Applying for a Medicare Savings Program

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You will need to call your local Medicaid office for exact rules on how to apply for a Medicare Savings Program in your state. Below is a general guide to the process.

Call your local Medicaid office to ask how you can submit your application. Many states allow you to submit your application online, through the mail, or through community health centers or other organizations. Some states still require that you schedule an appointment and go in person to the Medicaid office to apply.

Medicare Savings Program Financial Eligibility Guidelines by State

Examples of documentation that may be required for your MSP application include:

  • Your Social Security card
  • Your Medicare card
  • Your birth certificate, passport or green card
  • Proof of your address (i.e. electric or phone bill)
  • Proof of your income (i.e. Social Security Administration award letter, income tax return, pay stub)
  • Information about your assets, such as bank statements, stock certificates, life insurance policies, etc.

The list of the exact documents that you will need to have for your application varies by state. Some states do not require that you submit documentation of your income or assets. Contact your local Medicaid office to find out what documents you need.

Before submitting your application, be sure to make a copy of your completed application. If you are at the Medicaid office, ask the Medicaid office staff to make a copy for you.

You should be sent a Notice of Action which will notify you of your application status within 45 days of filing an application.

  • If you have been DENIED and are told you do not qualify for a Medicare Savings Program:
    • You have the right to appeal and ask for a fair hearing. 
  • If you have been APPROVED:
    • If you are eligible for SLMB or QI (but not QMB), you may receive retroactive benefits for three months prior to the date of your application. The state will pay your Part B premium starting the month indicated on your Notice of Action. However, it may take several months for the Part B premium of $104.90 (in 2014) to be added back into your monthly Social Security check. Don’t be discouraged; you have been approved and are enrolled in the program. You will be reimbursed with a lump-sum check for the months before the $104.90 is added to your Social Security check back to the month of application.
    • If you are eligible for QMB, your benefits will begin on the first of the month after your eligibility is approved.
    • If you don’t receive a Notice of Action within 45 days call the Medicaid office where you applied.

You will need to renew (recertify) your MSP every year. If you do not receive a notice in the mail to recertify, contact your local Medicaid office and ask what you need to do to make sure you keep getting your MSP benefits in the following year.

 

 


Case Examples
Ms. L qualified for a Medicare Savings Program but never received the benefit.

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