive QMB on an SSDI income of $1440 in AZ – how is this possible being over 100% of the the poverty level?
Hi Jim! This question would be better for your local Medicaid office, but there could be a Medicaid expansion available in your state.
Hello, My mother receives SS of $987 per month and had been enrolled in QMB but it was recently denied. She has dementia which I’m not sure is counted as a disability. The rent at her facility is $2700. I pay a third from her account and my brother and I pay 2/3 directly to the facility. She has no other assets. But due to our contribution she was denied QMB but still somehow qualified for SLMB, with only approx $260 called supplementation and maintenance. I have been questioning this to understand but fear that if I question it too much they might deny her any MSP at all as long as we help her which isn’t always financially easy. I also can’t apply for any further benefits for her through Medicaid as long as any help we give to her is counted as income. If she later moves to a nursing home surely the amount we have had to pay to her current facility will no longer be ‘income’ as she will no longer live there, correct? So then she would qualify for Medicaid? I worry that if she needs hospital care that we will not be able to afford the co-pays or deductibles as she cannot qualify for QMB as long as we are currently helping her live where she does. Any advice much appreciated. Suzanne
Hi Suzanna! Medicaid income limits vary greatly from state to state. I great resource for you would be your local SHIP department. They can help answer all your above questions.
Hi I get $402 in SS and $490 in SSI and I am turning 65 in a couple of months. I am on Medicaid and they are switching me to Medicare. I also get food stamps. I am in NY. I read somewhere because I get SNAP benefits I automatically get enrolled in a MSP probably a QMB. Is that true?
Hi William! You are probably dual-eligible for both Medicare & Medicaid. I’m not sure if you will automatically be enrolled or not, that’s possible! I would reach out to your local SHIP department. They are a free resource in each state and work for Medicaid and Medicare and help individuals like yourself understand your options.
I’m wondering how income is counted for Medicare Savings Plans. I live in Wisconsin and receive 784 in SSDI. I currently receive QMB and I want to return to work. I will be making $10 per hour @ 15hrs a week. Can you tell me how income is calculated?
Hi Ross! Your income is calculated off of your tax return. The following income is not counted:
• The first $20 of your monthly income
• The first $65 of your monthly wages
• Half of your monthly wages after the $65 is deducted
So, your monthly income that would count towards a Medicare Savings Program would be somewhere around $1,032.
Do you know what 2022 income limits will be?
Hi Marsha! I don’t believe those numbers have been announced yet. We will update this page as soon as they are!
My in-laws are green card holders and have been permanent residents for 5+ years. They have never worked or earned income in the U.S. They reside with us, but their full support is from my wife and me. Will they qualify for the Special Savings programs?
Hi Mike! Yes, your in-laws do qualify for Medicare and may be eligible for a savings program. We have a detailed article on Medicare for Green Card Holders that provides more information for you.
Does the MSP program consider your monthly expenses (rent) when deciding on eligibility for MSP. I meet the monthly income requirements to be eligible, but I may be moving into my daughter’s home and will not be paying rent. Would I still be eligible?
Hi Karen! MSPs are state-specific, I would contact your local Medicaid office to see how the change in what you pay for rent will impact your eligibility.
Thank you for being the first person I found to truly explain this clearly. Unfortunately, my ‘countable’ income or assets puts me over as far as an msp. Watching one of your videos, looks like I’m between a rock and a hard place. I’ll be 65 in March. My choice? As a healthy individual, I either choose medigap and pay monthly premiums I cannot afford, hoping that one day I’ll be so sick I’ll be thankful, (although at death’s door), that my finances will be in good shape….OR pay nothing or little now for a medicare advantage plan and when I do get a little sick, I’ll be so poor from out of pocket expenses, trying to find doctors on the plan etc, that I’ll wish I was at death’s door. Am I close?
Sorry to sound so cynical, but I don’t see much real positives in any of these plans unless you’re pretty rich or pretty poor.
Hi Joe! Well, yes, you said it right. However, there are high-deductible Medigap plans you could consider. For those stuck in between a rock and a hard place, High Deductible Plan G may be your best option. The premium is significantly lower than the standard Plan G, and you still get all the benefits of a Medigap plan.
A broker named Chris enrolled me into the United Healthcare Dual Complete plan. He said that because my monthly income is above $1,000 I will have to pay the 20% Part A & B copays. I have a notice from Washington State DSHS informing me that the Medicare Savings Program will pay for my $144 Part B monthly premium. I have another notice about having Level 1 coverage to the Extra Help plan for Part D. A friend who is an insurance broker says that I shouldn’t have to pay the 20% copay/coinsurances because my only income which is Social Security annually is under $16,971. Who is correct? Chris or my broker friend? Chris also had me end my Medicaid (Washington Apple Health), however United Healthcare states I need to have my Medicaid reinstated. Which is correct?
