Quick Guide to Medicare Savings Programs 2024
In Triage Health's free Quick Guide to Medicare Savings Programs, we'll answer the following questions:
Need help paying Medicare’s out-of-pocket costs?
You may qualify for one of the four Medicare Saving Programs. Each program has different income and resource limits, and provides different levels of help. The Medicare Extra Help Program helps with the out-of-pocket costs for prescriptions drugs. In addition, you may be able to receive Medicare and Medicaid, depending on your income and resources.
To learn about the coverage included in the different parts of Medicare, read:
Medicare Savings Programs
1. Qualified Medicare Beneficiary (QMB) Program
This program has the lowest income limits, but covers the most out-of-pocket costs.
- Individual monthly income is capped at $1,275, and resources are limited to $9,430.
- Monthly income for married couples is limited to $1,724, and resources are limited to $14,130.
It helps pay for: Part A premiums, Part B premiums, deductibles, co-insurance, and co-payments.
2. Specified Low-Income Medicare Beneficiary (SLMB) Program
The SLMB program only helps pay for Part B premiums, but has slightly higher individual and married couple income limits than the QMB program.
- Individual monthly income is capped at $1,526, and resources are limited to $9,430.
- Monthly income for married couples is limited to $2,064, and resources are limited to $14,130.
It helps pay for: Part B premiums.
3. Qualifying Individual (QI) Program
To qualify for the QI program, you must apply every year. Applications are approved on a first-come, first-serve basis, but individuals who received benefits in the previous year are prioritized. If you qualify for Medicaid, you cannot qualify for this program. This program has higher monthly income limits than the SLMB and QMB programs.
- Individual monthly income is capped at $1,715, and resources are limited to $9,430.
- Monthly income for married couples is limited to $2,320, and resources are limited to $14,130.
It helps pay for: Part B premiums.
4. Qualified Disabled and Working Individuals (QDWI) Program
The QDWI program accepts applicants who are working, disabled, and under 65; have lost their premium-free Part A after returning to work; are not getting medical assistance from their state, and meet the income and resource limits for your state. This program has higher income limits than other programs, but lower resource limits.
- Individual monthly income is limited to $5,105, and resources are limited to $4,000.
- Monthly income for married couples is limited to $6,899 a month, and resources are limited to $6,000.
It helps pay for: Part A premiums.
What are considered “resources” under the Medicare Savings Program?
Resources factored into your resource limit include:
- Money in your checking or savings account
- Individual Retirement Accounts (IRAs)
- Stocks, bonds, and mutual funds
Resources do not include:
- Your home and one car
- Burial plot and up to $1,500 put aside for funeral expenses
- Furniture, household, and personal items
Note: Limits are slightly higher in Alaska and Hawaii. Check your state’s limits for more information.
To apply for a Medicare Savings Program, contact your state Medicaid office.
Need help paying for Medicare’s out-of-pocket prescription drug costs?
The Extra Help Program helps people with limited income and resources pay Medicare’s prescription drug program costs, such as premiums, deductibles, and co-insurance. Extra Help is also referred to as the low-income subsidy or LIS.
If you qualify for the QMB, SLMB, or QI programs, you automatically qualify for Extra Help paying for Medicare’s out-of-pocket prescription drug costs.
You may need to show your Medicare Part D prescription drug plan that you qualify for Extra Help. These are examples of documents that you can show them:
- A purple notice from Medicare stating that you automatically qualify for Extra Help.
- A yellow or green Medicare automatic enrollment notice.
- An Extra Help “Notice of Award” from the Social Security Administration (SSA).
- An orange Medicare notice that your co-payment will change next year.
- A Supplemental Security Income (SSI) award letter from the SSA.
- A Medicaid card or other proof of your Medicaid coverage.
- Proof you have Medicaid and live in an institution or receive home or community-based services, such as a bill from an institution (like a nursing home).
Once you are approved for Extra Help, in 2024, your prescription drug costs will be no more than $4.50 for each generic drug and $11.20 for each brand-name-covered drug. Also, depending on your income level, some people will only pay a portion of their Medicare Part D plan premiums and deductibles.
To apply for Extra Help, visit SocialSecurity.gov/extrahelp or call 800-772-1213.
If you don’t qualify for Extra Help, some states have additional prescription drug assistance programs:
If you don’t qualify for these programs and have original Medicare (i.e., not a Medicare Advantage Plan), and need help paying for out-of-pocket costs, consider a Medigap Plan. For more information, read the Quick Guide to Medigap Plans.
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Last reviewed for updates: 01/2024
Disclaimer: This handout is intended to provide general information on the topics presented. It is provided with the understanding that Triage Cancer is not engaged in rendering any legal, medical, or professional services by its publication or distribution. Although this content was reviewed by a professional, it should not be used as a substitute for professional services. © Triage Cancer 2024