Medicare Savings Programs

Medicare Savings Programs are four state-administered assistance programs that use Medicaid funds to pay some or all of a Medicare enrollee's Part A and Part B premiums, deductibles, and coinsurance for people with limited income and modest savings. If your income is close to the federal poverty level, applying through your state Medicaid office is one of the most direct ways to lower your monthly Medicare costs. In most cases, qualifying for a Medicare Savings Program also qualifies you automatically for Extra Help with prescription drug costs.

This guide covers the four Medicare Savings Programs, who typically qualifies, how the programs connect to Extra Help, and how to apply.

There are four Medicare Savings Programs, and each one covers a different combination of Medicare costs:

• QMB (Qualified Medicare Beneficiary). Pays Part A and Part B premiums, deductibles, coinsurance, and copays. It is the most generous of the four programs.
• SLMB (Specified Low-Income Medicare Beneficiary). Pays the Part B premium only.
• QI (Qualifying Individual). Pays the Part B premium only. QI has limited annual funding and is awarded first come, first served each year.
• QDWI (Qualified Disabled and Working Individual). Pays the Part A premium for people with disabilities who are working and lost premium-free Part A.

For official program definitions, see Medicare.gov's Medicare Savings Programs page.

Income and asset limits for Medicare Savings Programs change every year and vary by state, so the figures below are general guidelines rather than exact cutoffs for your state.

• QMB generally requires income at or below 100% of the federal poverty level.
• SLMB generally allows income up to about 120% of the federal poverty level.
• QI generally allows income up to about 135% of the federal poverty level.

Most states also apply an asset test that counts resources such as cash, stocks, and bonds above a modest limit, though a few states have dropped the asset test. Some states set higher income limits or run additional state-funded savings programs beyond the four listed here. Because rules differ by state, it helps to understand how Medicare and Medicaid work together before you apply.

You may be a candidate for a Medicare Savings Program if your income is close to the federal poverty level, your savings are limited, and you are already enrolled in or eligible for Medicare Part A and/or Part B. Because the four programs test income and assets differently, you don't need to guess which one fits. Your state Medicaid office matches you to the right program based on your application and current household numbers.

If you qualify for any of the four Medicare Savings Programs, you automatically qualify for Extra Help (the Low-Income Subsidy), a separate program that lowers what you pay for Medicare Part D prescription drug coverage. That link matters. For someone with limited income, applying for a Medicare Savings Program is often the single biggest move available, since one application can lower Part B premiums, deductibles, and coinsurance while also cutting prescription drug costs through Extra Help. See the Social Security Administration's Extra Help program page for eligibility details, and read our guide on ways to reduce Medicare Part D costs for more on stacking these savings.

Medicare Savings Programs pay specific Medicare costs, mainly the Part B premium and, for QMB, deductibles and coinsurance. They don't pay Medicare Advantage or Medigap premiums, and they don't replace Extra Help for Part D costs, though qualifying for an MSP triggers Extra Help automatically. For a fuller picture of what you pay under Original Medicare versus Medicare Advantage, see our guide on real-world Medicare costs.