For many people, the cost of Medicare can be overwhelming. Monthly premiums, deductibles, and out-of-pocket expenses quickly make healthcare unaffordable for some. Fortunately, the Medicare Savings Program (MSP) is designed to help low-income individuals reduce or eliminate many of these costs.
Medicare Savings Programs can help pay for:
- Medicare Part A & B premiums
- Deductibles
- Copayments & coinsurance
If you qualify for an MSP, you may also be eligible for Extra Help, a program that lowers prescription drug costs. Some MSP beneficiaries may also be eligible for a Medicare Special Needs Plan (SNP), a Medicare Advantage plan that provides extra benefits and coordinated care.
In this guide, we’ll explore:
🔹 The four types of Medicare Savings Programs
🔹 How to apply and qualify for MSP assistance
🔹 How MSPs connect to Dual-Eligible Special Needs Plans (D-SNPs) for even more benefits
If you’re struggling with Medicare costs, you might qualify for assistance—keep reading to find out how!
Do You Qualify for a Medicare Savings Program?
If you’re struggling with Medicare costs, you might qualify for a Medicare Savings Program (MSP)! Check the quick checklist below:
✔ Are you enrolled in Medicare Part A & B?
✔ Is your monthly income under $1,661 (single) or $2,239 (married)?
✔ Do you have limited savings/assets?
👉 If you answered YES, you might qualify! Keep reading to learn how to apply.
What Are Medicare Savings Programs (MSPs)?
Medicare Savings Programs (MSPs) are state-run programs that help low-income Medicare beneficiaries pay for certain healthcare costs. These programs reduce or eliminate out-of-pocket expenses for Medicare Part A (hospital insurance) and Part B (medical insurance).
How Do Medicare Savings Programs Work?
If you qualify for an MSP, the program may:
- Pay your Medicare Part A & B premiums
- Cover deductibles, copayments, and coinsurance
- Automatically enroll you in Extra Help, a program that lowers prescription drug costs
State Medicaid offices administer Medicare Savings Programs, but you don’t have to be on Medicaid to qualify. Eligibility is based on income and resource limits, which vary by state and change yearly.
💡 Important: Some states have higher income limits than others, and certain states may not count assets when determining eligibility.
Next, let’s explore the four types of Medicare Savings Programs and the benefits they provide.
The Four Types of Medicare Savings Programs (MSPs)
There are four different types of Medicare Savings Programs (MSPs), each designed to help with different aspects of Medicare costs. Your eligibility depends on your income, assets, and state-specific rules.
| MSP Type | Covers Part A? | Covers Part B? | Covers Deductibles & Copays? | Monthly Income Limit (2025) |
| QMB | ✅ Yes | ✅ Yes | ✅ Yes | $1,235 (Single) / $1,663 (Married) |
| SLMB | ❌ No | ✅ Yes | ❌ No | $1,478 (Single) / $1,992 (Married) |
| QI | ❌ No | ✅ Yes | ❌ No | $1,661 (Single) / $2,239 (Married) |
| QDWI | ✅ Yes | ❌ No | ❌ No | $5,302 (Single) / $7,135 (Married) |
1. Qualified Medicare Beneficiary (QMB) Program
The QMB Program offers the most comprehensive coverage, eliminating nearly all out-of-pocket Medicare costs for those who qualify.
What QMB Covers:
- Medicare Part A & B premiums
- Deductibles, copayments, and coinsurance
- Protection from improper billing – doctors and hospitals cannot charge QMB enrollees for Medicare-covered services
QMB Income & Resource Limits (2025):
- Individual: $1,235/month income | $9,660 in assets
- Married couple: $1,663/month income | $14,470 in assets
⚠ Important: If you’re in the QMB program, always show your QMB card or Medicare Summary Notice (MSN) at doctor’s visits to ensure you aren’t billed incorrectly. If you receive a bill by mistake, contact Medicare immediately for assistance.
2. Specified Low-Income Medicare Beneficiary (SLMB) Program
The SLMB Program helps pay for Medicare Part B premiums covering doctor visits and outpatient care.
