Medicare Savings Programs: How to Get Help Paying for Medicare Costs
If you're on Medicare and struggling to keep up with premiums, deductibles, and copays, you're not alone. Millions of beneficiaries face the same challenge every month. But here's what many people don't know: there are federal programs that can pay some or all of your Medicare costs for you. They're called Medicare Savings Programs, and if you qualify, they can save you thousands of dollars a year.
These programs fly under the radar. According to the Centers for Medicare & Medicaid Services, millions of people who are eligible for help never apply. Whether you're already enrolled in Medicare or figuring out who is eligible for Medicare in the first place, understanding these programs could make a real difference in your budget.
What Are Medicare Savings Programs?
Medicare Savings Programs (MSPs) are state-administered programs funded through Medicaid that help people with limited income and resources pay for their Medicare costs. Even though they're run by your state's Medicaid office, you do not need to be on full Medicaid to qualify. These are separate programs specifically designed to assist Medicare beneficiaries.
There are four distinct Medicare Savings Programs, each covering different costs and serving different income levels. The key thing to understand is that all four programs are free — there's no cost to enroll, and the benefits can be substantial.
If you're enrolled in Original Medicare (Parts A and B), these programs can reduce or eliminate the out-of-pocket costs that come with that coverage.
The Four Medicare Savings Programs
Each MSP targets a specific group based on income and covers a different set of Medicare costs. Here's a breakdown of all four.
1. Qualified Medicare Beneficiary (QMB)
The QMB program is the most comprehensive of the four. If you qualify, it covers:
- Medicare Part A premiums
- Medicare Part B premiums
- Deductibles for both Part A and Part B
- Coinsurance and copayments
This is as close to zero-cost Medicare as it gets. QMB essentially eliminates your out-of-pocket spending on Medicare-covered services. One important protection: Medicare providers are legally prohibited from billing QMB members for cost-sharing. If a doctor or hospital tries to charge you a copay or coinsurance when you have QMB coverage, that's a violation of federal law.
2025 Income Limits for QMB:
- Individual: $1,275/month ($15,300/year)
- Married couple: $1,724/month ($20,688/year)
2. Specified Low-Income Medicare Beneficiary (SLMB)
The SLMB program covers your Part B premium only. It doesn't help with deductibles or copays, but eliminating that monthly Part B premium — which is $185/month in 2025 for most people — saves you over $2,200 per year.
2025 Income Limits for SLMB:
- Individual: $1,526/month ($18,312/year)
- Married couple: $2,063/month ($24,756/year)
3. Qualifying Individual (QI)
The QI program also pays your Part B premium, similar to SLMB, but with slightly higher income limits. There's one important catch: QI funding is limited and awarded on a first-come, first-served basis. You must reapply every year, and if funding runs out, you may not receive benefits even if you qualify.
2025 Income Limits for QI:
- Individual: $1,715/month ($20,580/year)
- Married couple: $2,320/month ($27,840/year)
Note: You cannot receive QI benefits if you're already on Medicaid.
4. Qualified Disabled and Working Individual (QDWI)
The QDWI program is specifically for people under 65 who have a disability and are working. When disabled individuals return to work and lose their premium-free Part A coverage, QDWI steps in to pay the Part A premium so they can maintain their Medicare hospital insurance.
2025 Income Limits for QDWI:
- Individual: $4,471/month ($53,652/year)
- Married couple: $6,047/month ($72,564/year)
Income and Resource Limits: What You Need to Know
The income and resource limits listed above are federal minimum guidelines. Here's the important part: many states set their limits higher than the federal minimum, which means you could qualify even if your income exceeds the numbers above.
When calculating income for MSP eligibility, not everything counts. The following are typically excluded:
- The first $20 of most income you receive per month
- The first $65 of earned income per month
- SNAP (food stamp) benefits
- Housing assistance
Resource limits (what you own) for MSPs in 2025 are generally $9,430 for an individual and $14,130 for a couple. Resources include bank accounts, stocks, and bonds. They do not include your home, one vehicle, personal belongings, burial plots, or up to $1,500 in burial funds.
Some states have eliminated the resource test entirely for MSPs, making it even easier to qualify. Check with your state Medicaid office for the most current limits in your area.
How to Apply for a Medicare Savings Program
Applying for an MSP is straightforward, though the exact process varies by state. Here are your options:
- Contact your state Medicaid office directly. This is the most common route. You can find your state's Medicaid office through Medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227).
- Apply through your local Social Security office. Social Security can take your MSP application and forward it to your state for processing.
- Contact your State Health Insurance Assistance Program (SHIP). SHIP counselors provide free, unbiased help with Medicare questions and can walk you through the application.
Documents you'll typically need:
- Proof of identity (driver's license, state ID, or passport)
- Your Medicare card (or Medicare number)
- Proof of income (Social Security benefit letter, pension statements, tax returns)
- Bank statements and financial account information
- Proof of resources (if your state still uses a resource test)
Processing times vary, but most states make a determination within 45 days. If approved, your benefits may be retroactive to the month you applied.
Extra Help / Low-Income Subsidy for Part D
If you have Medicare Part D prescription drug coverage, there's another program you should know about: Extra Help, also known as the Low-Income Subsidy (LIS).
Extra Help pays for Part D premiums, deductibles, and copayments for prescription drugs. The savings can be worth up to $5,300 per year.
Here's the connection to Medicare Savings Programs: if you qualify for any of the four MSPs, you automatically qualify for Extra Help. You don't need to apply separately — Social Security will enroll you. This is a major added benefit that many people overlook.
Extra Help also eliminates the Part D coverage gap (the "donut hole"), which can otherwise leave you paying a larger share of your drug costs during a portion of the year.
Even if you don't qualify for an MSP, you may still qualify for Extra Help on its own. The income limits for Extra Help are slightly different, so it's worth applying separately through Social Security if you're close to the thresholds.
Benefits Beyond Premium Savings
The financial savings from MSPs are significant, but there are additional protections that come with enrollment:
- QMB billing protections: As mentioned above, Medicare providers cannot bill QMB members for deductibles, coinsurance, or copayments. If a provider sends you a bill for cost-sharing, you have the right to dispute it. This protection is unique to QMB and is backed by federal law.
- Automatic Extra Help: All four MSPs trigger automatic enrollment in Extra Help for Part D, reducing your prescription drug costs without a separate application.
- No impact on Medicare benefits: Enrolling in an MSP does not change your Medicare coverage in any way. You keep the same doctors, hospitals, and benefits — you just pay less (or nothing) out of pocket.
- Special Enrollment Periods: Qualifying for an MSP may give you a Special Enrollment Period to switch Medicare Advantage or Part D plans outside of the regular enrollment windows.
Don't Leave Money on the Table
Medicare Savings Programs exist to make Medicare affordable for people who need it most. Yet millions of eligible beneficiaries never apply — often because they simply don't know these programs exist or assume they won't qualify.
If your income is limited, it's worth taking 30 minutes to check your eligibility. The potential savings — covering your Part B premium alone saves over $2,200 a year — can make a meaningful difference in your monthly budget. Contact your state Medicaid office, call 1-800-MEDICARE, or reach out to your local SHIP program to get started.