{"id":55232,"date":"2022-11-11T13:20:21","date_gmt":"2022-11-11T18:20:21","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=55232"},"modified":"2024-10-25T11:03:06","modified_gmt":"2024-10-25T15:03:06","slug":"medicare-savings-program","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/medicare-savings-program\/","title":{"rendered":"Medicare Savings Program"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Although Medicare reduces healthcare costs for many Americans, it is not free. Medicare Savings Programs (MSP) help offset the cost-share and premiums associated with Original Medicare. Qualifying beneficiaries can use this program to lower their Medicare cost-share to a manageable amount.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">We&#8217;ll discuss the different Medicare Savings Programs and how to apply for a Medicare Savings Program.<\/span><\/p>\n<h2 id=\"what-are-medicare-savings-programs\"><span style=\"font-weight: 400;\">What are Medicare Savings Programs?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">State and local governments administer Medicare Savings Programs, which help low-income Medicare beneficiaries by covering some or all of their out-of-pocket Medicare costs.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are several different programs based on your monthly income and assets. When you apply for a Medicare Savings Program, you&rsquo;ll be assigned to the appropriate program. Since this program is regulated at a state level, the eligibility requirements for medical assistance can vary. Like Medicaid, states have the option of being more generous with their programs, but all states have a minimum threshold they must meet.<\/span><\/p>\n<h2 id=\"4-types-of-medicare-savings-programs\"><span style=\"font-weight: 400;\">4 types of Medicare Savings Programs<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The four Medicare Savings Programs are:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Qualified Medicare Beneficiary (QMB)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Specified Low-Income Medicare Beneficiary (SLMB)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Qualified Individual (QI)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Qualified Disabled Working Individuals (QDWI)&nbsp;<\/span><\/li>\n<\/ul>\n<table class=\" singlecare-table\">\n<thead>\n<tr>\n<th>\n<h2 id=\"compare-medicare-savings-programs\"><span class=\"title\">Compare Medicare Savings Programs<\/span><\/h2>\n<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr class=\"header-row\">\n<td><b>Program<\/b><\/td>\n<td><b>Eligibility<\/b><\/td>\n<td><b>Benefits<\/b><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Qualified Medicare Beneficiary (QMB) Program<\/span><\/td>\n<td>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Eligible for Part A<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Under your state&rsquo;s federal monthly income limits<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">No assets or resources that exceed state-outlined limits<\/span><\/li>\n<\/ul>\n<\/td>\n<td>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Part B premium<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Part A &amp; B deductibles, copays, coinsurance, and excess charges<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Automatic qualification for Part D&rsquo;s Extra Help subsidy<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ongoing Part D Special Enrollment Period, allowing you to make plan changes quarterly<\/span><\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Specified Low-Income Medicare Beneficiary (SLMB) Program<\/span><\/td>\n<td>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Income\/assets are too high for the QMB program but not more than 20% above the federal poverty level<\/span><\/li>\n<\/ul>\n<\/td>\n<td>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Part B premium<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Automatic qualification for Part D&rsquo;s Extra Help subsidy<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ongoing Part D Special Enrollment Period, allowing you to make plan changes quarterly<\/span><\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Qualified Individual (QI) Program<\/span><\/td>\n<td>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Income is 20%-35% above the national poverty level<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">You do not qualify for Medicaid<\/span><\/li>\n<\/ul>\n<\/td>\n<td>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Part B premium<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Automatic qualification for Part D&rsquo;s Extra Help subsidy<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ongoing Part D Special Enrollment Period, allowing you to make plan changes quarterly<\/span><\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Qualified Disabled and Working Individuals (QDWI) Program<\/span><\/td>\n<td>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Working disabled people younger than 65<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Returned to work and lost premium-free Part A<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">No medical assistance from your state<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Meet your state&rsquo;s income and resource limits<\/span><\/li>\n<\/ul>\n<\/td>\n<td>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Part A premium<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ongoing Part D Special Enrollment Period, allowing you to make plan changes quarterly<\/span><\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3 id=\"qualified-medicare-beneficiary-qmb-program\"><span style=\"font-weight: 400;\">Qualified Medicare Beneficiary (QMB) Program<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The <\/span><a href=\"https:\/\/www.cms.gov\/Medicare-Medicaid-Coordination\/Medicare-and-Medicaid-Coordination\/Medicare-Medicaid-Coordination-Office\/QMB\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">QMB Program<\/span><\/a><span style=\"font-weight: 400;\"> is the MSP that provides the most benefits. Medicare beneficiaries with limited income may qualify. The QMB program may pay your Medicare Part B premiums and the other costs associated with Medicare, which includes Medicare Part A and Part B deductibles, copays, coinsurance, and excess charges.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The QMB program&#8217;s qualification rules may vary depending on your state, but the minimum requirements are standardized by the federal government.