Could I be eligible for a government program other than Medicaid to help with my health care costs (Medicare Savings Programs)?
Yes. Medicare Savings Programs (MSPs), also known as Medicare Buy-In programs or Medicare Premium Payment Programs, help pay your Medicare costs if you have limited finances. There are three main programs, and each has different income eligibility limits.
- Qualified Medicare Beneficiary (QMB): Pays for Medicare Part A and B premiums, deductibles and coinsurances or co-pays. If you have QMB, you will have no coinsurance or copayment for Medicare-covered services you get from doctors who participate in Medicare or Medicaid or are in your Medicare private health plan’s network.
- Specified Low-income Medicare Beneficiary (SLMB): Pays for Medicare's Part B premium.
- Qualifying Individual (QI) Program: Pays for Medicare's Part B premium.
To find out what costs are under Medicare Parts A and B, click on the link in the GO TO box.
If you enroll in an MSP, you will also automatically get Extra Help, the federal program that helps pay most of your Medicare prescription drug (Part D) plan costs.
For more information about Extra Help, click on the links in the GO TO box.
To qualify for an MSP, you must have Medicare Part A and meet income and assets guidelines. If you do not have Part A but meet QMB eligibility guidelines, your state will have a process to allow you to enroll in Part A and QMB. Many states allow this throughout the year, but others limit when you can enroll in Part A.
For more information about enrolling in Part A and QMB, contact your local State Health Insurance Assistance Program (SHIP). For your SHIP’s contact information, click on the link in the LINKS box.
States use different rules to count your income (money you take in, for example, Social Security payments that you get or wages that your earn) and assets (resources such as checking accounts, stocks and some property) to determine if you are eligible for an MSP. Certain income or assets may not count. Some states do not have an asset limit.
For this reason, if your income or assets seem to be above the MSP guidelines, you should still apply if you need the help.
To find out more about applying if you are over the income guidelines, click on the link in the GO TO box.
Qualified Disabled Working Individual (QDWI) is a less common MSP that pays for the Medicare Part A premium. To be eligible for QDWI, you must:
- be under the age of 65;
- be working but continue to have a disabling impairment;
- have limited income and resources; and
- not already be eligible for Medicaid.
For more information about the MSPs, contact your local Medicaid office or your state’s SHIP. For Medicaid and SHIP contact information, click on the links in the LINKS box.
For more information about government programs that can help you pay for your health care, click on the link in the GO TO box.
For more information about hospitals and health care facilities that offer care at a reduced cost, click on the link in the GO TO box.
For more information on programs that can help pay for your prescriptions, click on the GO TO box.