It has been challenging to live on a fixed income recently. A friend told me she has the Medicare Savings Program and that it really helps her financially. What should I know about this program?
-Sabrina (Randleman, SC)
Medicare Savings Programs help pay your Medicare costs if you have limited income and savings. Medicare Savings Programs are also called MSPs, Medicare Buy-In programs, or Medicare Premium Payment Programs. There are three main programs, with different benefits and eligibility requirements. *
- Qualifying Individual (QI) Program: Pays for Medicare Part B premium. Also reimburses for premiums paid up to three months before your MSP effective date, and within the same year of that effective date.
- Specified Low-income Medicare Beneficiary (SLMB): Pays for Medicare Part B premium. Also reimburses for premiums paid up to three months before your MSP effective day, but unlike QI, you may be reimbursed for premiums from the previous calendar year.
- Qualified Medicare Beneficiary (QMB): Pays for Medicare Parts A and B premiums. If you have QMB, typically you should not be billed for Medicare-covered services when seeing Medicare providers or providers in your Medicare Advantage Plan’s network. This means you should not owe Medicare deductibles, copayments, and coinsurances, as long as you see the right providers.
*There is a fourth MSP called the Qualified Disabled Working Individual (QDWI), which pays for the Medicare Part A premium for certain people who are eligible for Medicare due to disability. Contact your local Medicaid office to learn more.
There are even more benefits to enrolling in an MSP. MSP enrollment:
- Allows you to enroll in Part B outside of the regular enrollment periods
- Eliminates your Part B late enrollment penalty if you have one
- Automatically enrolls you in Extra Help, the federal program that helps pay your Medicare prescription drug (Part D) plan costs
To qualify for an MSP, you must have Medicare Part A and meet income and asset guidelines.
If you do not have Part A but meet QMB eligibility guidelines, your state may have a process to allow you to enroll in Part A and QMB outside of the General Enrollment Period.
It also may be helpful to note that income and asset guidelines vary by state. Certain income and assets may not count and some states do not count assets at all when assessing MSP eligibility. You can contact your State Health Insurance Assistance Program (SHIP) to learn more about MSPs in your state and to receive assistance with the application process.
This really is a great program that helps so many beneficiaries with their Medicare costs! Again, contact your local SHIP to see if you’re eligible for an MSP in your state. Best of luck!