Medicare Savings Programs

You can get help from your state paying your Medicare premiums. In some cases, Medicare Savings Programs may also pay 

 and 

 deductibles, coinsurance, and copayments if you meet certain conditions. These conditions are listed below under "How do I apply for Medicare Savings Programs?"

4 kinds of Medicare Savings Programs

If you have income from working, you may qualify for these 4 programs even if your income is higher than the income limits listed below.

Qualified Medicare Beneficiary (QMB) Program

QMB income & resource limits in 2019:

Individual monthly income limit*

$1,061

Married couple monthly income limit*

$1,430

Individual resource limit

$7,730

Married couple resource limit

$11,600

Program helps pay for:

• Part A premiums
• Part B premiums
• Deductibles, coinsurance, and copayments

Note

Medicare providers aren’t allowed to bill you for services and items Medicare covers, including deductibles, coinsurance, and copayments, except outpatient prescription drugs. Pharmacists may charge you up to a limited amount (no more than $3.80 in 2019) for prescription drugs covered by Medicare Part D.

To make sure your provider knows you're in the QMB program, show both your Medicare and Medicaid or QMB card each time you get care. If you get a bill for medical care Medicare covers, call your provider or plan about the charges. Tell them that you're in the QMB program and can’t be charged for Medicare deductibles, coinsurance and copayments. If this doesn’t resolve the billing problem,

call us at 1-800-MEDICARE (1-800-633-4227).

 

Specified Low-Income Medicare Beneficiary (SLMB) Program

SLMB income & resource limits in 2019:

Individual monthly income limit*

$1,269

Married couple monthly income limit*

$1,711

Individual resource limit

$7,730

Married couple resource limit

$11,600

Program helps pay for:

Part B premiums only

Qualifying Individual (QI) Program

You must apply every year for QI 

Benefits [Glossary]

. QI applications are granted on a first-come, first-served basis, with priority given to people who got QI benefits the previous year. (You can't get QI benefits if you qualify for Medicaid).

QI income & resource limits in 2019:

Individual monthly income limit*

$1,426

Married couple monthly income limit*

$1,923

Individual resource limit

$7,730

Married couple resource limit

$11,600

Program helps pay for:

Part B premiums only

Qualified Disabled and Working Individuals (QDWI) Program

The QDWI program helps pay the Part A premium. You may qualify if any of these apply to you:

• You're a working disabled person under 65
• You lost your premium-free Part A when you went back to work
• You aren't getting medical assistance from your state
• You meet the income and resource limits required by your state

QDWI income & resource limits in 2019:

Individual monthly income limit*

$4,249

Married couple monthly income limit

$5,722

Individual resource limit

$4,000

Married couple resource limit

$6,000

Program helps pay for:

Part A premiums only

If you qualify for the QMB program, SLMB, or QI program, you automatically qualify to get Extra Help paying for Medicare prescription drug coverage.

What items are included in the Medicare Savings Program resource limits?

How do I apply for Medicare Savings Programs?

If you answer yes to these 3 questions, call your State Medicaid Program to see if you qualify for a Medicare Savings Program in your state:

1. Do you have, or are you eligible for, Part A?
2. Is your income for 2019 at, or below, the income limits above?
3. Do you have limited resources, below the limits above?

It's important to call or fill out an application if you think you could qualify for savings—even if your income or resources are higher than the amounts listed here.

How can I keep my costs down?

• Make sure your Medicare card [JPG]  is valid and that you've paid your Part B premium.
• Go to a doctor, other health care provider, or Supplier that accepts Assignment .
• Read about how to get help with medical and prescription drug costs.