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To qualify, you must be eligible for Medicare Part A and be under your state&#8217;s federal monthly income limits. You cannot have assets or resources that exceed the outlined limits. Typically, your home, personal vehicle, and other personal items aren&#8217;t considered resources.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Some states do not have an asset test for Medicare Savings Programs. Check with your local Department of Social Services or Medicaid office to verify.<\/span><\/p>\n<h3 id=\"specified-low-income-medicare-beneficiary-slmb-program\"><span style=\"font-weight: 400;\">Specified Low-Income Medicare Beneficiary (SLMB) Program<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The <\/span><a href=\"https:\/\/www.benefits.gov\/benefit\/6178\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">SLMB program<\/span><\/a><span style=\"font-weight: 400;\"> is for Medicare beneficiaries whose income is too high for the QMB program but is not more than 20% above the federal poverty level. SLMB will only pay your Medicare Part B premium.<\/span><\/p>\n<h3 id=\"qualified-individual-qi-program\"><span style=\"font-weight: 400;\">Qualified Individual (QI) Program<\/span><\/h3>\n<p><a href=\"https:\/\/www.benefits.gov\/benefit\/6176\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">QI is for individuals<\/span><\/a><span style=\"font-weight: 400;\"> whose income is between 20% to 35% above the national poverty level. This program will still assist with your Medicare Part B premiums.&nbsp;<\/span><\/p>\n<h3 id=\"qualified-disabled-and-working-individuals-qdwi-program\"><span style=\"font-weight: 400;\">Qualified Disabled and Working Individuals (QDWI) Program<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The <\/span><a href=\"https:\/\/www.benefits.gov\/benefit\/6180\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">QDWI program<\/span><\/a><span style=\"font-weight: 400;\"> assists qualified beneficiaries with their Medicare Part A premiums only. To be eligible for QDWI, you must have the same qualifications as QI. In addition, you must also receive Social Security Disability, be disabled, and lose premium-free Part A because you returned to work. The income requirements are also higher than other MSP programs.<\/span><\/p>\n<h2 id=\"medicare-savings-program-advantages\"><span style=\"font-weight: 400;\">Medicare Savings Program advantages<\/span><\/h2>\n<h3 id=\"extra-help\"><span style=\"font-weight: 400;\">Extra Help<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">For all of the MSPs, except QDWI, you&#8217;ll automatically receive <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medicare-extra-help\/\"><span style=\"font-weight: 400;\">Extra Help<\/span><\/a><span style=\"font-weight: 400;\"> for prescriptions through Medicare Part D. This is provided through the Federal Low-Income Subsidy (LIS) program. Those who qualify will automatically be enrolled in the Extra Help drug assistance program. Your prescriptions must be on the <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medicare-formulary\/\"><span style=\"font-weight: 400;\">formulary<\/span><\/a><span style=\"font-weight: 400;\"> of your Medicare plan for Extra Help to assist with the costs of your medications.<\/span><\/p>\n<h3 id=\"ongoing-special-enrollment-period\"><span style=\"font-weight: 400;\">Ongoing Special Enrollment Period<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">If a beneficiary qualifies for Extra Help by virtue of having an MSP, they&#8217;ll also be granted an ongoing Part D Special Enrollment Period (SEP) that allows them to make a plan change quarterly. They can apply to Part D prescription drug coverage, and Medicare Advantage plans under an SEP.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Their SEP allows one change from January through March, April through June, and July through September. Once they make their change, the policy will start at the beginning of the following month. They also have access to all other election periods, such as the Annual Enrollment Period and Medicare Advantage Open Enrollment Period.<\/span><\/p>\n<h3 id=\"medicare-advantage-dual-special-needs-plans\"><span style=\"font-weight: 400;\">Medicare Advantage Dual Special Needs Plans<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">These MSPs, in many cases, will give Medicare beneficiaries the right to enroll in Medicare Advantage Dual Special Needs Plans. These plans typically have benefits that are richer than those of non-SNP Medicare plans.<\/span><\/p>\n<h2 id=\"how-to-apply-to-the-medicare-savings-program\"><span style=\"font-weight: 400;\">How to apply to the Medicare Savings Program<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">You&#8217;ll need to contact your state&#8217;s Medicaid office to apply for the Medicare Savings Program. You can also apply for benefits online. Medicaid.gov lists each<\/span> <a href=\"https:\/\/www.medicaid.gov\/about-us\/beneficiary-resources\/index.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">state&#8217;s<\/span><\/a><span style=\"font-weight: 400;\"> contact information for Medicaid services on its website.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You can also apply at the same time you&#8217;re applying for Extra Help on the<\/span> <a href=\"https:\/\/secure.ssa.gov\/i1020\/start\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Social Security<\/span><\/a><span style=\"font-weight: 400;\"> Administration&#8217;s website. There is a question on the Federal Low-Income Subsidy application that you can answer to send the information to the state to see if you qualify. Your state may ask you for additional information in order to complete and fully process your MSP application.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Although Medicare reduces healthcare costs for many Americans, it is not free. Medicare Savings Programs (MSP) help offset the cost-share and premiums associated with Original Medicare. Qualifying beneficiaries can use this program to lower their Medicare cost-share to a manageable amount. We&#8217;ll discuss the different Medicare Savings Programs and how to apply for a Medicare [&hellip;]<\/p>\n","protected":false},"author":133,"featured_media":55233,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2],"tags":[608,15],"coauthors":[20918],"class_list":["post-55232","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-company","tag-health-insurance","tag-medicare","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Medicare Savings Program: Application and advantages<\/title>\n<meta name=\"description\" content=\"Medicare Savings Programs help pay the Medicare-related expenses of low-income individuals. 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