Dear Marci,
My Part B premium is difficult for me to afford each month. I called Medicare to ask about help paying for this, and they told me to apply for a Medicare Savings Program. What is a Medicare Savings Program?
– Emma (Jackson, MS)
Dear Emma,
A Medicare Savings Program (MSP) is an assistance program that can help pay for your Medicare costs if you have limited finances. MSPs may also be called Medicare premium assistance programs or Medicare buy-in programs.
There are three main types of MSPs. Each program has certain income and asset limits in order to qualify for them.
- Qualified Medicare Beneficiary (QMB) pays yourMedicare Part B premium, as well as your Medicaredeductibles, coinsurances, and copayments. Although most people get Part A for free, some individuals must pay a Part A premium. QMB also helps pay the Part A premium. You can qualify for QMB even if you qualify for Medicaid.
- Specified Low Income Medicare Beneficiary (SLMB)pays your Medicare Part B premium. You can qualify for SLMB even if you qualify for Medicaid.
- Qualifying Individual (QI) pays your Medicare Part B premium. You cannot have both QI and Medicaid.
In addition, all three MSPs allow you to enroll in Medicare outside of the formal Medicare enrollment periods. They also waive any late enrollment Part B premium penalties that you may have. When you have an MSP, you also automatically qualify for Extra Help, the federal assistance program that helps to pay Medicare prescription drug costs.
To qualify for an MSP, you must have Medicare Part A and meet certain income and assets guidelines. If you do not have Part A but meet QMB eligibility guidelines, your state should 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.
Keep in mind that you should still apply for an MSP if you need the help even if your income seems slightly above your state’s income and asset guidelines. This is because states use different rules to count your income and assets to determine your eligibility for an MSP. Certain income or assets may not count, and some states do not have an asset limit. Know that you cannot choose which MSP you receive, but are assigned to one of the three MSPs based on your income and assets. To learn about MSPs in your state and to find out where to apply, contact your State Health Insurance Assistance Program (SHIP) or your local Medicaid office. You can find the contact information for your SHIP by going towww.shiptacenter.org or by calling 877-839-2675.
-Marci