What SLMB Covers:
- Medicare Part B premium (saves $185.00/month in 2025)
- Automatic enrollment in Extra Help for prescription drug savings
SLMB Income & Resource Limits (2025):
- Individual: $1,478/month income | $9,660 in assets
- Married couple: $1,992/month income | $14,470 in assets
3. Qualifying Individual (QI) Program
The QI Program is similar to SLMB but has limited funding, meaning applications are approved on a first-come, first-served basis.
What QI Covers:
- Medicare Part B premium
- Automatic Extra Help enrollment
QI Income & Resource Limits (2025):
- Individual: $1,661/month income | $9,660 in assets
- Married couple: $2,239/month income | $14,470 in assets
⚠ Important: You must reapply yearly for QI benefits, and Medicaid recipients are not eligible for QI.
4. Qualified Disabled and Working Individuals (QDWI) Program
The QDWI Program helps pay for Medicare Part A premiums for individuals who have returned to work after receiving disability benefits.
What QDWI Covers:
- Medicare Part A premium ($278)
QDWI Income & Resource Limits (2025):
- Individual: $5,302/month income | $4,000 in assets
- Married couple: $7,135/month income | $6,000 in assets
⚠ Who Qualifies? You may be eligible for QDWI if you:
- Are under 65 and disabled
- Lost premium-free Medicare Part A because you returned to work
- Aren’t eligible for Medicaid
How Do I Know Which MSP I Qualify For?
Your eligibility depends on income, assets, and state-specific guidelines. Some states don’t count resources (assets) when determining eligibility.
💡 Next Step: Contact your State Medicaid Office or use the Medicare Savings Program eligibility tool on Medicare.org to see if you qualify.
Next, we’ll cover how to apply for an MSP and what documents you need.
Meet Mary – How an MSP & D-SNP Saved Her Over $3,000 a Year!
Mary, a retired teacher, struggled to afford her Medicare premiums and prescription costs. She had no idea she qualified for a Medicare Savings Program and a Dual-Eligible Special Needs Plan (D-SNP).
After applying:
✔ Her $$185.00 monthly Part B premium was eliminated
✔ Her new D-SNP covered dental & vision care for free
✔ She saved over $3,000 per year on healthcare costs
👉 Think you might qualify?
Keep reading to find out!
How to Apply for a Medicare Savings Program (MSP)
If you meet the income and resource limits, applying for a Medicare Savings Program (MSP) can help you save hundreds—if not thousands—of dollars in Medicare costs each year. The application process is free, and you can apply through your State Medicaid Office.
Step-by-Step Guide to Applying for an MSP
Step 1: Gather Required Documents
Before applying, you’ll need to provide proof of eligibility. Documents may include:
✔ Proof of Medicare enrollment (Medicare card)
✔ Proof of income (pay stubs, Social Security award letter, or tax returns)
✔ Bank statements or proof of assets (checking, savings, or investment accounts)
✔ Proof of residency (driver’s license, utility bill, or lease agreement)
💡 Tip: Some states don’t count assets when determining MSP eligibility, so check with your local Medicaid office for exact requirements.
Step 2: Contact Your State Medicaid Office
Each state administers its own Medicare Savings Program, so you’ll need to apply through your state’s Medicaid office. You can:
📞 Call your state’s Medicaid office (Find your state’s contact info at Medicaid.gov)
💻 Apply online through your state’s Medicaid website
📍 Visit your local Medicaid office in person
Step 3: Complete and Submit Your Application
- Fill out the Medicare Savings Program application provided by your state.
- Submit the application along with required documents (online, by mail, or in person).
- Wait for your approval letter, which can take 30-45 days in most states.
💡 Good to Know: Some states allow retroactive coverage, meaning you may be reimbursed for Medicare costs you’ve already paid if you qualify.
