See if you're eligible for a Medicare Savings Program

How Does the Medicare Savings Program Work?

If you are enrolled or eligible for Medicare and have low-income, you may be eligible to enroll in a Medicare Savings Program (MSP), which can help you cover out-of-pocket expenses like premiums, coinsurance, copayments, and deductibles. The four programs available are:

H1: Qualified Medicare Beneficiary (QMB) Program

The QMB Program helps pay the Medicare Part A and B premiums, as well as coinsurance, copayments, and deductibles. If you qualify for this program, you will also become eligible for the Extra Help Program, a program that covers prescription drug costs.

H2: Specified Low-Income Medicare Beneficiary (SLMB) Program

If you earn a little more than the maximum income requirement for the QMB program, you may be eligible for the SLMB program. This program specifically helps pay the Part B premium and nothing else because it allows the beneficiary to have a higher income. If you qualify for this program, you will also be eligible for the Extra Help Program.

H3: Qualifying Individual (QI) Program

If you do not qualify for the QMB and SLMB Programs, you may qualify for the QI Program, which pays for the Part B premiums. It also automatically qualifies you for the Extra Help Program. However, with the QI Program, you must reapply every year as its benefits are on a first-come, first-served basis.

If you happen to qualify for Medicaid, you cannot receive benefits from the QI Program.

H4: Qualified Disabled and Working Individuals (QDWI) Program

The QDWI Program only pays for Medicare Part A premiums. There are several ways in which you can qualify for this program, all of which include:

  • Returning to work but losing your premium-free Part A coverage.
  • Being under 65, disabled, and working.
  • Not receiving state medical assistance.
  • Meeting the income and resource requirements that are listed within your state.

H5: Do I qualify?

To qualify for one of the MSPs, you must be enrolled or eligible for Medicare Part A with income and resources set below a certain amount. The resources refer to bank accounts, such as checking or savings, stocks, bonds, IRAs, or mutual funds. 

MSPs are run by state Medicaid programs, meaning that their calculations for incomes and assets vary. This means you may qualify even if your income and resources are more than the limit. To ensure that you are eligible for an MSP, contact the Medicaid office within your state.

To learn more about your Medicare options, call Barnhart Insurance Group today! Our direct line is 586-506-0340.