Medicare beneficiaries who have a limited income may be eligible for help paying for some healthcare costs. That’s where a Medicare agent can provide some insight into understanding the Medicare savings program. This can be a great resource for individuals who qualify. The Medicare Savings Programs (MSPs) are state-run programs that help pay Medicare premiums, deductibles, copays, and coinsurance, depending on the individual’s financial situation.
There are four main MSP categories, each with slightly different income and resource limits; each provides a different level of help. We will break them down to provide a better understanding of each level.
QMB (Qualified Medicare Beneficiary)
QMB provides the most comprehensive benefits. It helps pay for:
- Medicare Part A premiums (if applicable)
- Medicare Part B premiums
- Medicare deductibles
- Medicare coinsurance and copays
- Help paying for prescription drugs (beneficiaries pay no more than $12.15 for each prescription covered by their Medicare drug plan).
If an individual qualifies at the QMB level, doctors and medical providers do not bill them for services covered by Medicare; except in very limited situations.
2025 QMB income and resource limits:
- Individual: monthly income limit $1,325; resource limit $9,660
- Married couple: monthly income limit $1,783; resource limit $14,470
(Limits vary by state)
What counts in resource limits: Money in checking, savings and retirement accounts, stocks and bonds. States do not count: Your home, furnishings, household and personal items, one car, burial plots, up to $1,500 for burial expenses if that money is put aside.
SLMB (Specified Low-Income Medicare Beneficiary)
The SLMB Program is more limited than the QMB Program but still provides assistance. The only premium it helps pay for is the Medicare Part B premium (beneficiaries must have both Part A & Part B to qualify for the program).
The program also provides help paying for prescription drugs. Individuals pay no more than $12.15 for any drug covered by their Medicare drug plan.
This program is useful for people with limited income slightly above the QMB threshold.
2025 Income and resource limits:
- Individual: monthly income of $1,585 with a resource limit of $9,660.
- Married couple: monthly income of $2,135 with a resource limit of $14,470.
QI (Qualifying Individual)
The QI Program also helps pay the Medicare Part B premium, just like the SLMB program, but with slightly higher income limits. QI beneficiaries also receive extra help paying for their prescription drugs and pay no more than $12.15 in 2025 for any drug covered on their Medicare plan. The QI benefit is provided on a first come, first served basis, and individuals must apply every year to continue receiving benefits.
Important: Individuals who are eligible for Medicaid do not qualify for QI program.
2025 Income and resource limits:
- Individual: monthly income limit of $1,781 with resource limits of $9,660 (the same as QMB & SLMB).
- Married couple: monthly income limit of $2,400 with resource limits of $14,470 (the same as QMB & SLMB).
QDWI (Qualified Disabled and Working Individuals)
The QDWI Program is specifically for individuals under age 65 who are disabled but have returned to work and lost their Social Security disability benefits and premium-free Medicare Part A.
QDWI helps pay the Medicare Part A premium for these individuals.
2025 Income and resource limits:
- Individual: monthly income limit of $5,302 with resource limits of $4,000.
- Married couple: monthly income limit of $7,135 with resource limits of $6,000.
Please note: Income limits vary by states. The amounts listed in this post are federal limits. Individuals with slightly higher incomes may still qualify in their states. Check your state to find out.
Apply for MSP (Medicare Savings Program)
Because MSPs are administered by each state’s Medicaid office; the application process varies by state. In general, individuals will need to provide:
- Proof of income (such as Social Security or pension statements)
- Information about assets (like savings, investments, etc.)
- Medicare card and ID
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Medicare Savings Programs can make a huge difference in the lives of people within the income limits. They provide assistance for important medical services that are essential for quality of life. It is free to apply, and the potential savings can be substantial.
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