Step 4: If Approved, Understand Your Benefits
Once approved for an MSP, you will:
✔ Have Medicare premiums covered automatically
✔ Be enrolled in Extra Help, reducing prescription drug costs
✔ Receive a QMB card (if in the QMB program), which prevents improper billing
Step 5: If Denied, Appeal the Decision
If your application is denied, don’t panic! You have the right to appeal. Contact your State Medicaid Office for instructions on how to:
✔ Request a reconsideration
✔ Provide additional documentation
✔ Get assistance from a Medicare counselor or advocate
Need Help Applying?
If you need assistance, free resources are available:
📞 State Health Insurance Assistance Program (SHIP) – Get free, unbiased Medicare counseling. Find your local SHIP at shiphelp.org.
📞 Medicare.gov Helpline – Call 1-800-MEDICARE (1-800-633-4227) for questions.
Next, let’s discuss Extra Help, a program that reduces prescription drug costs for MSP beneficiaries.
Extra Help: The Prescription Drug Benefit Connection
If you qualify for a Medicare Savings Program (MSP), you’re automatically eligible for Extra Help, a federal program that reduces prescription drug costs under Medicare Part D.
What Is Extra Help?
Extra Help—also known as the Low-Income Subsidy (LIS)—is a Medicare program that lowers out-of-pocket costs for prescription drugs. The Social Security Administration (SSA) estimates that Extra Help is worth about $5,300 per year in savings.
How Extra Help Lowers Drug Costs
If you’re enrolled in Extra Help, you’ll receive:
- Lower (or $0) monthly premiums for Medicare Part D prescription drug plans
- Reduced annual deductibles for medications
- Lower copayments or coinsurance for prescription drugs
- No late enrollment penalty, even if you sign up for Medicare Part D after your initial enrollment period
💡 Example:
Without Extra Help → A Medicare beneficiary might pay $590 deductible per year.
With Extra Help → The deductible could be $0, and the monthly premium could be eliminated.
Extra Help Income & Asset Limits (2025)
To qualify for Extra Help outside of an MSP, you must meet the following income and resource limits:
| Category | Monthly Income Limit | Asset Limit |
| Individual | $21,870 | $16,660 |
| Married couple | $29,580 | $33,240 |
⚠ Important: If you already qualify for an MSP, you are automatically enrolled in Extra Help—no separate application is needed!
How to Apply for Extra Help (If Not in an MSP)
If you don’t qualify for an MSP but still want Extra Help, you can apply through the Social Security Administration (SSA):
📞 Call: 1-800-772-1213 (TTY: 1-800-325-0778)
💻 Apply online at: ssa.gov/extrahelp
📍 Visit a local Social Security office
How Extra Help & MSPs Connect to Special Needs Plans (SNPs)
If you qualify for an MSP and Extra Help, you may also be eligible for a Medicare Special Needs Plan (SNP), which provides additional healthcare benefits at little to no cost.
Medicare Special Needs Plans (SNPs): A Smart Choice for MSP Beneficiaries
If you qualify for a Medicare Savings Program (MSP) and receive Extra Help, you may also be eligible for a Medicare Special Needs Plan (SNP). These Medicare Advantage (Part C) plans are designed to provide enhanced benefits and tailored care for specific groups of beneficiaries—including those with limited income.
Find Plans in your area with your ZIP Code
What Are Medicare Special Needs Plans (SNPs)?
SNPs are a type of Medicare Advantage plan that offers extra benefits and coordinated care for individuals with unique healthcare needs. These plans are offered by private insurance companies but must follow Medicare rules.
There are three types of SNPs:
1️⃣ Dual-Eligible SNPs (D-SNPs) – Designed for individuals who qualify for both Medicare and Medicaid (most relevant for MSP beneficiaries!)
2️⃣ Chronic Condition SNPs (C-SNPs) – Tailored for those with specific chronic illnesses like diabetes or heart disease
3️⃣ Institutional SNPs (I-SNPs) – Designed for individuals who live in nursing homes or long-term care facilities
Since most MSP beneficiaries are also dual-eligible, D-SNPs are the most beneficial option for people receiving Medicare cost assistance.
