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Medicare · Financial Help

What are Medicare Savings Programs (MSPs)?

Answered by SilverEdge licensed advisors · Updated 2026-05-08

Medicare Savings Programs (MSPs) are state-administered programs that pay your Medicare Part B premium — and sometimes your Part A deductibles and copays. They're separate from Extra Help (which pays drug costs) but you typically qualify for both if your income is low enough.

The four MSPs:

1. QMB — Qualified Medicare Beneficiary

Eligibility (2026 estimates, vary by state):
- Income limit: ~$1,275/month single, ~$1,724/month married
- Resource limit: ~$9,660 single, ~$14,470 married

What QMB pays:
- Part B premium ($202.90/month savings = $2,435/year)
- Part A premium (if you owe one — most don't)
- All Part A and Part B deductibles, copays, and coinsurance
- You should pay $0 to providers for Medicare-covered services if you're QMB. Providers cannot bill QMB members for cost-sharing.

QMB members are also automatically eligible for Extra Help on prescriptions.

2. SLMB — Specified Low-Income Medicare Beneficiary

Eligibility (2026):
- Income limit: ~$1,526/month single, ~$2,064/month married
- Resource limit: ~$9,660 single, ~$14,470 married

What SLMB pays:
- Part B premium only ($202.90/month = $2,435/year)
- Does NOT pay Part A or Part B deductibles/copays

SLMB members are also automatically eligible for Extra Help on prescriptions.

3. QI — Qualifying Individual

Eligibility (2026):
- Income limit: ~$1,715/month single, ~$2,320/month married
- Resource limit: ~$9,660 single, ~$14,470 married

What QI pays:
- Part B premium only ($202.90/month = $2,435/year)
- First-come, first-served (limited federal funding)
- Cannot also get Medicaid

QI members are also automatically eligible for Extra Help on prescriptions.

4. QDWI — Qualified Disabled and Working Individual

For under-65 disabled people who returned to work and lost premium-free Part A. Helps pay Part A premium only. Higher income limits than QMB/SLMB/QI. Rare program.

State-by-state variation:

  • Most states use the federal income/resource limits above
  • Some states have HIGHER income limits: Alabama, Arizona, Connecticut, DC, Delaware, Maine, Mississippi, New York, Vermont — check your state Medicaid office
  • Some states have NO resource test: Alabama, Arizona, Connecticut, DC, Delaware, Mississippi, New York, Vermont — substantially expands eligibility
  • California uses different rules and has higher limits

Resources that don't count:
- Your primary home (any value)
- One vehicle
- Household goods, personal effects
- Burial expenses up to $1,500 each
- Life insurance with face value under $1,500

Resources that DO count:
- Bank accounts (checking, savings, CDs)
- Stocks, bonds, mutual funds
- IRAs and 401(k)s — though some states exclude when they're the spouse's
- Real estate other than your primary home
- Cash on hand

How to apply:

  • Apply through your state Medicaid office (not Social Security)
  • In most states: online application, paper application, in-person visit, or call
  • Some states use a shared application form for Medicaid + MSP
  • Free help from State Health Insurance Assistance Program (SHIP) at 1-877-839-2675
  • Many people qualify but never apply because they think they have too much money — REMEMBER, primary home and one car don't count

Approval timing: 30–60 days typical. Once approved, MSP enrollment can be retroactive up to 3 months (i.e., you can recoup Part B premiums you already paid in those months).

Why this matters financially:

A QMB-eligible senior who isn't enrolled is overpaying about $3,500–$5,000 per year for Medicare cost-sharing. Over 10 years, that's $35,000–$50,000.

The national MSP enrollment rate is far below eligibility — millions of seniors qualify but never apply. If you're at or below the income limits, apply even if you think you have too many resources; the home and vehicle exemptions surprise people.

Combining MSP with Extra Help:

If you qualify for any MSP (QMB, SLMB, QI), you AUTOMATICALLY qualify for Extra Help on prescription drugs. Extra Help eliminates Part D premium and reduces drug copays to $4.90/$12.15. Combined with MSP, your total Medicare out-of-pocket can be near zero.

What to do next: Call (866) 534-1886. We screen you for QMB/SLMB/QI eligibility, help with the application process, and pair you with the best Medicare Advantage or Original Medicare + Part D plan that maximizes your subsidies. Free.

This answer reflects 2026 Medicare rules. SilverEdge represents 40+ Medicare carriers but does not offer every plan available in your area. For all options, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP. Information current as of the date shown above.

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