Help with Medicare costs · Licensed in 48 states

Medicare Savings Programs

State help with what Medicare costs you

Medicare Savings Programs are state-run programs that help pay Medicare premiums, and in some cases deductibles and coinsurance too. Many people who qualify never apply, usually because they assume they earn too much. The limits are higher than most expect, and applying costs nothing.

What to expect

Medicare Savings Programs: what to expect

Three things are worth understanding before you look at the programs themselves.

They pay your Part B premium

Every Medicare Savings Program helps with the Part B premium at minimum. For someone on a fixed income, that alone is a meaningful monthly difference.

Your state runs the program

Income and resource limits are set within federal guidelines but administered by your state, and they differ from one state to the next. Some states disregard certain income or resources entirely. Only your state Medicaid office can decide whether you qualify.

Qualifying opens another door

Enrolling in a Medicare Savings Program generally qualifies you automatically for Extra Help with Part D prescription costs. People often apply for one and receive the benefit of both.

Worth applying even if you think you earn too much

The most common reason people miss out is assuming they will not qualify. Limits change annually, several states are more generous than the federal baseline, and some income and resources may not count at all.

We can help you understand the programs and point you to your state office. The application itself is free.

Plan types

The Medicare Savings Programs

Three main programs, each helping with a different amount. Your income and resources determine which one applies.

QMB

Qualified Medicare Beneficiary. The most comprehensive of the programs — it helps with Part A and Part B premiums, and also with deductibles, coinsurance and copayments. Providers who accept Medicare are generally prohibited from billing a QMB member for those costs.

SLMB

Specified Low-Income Medicare Beneficiary. Helps with the Part B premium only. Income limits sit above the QMB level, so people who are just over the line for QMB frequently qualify here instead.

QI

Qualifying Individual. Also helps with the Part B premium, with limits above SLMB. QI is granted on a first-come, first-served basis and must be reapplied for each year, so applying early matters. You cannot receive QI if you also qualify for Medicaid.

Side by side

Compare the Medicare Savings Programs

All three help with the Part B premium. They differ in what else they cover, and in where the income limits fall.

Feature	QMB	SLMB	QI
In short	The most help available	Part B premium help	Part B premium help, limited funding
Helps with	Part A and Part B premiums, plus deductibles, coinsurance and copayments.	The Part B premium.	The Part B premium.
Income limits	The lowest of the three	Above QMB	Above SLMB
Pros	Covers cost sharing as well as premiums Providers generally cannot bill you for covered costs Qualifies you for Extra Help	Higher income limits than QMB Qualifies you for Extra Help	Highest income limits of the three Qualifies you for Extra Help
Cons	Strictest income and resource limits	Does not help with deductibles or coinsurance	First come, first served each year Must reapply annually Not available if you qualify for Medicaid
Where to apply	Your state Medicaid office	Your state Medicaid office	Your state Medicaid office

Scroll sideways to compare all three →

What to gather before you apply

Your state office will ask for documentation. Having these ready makes the process considerably faster.

Proof of incomeSocial Security award letter, pensions, wages

Resource informationBank accounts and certain assets, where counted

Your Medicare cardShowing Part A and Part B enrollment

Proof of residencyYour state administers the program

Household detailsWhether you are single or married affects limits

Your state officeApplications go to state Medicaid, not to us

Common questions

Do I earn too much to qualify?

Very possibly not. This is the most common reason people fail to apply, and the limits are higher than most expect. Several states are more generous than the federal baseline, and some income and resources may not be counted at all. There is no cost to applying and being told no.

What are the current income limits?

They change every year and differ by state, so any figure published on a website goes out of date quickly and could cost you a benefit you were entitled to. Your state Medicaid office holds the current limits for where you live, and that is the only reliable source. We are happy to point you to it.

Does QMB stop providers billing me?

Generally yes, for Medicare-covered services. Providers who accept Medicare are prohibited from billing a QMB member for Medicare deductibles, coinsurance or copayments. If you receive such a bill, it may have been sent in error and is worth querying.

Do I get help with prescriptions too?

Usually. Enrolling in a Medicare Savings Program generally qualifies you automatically for Extra Help, which lowers Part D premiums, deductibles and copayments. Many people apply for one and receive both.

Where do I apply?

Through your state Medicaid office, not through Medicare and not through us. Each state runs its own application process. We can explain how the programs work and help you understand what you are looking at, but the eligibility decision is the state’s alone.

Can I have a Medicare Savings Program and an Advantage plan?

Yes, these are not mutually exclusive. Some people who qualify are also eligible for a Dual Eligible Special Needs Plan, which is designed for people with both Medicare and Medicaid. Whether that suits you depends on the plans available in your county.

Talk through your options

Tell us your situation and we will explain how the programs work and where to apply in your state. We cannot determine eligibility — only your state Medicaid office can do that — but we can make sure you are not missing something you are entitled to.

All Solution Plus is a licensed insurance agency. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP), to get information on all of your options. All Solution Plus is not connected with or endorsed by the United States government or the federal Medicare program. Medicare Savings Programs are administered by individual states, and eligibility rules, income limits and resource limits are set by your state and by federal guidelines, change every year, and differ from state to state. Nothing on this page is a determination of eligibility. Only your state Medicaid office can determine whether you qualify. Coverage is governed solely by the terms of the program or policy issued.