Why MSP Beneficiaries Should Consider a D-SNP
If you’re enrolled in an MSP, a D-SNP can provide even greater savings and better healthcare access.
Key Benefits of a Dual-Eligible SNP (D-SNP):
✔ $0 monthly premiums – Most D-SNPs have no additional premium beyond what’s covered by Medicaid/MSP
✔ $0 copays and deductibles – MSPs and Medicaid help cover Medicare out-of-pocket costs
✔ Prescription drug coverage included – Extra Help ensures lower costs for medications
✔ Dental, vision, and hearing benefits – Many D-SNPs offer expanded coverage beyond Original Medicare
✔ Transportation to medical appointments – Some plans provide free rides to the doctor or pharmacy
✔ Care coordination services – A personal care team helps manage chronic conditions and preventive care
💡 Example:
Without a D-SNP → An MSP enrollee might have some healthcare costs, like limited dental coverage.
With a D-SNP → Many extra benefits are included at no additional cost!
How to Enroll in a Special Needs Plan (SNP)
If you’re enrolled in an MSP and Medicaid, you can sign up for a D-SNP at any time during the year (no need to wait for Medicare’s Annual Enrollment Period!).
🔹 Steps to Enroll in a D-SNP:
1️⃣ Check if you qualify – If you have Medicare + Medicaid, you are likely eligible.
2️⃣ Compare plans in your area – Visit Medicare.gov or Medicare.org to see which D-SNPs are available in your state.
3️⃣ Enroll online or by phone – Contact the plan provider or call 1-800-MEDICARE for assistance.
⚠ Important: D-SNPs are not available in every location, and benefits may vary by state and plan provider.
Frequently Asked Questions (FAQs)
Can I have both a Medicare Savings Program (MSP) and a Special Needs Plan (SNP)?
Yes! If you qualify for an MSP, you may also be eligible for a Dual-Eligible Special Needs Plan (D-SNP). A D-SNP provides extra benefits like dental, vision, and care coordination, while the MSP helps cover Medicare costs.
Do all states offer the same MSP benefits?
No, each state sets its own income and resource limits for MSPs, and some states offer additional benefits. Check with your State Medicaid Office to find out what’s available in your area.
What happens if my income changes?
If your income increases, you may no longer qualify for your current MSP level—but you might still be eligible for a different MSP with fewer benefits. If your income decreases, you may qualify for more assistance. Always report income changes to your State Medicaid Office to avoid losing coverage.
Can I be enrolled in Extra Help without an MSP?
Yes! While MSP enrollees automatically qualify for Extra Help, you can apply for Extra Help separately if you don’t qualify for an MSP but still need assistance with Medicare prescription drug costs.
What should I do if I get billed incorrectly?
If you’re enrolled in an MSP (especially QMB), doctors and hospitals cannot bill you for Medicare-covered services. If you receive a bill by mistake:
✔ Show your QMB card or Medicare Summary Notice (MSN)
✔ Call your provider and remind them you cannot be billed
✔ Contact Medicare at 1-800-MEDICARE if the issue isn’t resolved
Can I apply for an MSP and a D-SNP at the same time?
Yes! If you qualify for Medicare & Medicaid, you can apply for both an MSP and a D-SNP at the same time to maximize your benefits.
Conclusion: Your Next Steps
A Medicare Savings Program (MSP) can help pay for premiums, deductibles, and other expenses if you’re struggling with Medicare costs. If you qualify for an MSP, you’ll automatically receive Extra Help to lower prescription drug costs.
For even more benefits, consider enrolling in a Dual-Eligible Special Needs Plan (D-SNP), which provides dental, vision, hearing, transportation, and more—at little or no cost.
Your Next Steps:
✅ Check if you qualify for an MSP – Contact your State Medicaid Office or visit Medicare.org
✅ Apply for Extra Help (if needed) – Visit ssa.gov/extrahelp
✅ Explore D-SNP options – Compare plans at Medicare.org or Medicare.gov
💡 Remember: MSPs, Extra Help, and D-SNPs can significantly reduce your healthcare costs—so take advantage of these programs if you qualify!