July 14

Medicare Savings Programs

You can get help from your state paying your Medicare premiums. In some cases, Medicare Savings Programs may also pay Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) deductibles, coinsurance, and copayments if you meet certain conditions.

There are four different Medicare Savings Programs, each with different income and resource eligibility limits.  If you have income from working, you still may qualify for these 4 programs even if your income is higher than the income limits listed for each program. These are the Medicare Savings Programs eligibility limits for 2022:

Qualified Medicare Beneficiary (QMB): People may qualify if they have income less than 100% of the Federal Poverty Level (FPL) and resources under $8,400 if single, $12,600 if married. If eligible, QMB will cover the Medicare premiums (Part A, if applicable, and Part B), deductibles, copayments and/or coinsurance. Monthly income limits include a $20 general income disregard; Alaska and Hawaii have slightly higher limits:

  • Residents of 48 states & District of Columbia: $1,153/$1,546 single/married
  • Alaska: $1,436/$1,928 single/married
  • Hawaii: $1,323/$1,775 single/married

Specified Low-Income Beneficiary (SLMB): Seniors/adults with disabilities may qualify if they have income between 100-120% FPL and resources under $8,400 if single, $12,600 if married. If eligible, SLMB will cover the Medicare Part B premium ($170.10 in 2022). Monthly income limits include a $20 general income disregard; residents of Alaska and Hawaii have slightly higher income limits:

  • Residents of 48 states & District of Columbia: $1,379/$1,851 single/married
  • Alaska—$1,719/$2,309 single/married
  • Hawaii—$1,583/$2,126 single/married

Qualifying Individual (QI): QI is a limited program (block-grant to states), and is available on a first-come, first-serve basis. People with Medicare may qualify if they have income between 120-135% FPL and resources under $8,400 if single, $12,600 if married. If eligible, QI will cover the Medicare Part B premium. Monthly income limits include a $20 general income disregard; Alaska and Hawaii have slightly higher limits:

  • Residents of 48 states & District of Columbia: $1,549/$2,080 single/married
  • Alaska: $1,931/$2,595 single/married
  • Hawaii: $1,778/$2,389 single/married

Qualified Disabled Working Individual (QDWI): Adults under age 65 and disabled but who recently returned to work and are no longer eligible for premium-free Part A may qualify for QDWI. Their income must be at or below 200% FPL and their resources under $4,000 if single, $6,000 if married. However, there are additional earned income disregards that raise the income ceiling for QDWI up to 400% FPL. If eligible, QDWI will cover their Part A premium. Monthly income limits include a $20 general income disregard and a $65 earned income disregard; Alaska and Hawaii have slightly higher limits:

  • Residents of 48 states & District of Columbia: $4,615/$6,188 single/married
  • Alaska: $5,748/$7,715 single/married
  • Hawaii: $5,295/$7,105 single/married

If you qualify for the QMB program, SLMB, or QI program, you automatically qualify to get Extra Help paying for Medicare drug coverage.

Note: The limits above are federal guidelines. Some states may choose to increase these federal guideline amounts or eliminate the resource test all together. Refer to your state eligibility rules.

To qualify for an MSP, you must have Medicare Part A and meet income and asset guidelines (note that these guidelines vary by state, and some states do not count assets when determining MSP eligibility). 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. Many states allow this throughout the year, but others limit when you can enroll in Part A.

 In all states, there are certain resources that will never be counted as assets. These include:

  • Your primary house
  • One car
  • Household goods and wedding/ engagement rings
  • Burial spaces
  • Burial funds up to $1,500 per person
  • Life insurance with a cash value of less than $1,500

Some states may exclude other types of assets as well.

Remember, states use different rules to count your income and assets to determine if you are eligible for an MSP. Examples of income include wages and Social Security benefits you receive. Examples of assets include checking accounts and stocks. Certain income and assets may not count when determining your MSP eligibility. And some states do not have an asset limit. Call your local Medicaid office for Information about Medicare Savings Programs in your area.

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