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MEDICARE SAVINGS PROGRAMS

Get help from your state paying your
Medicare Part A (Hospital Insurance)

Part A (Hospital Insurance)
Part A covers inpatient hospital stays, skilled nursing facility care, hospice
care, and some home health care.

and
Part B (Medical Insurance)

Part B (Medical Insurance)
Part B covers certain doctors’ services, outpatient care, medical supplies, and
preventive services.

premiums through a Medicare Savings Program. If you qualify, Medicare Savings
Programs might also pay your Part A and Part B deductibles, coinsurance, and
copayments.

You’ll apply for Medicare Savings Programs through your state. When you apply,
your state determines which program(s) you qualify for. Even if you don’t think
you qualify, you should still apply.

What's a premium, deductible, coinsurance, or copayment?

How to qualify for the 4 Medicare Savings Programs

In many cases, to qualify for a Medicare Savings Program, you must have income
and resources below a certain limit, as described below. These limits go up each
year. 

You may still qualify for these programs even if your income or resources are
higher than the limits listed. Some states don’t count certain types or specific
amounts of income or resources when deciding who qualifies.

Contact Your State

 


QUALIFIED MEDICARE BENEFICIARY (QMB) PROGRAM

Helps pay for: Part A premiums; Part B premiums, deductibles, coinsurance, and
copayments (for services and items Medicare covers).

Monthly income and resource limits for 2022:

Your situation: Monthly income limit:* Resource limit:
What counts in resource limits? Individual $1,153 $8,400 Married couple $1,546
$12,600

* Limits slightly higher in Alaska and Hawaii

If you qualify for the QMB program:

 * Medicare providers aren’t allowed to bill you for services and items Medicare
   covers, including deductibles, coinsurance, and copayments. What should I do
   if I get a bill?  
 * You may get a bill for a small Medicaid copayment, if one applies.
 * You'll also get
   Extra Help
   
   Extra Help
   A Medicare program for people with limited income and resources that helps
   lower Medicare drug plan costs (like premiums, deductibles, and coinsurance).
   
   paying for your prescription drugs. You’ll pay no more than $4 in 2022 for
   each drug covered by your Medicare drug plan.

Show both your Medicare card and Medicaid card (or QMB card) each time you get
care. If you have Original Medicare, you can also show one of your claims
statements, called Medicare Summary Notices. These statements show you’re in the
QMB program. Get a sample of a Medicare Summary Notice.


SPECIFIED LOW-INCOME MEDICARE BENEFICIARY (SLMB) PROGRAM

Helps pay for: Part B premiums (You must have both Part A and Part B to
qualify.)

Monthly income and resource limits for 2022:

Your situation: Monthly income limit:* Resource limit:
What counts in resource limits? Individual $1,379 $8,400 Married couple $1,851
$12,600

* Limits slightly higher in Alaska and Hawaii

If you qualify for the SLMB Program: 

 * You’ll also get
   Extra Help
   
   Extra Help
   A Medicare program for people with limited income and resources that helps
   lower Medicare drug plan costs (like premiums, deductibles, and coinsurance).
   
   paying for your prescription drugs.
 * You’ll pay no more than $9.85 in 2022 for each drug your Medicare drug plan
   covers.


QUALIFYING INDIVIDUAL (QI) PROGRAM

Helps pay for: Part B premiums (You must have both Part A and Part B to
qualify.)

Monthly income and resource limits for 2022:

Your situation: Monthly income limit:* Resource limit:
What counts in resource limits? Individual $1,549 $8,400 Married couple $2,080
$12,600

* Limits slightly higher in Alaska and Hawaii

If you qualify for the QI program:

 * You must apply every year to stay in the QI Program.
 * States approve applications on a first-come, first-served basis – priority is
   given to people who got QI benefits the previous year.
 * You’ll also get
   Extra Help
   
   Extra Help
   A Medicare program for people with limited income and resources that helps
   lower Medicare drug plan costs (like premiums, deductibles, and coinsurance).
   
   paying for your prescription drugs. You’ll pay no more than $9.85 in 2022 for
   each drug your Medicare drug plan covers

If you qualify for
Medicaid

Medicaid
A joint federal and state program that helps with medical costs for some people
with limited income and resources. Medicaid programs vary from state to state,
but most health care costs are covered if you qualify for both Medicare and
Medicaid.

, you can't get help from the QI program, but you may qualify for help from
another Medicare Savings Program.


QUALIFIED DISABLED WORKING INDIVIDUAL (QDWI) PROGRAM

You may qualify for the QDWI Program if you:

 * Have a disability
 * Are working
 * Lost Your Social Security disability benefits and Medicare premium-free Part
   A because you returned to work

Helps pay for: Part A premiums only

Monthly income and resource limits for 2022:

Your situation: Monthly income limit:* Resource limit:
What counts in resource limits? Individual $4,615 $4,000 Married couple $6,189
$6,000

* Limits slightly higher in Alaska and Hawaii

 


HOW TO APPLY FOR A MEDICARE SAVINGS PROGRAM

These programs are run by your state. Contact your state to apply.


WHAT DO YOU WANT TO DO NEXT?

 * Next Step: Lower your drug costs
 * Take Action: Talk to someone
 * Get details: Learn about Medicaid


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