Hi Michael. It sounds like you need to call Medicaid to get this sorted out. Each state is different, so your best option is to speak to your local Medicaid office. They will be able to give you a direct and honest answer. Unfortunately, it sounds like the broker you worked with may have been misinformed.
Just turning 65, I’ve been strapped with Medicare Parts A and B and the “premium” deduction to pay Part B now leaves me with basic living expenses (rent and utilities) at 124% of my monthly income. My local (New York) Medicaid office is telling me that I qualify for QMB because 2020 “Income Requirements” (100%FPL + $20) is $1084/month and my Social Security (only income) is, before Medicare Part B deduction, $1077. My “assets” (one vehicle) total $1900. I have had to file 2 applications, on the advice of the local Medicaid office, because NY State denies “timely receipt” of applications. I have no cause to doubt the efficiency of my local office. I am seriously considering dropping Part B entirely but have been advised against that. I don’t currently have medical expenses as I’ve been blessed with good health but have been advised that applying for Part B at a later date will result in heavy “penalties”. Any advice as to how best to proceed with this?
Hi Jude! Whoever advised you not to drop Part B due to being penalized is correct. If you drop Part B without having creditable coverage or qualify for a Special Election Period, you’ll be penalized 10% of the monthly premium per 12 months you went without coverage. So if you drop your Part B for 2 years, or 24 months, and choose to enroll again, you’ll have to pay 20% above the standard premium for as long as you have Part B. We just recorded a great video that goes over how the penalty works in depth. Once we update it, I’ll update this comment with the link to it. I hope this helps!
I get 917.00 in social security & work part time, 20 hours @ 12.20 an hour, can I still get Medicare help??
Hi John! Unfortunately, it sounds like your income is above the limit. However, some states calculate income differently. I would give your local Social Security office a call to see if you qualify where you live.
My only source of income is social security of $1427 per month. I have been a QI1 for years. Will I remain eligible for state payment of medicare premium in 2020? I have been disabled since 2005 with significant medical expenses.
Hi Grace! Thank you for your question. It is possible that you no longer will qualify for QI. However, Social Security does sometimes make exceptions in cases like this. They could very well make an exception for you. The only place to find the answer to this is through Social Security. I would recommend giving them a call.
Do the monthly income amounts account for any monthly expenses such as mortgage, cars, food, etc. to be deducted before looking at the income limit or is it the monthly income before any expenses are removed?
Hi Laura! It’s your monthly income before expenses that are used to determine eligibility.
So, I make $2 too much for QMB. I see about 7 or 8 different specialists. And I can’t afford this. I truly NEED QMB. What can I do to get this???
Hi Sam! I would recommend giving us a call, one of our agents may be able to help you with this.
C Stewart, It has nothing to do with who is on or why that person is on. It is simply based on what your total household income is and total assets. It has nothing to do with how you file your taxes. Your state will have access to all of that information regardless on how you file. Depending on your state you live in, there will be some wiggle room based on terminal illnesses and or disabling illnesses. In those cases you will need to get a qualified Dr to submit the proper paperwork with your state.
Good evening I will be 65 in January and I am receiving my social security benefits plus I have Medicaid..My monthly benefits are 1047..will I automatically qualify and be enrolled in a Medicare Savings Plan..I live in Illinois..Thank you
Hi Carol! The answer depends on the level of Medicaid. I would recommend reaching out to Social Security to verify the income level that you have is equivalent to what it has to be to get an MSP. It should happen automatically, however, we’ve seen it not sync up and the beneficiary has to apply manually. I hope this helps!
WHAT IF YOU ARE MARRIED AND THE HOUSEHOLD IS 2 BUT ONLY ONE IS ON MEDICARE DUE TO DISABILITY, TERMINAL CANCER.. WHICH INCOME LIMIT WILL BE USED FOR QI1 QUALIFICATION: ( INDIVIDUAL) 1406 OR (COUPLE) 1903? THANKS.
This depends on how you file your taxes… if you file as a married couple then both incomes would be used. I would call your local SHIP office, they can help you!
My husband and I are both disabled and both on Medicare, we also have a 4 year old but nothing on here shows income of a three income house, does this change?
Hi Patricia! If I’m understanding your question correctly… having a dependent does not change your eligibility. If you and your husband make less than $1,430 monthly combined, with or without a dependent, you will qualify for an MSP.