Millions of Americans with Medicare struggle to afford premiums, deductibles, and cost-sharing — yet many don’t realize that government programs exist specifically to help cover these costs. Medicare Savings Programs (MSPs) are state-administered programs that pay some or all of your Medicare out-of-pocket costs if your income and assets are limited.

If you have Medicare and a modest income, you could save hundreds or thousands of dollars per year through an MSP. This guide explains exactly what each program covers, who qualifies, and how to apply at no cost.

What Are Medicare Savings Programs?

Medicare Savings Programs are state Medicaid programs designed to help people with Medicare who have limited income and resources. Unlike Medicaid itself (which provides full health coverage), MSPs specifically help pay for Medicare’s cost-sharing — premiums, deductibles, and coinsurance.

There are four levels of MSPs, each covering different costs and serving different income levels. States administer these programs, so the application process varies by state — but the eligibility income and resource guidelines are set federally and are similar across states.

The Four Medicare Savings Programs

1. Qualified Medicare Beneficiary (QMB) Program

The QMB program is the most comprehensive MSP. It covers:

  • Your Medicare Part A premium (if you pay one)
  • Your Medicare Part B premium ($185/month in 2025)
  • Medicare deductibles (both Part A and Part B)
  • Medicare coinsurance and copays

QMB is the strongest protection available: if you’re enrolled in QMB, healthcare providers who accept Medicare cannot bill you for Medicare cost-sharing at all — it’s illegal for them to do so, and if they try, you have the right to refuse payment.

2025 QMB Income Limits (approximately):

  • Individual: $1,255/month ($15,060/year)
  • Couple: $1,704/month ($20,448/year)

Resource limits (excluding your home, one car, and household goods):

  • Individual: $9,430
  • Couple: $14,130

Exact figures are updated annually and vary slightly by state, so always verify with your state Medicaid office.

2. Specified Low-Income Medicare Beneficiary (SLMB) Program

The SLMB program covers your Medicare Part B premium ($185/month in 2025) but not other cost-sharing like deductibles and copays.

2025 SLMB Income Limits (approximately):

  • Individual: $1,478/month ($17,736/year)
  • Couple: $1,991/month ($23,892/year)

Resource limits are the same as QMB.

If your income is between the QMB and SLMB limits, SLMB can save you $2,220 per year just on the Part B premium.

3. Qualifying Individual (QI) Program

The QI program also covers the Medicare Part B premium only, at the same level as SLMB. The difference is funding: QI funding is limited and is given out on a first-come, first-served basis each year. If funding runs out before you apply, you’d need to wait until the following year.

2025 QI Income Limits (approximately):

  • Individual: $1,660/month ($19,920/year)
  • Couple: $2,239/month ($26,868/year)

Resource limits are the same as QMB and SLMB.

Apply early in the calendar year to maximize your chance of receiving QI benefits.

4. Qualified Disabled and Working Individuals (QDWI) Program

The QDWI program is specifically for people under 65 who:

  • Have a disability
  • Are working
  • Lost premium-free Medicare Part A because of returning to work

QDWI pays the Part A premium only. Income and resource limits are higher than other MSPs.

2025 QDWI Income Limits (approximately):

  • Individual: $4,945/month
  • Couple: $6,659/month

How MSPs Interact With Extra Help (Part D LIS)

If you qualify for a Medicare Savings Program (QMB, SLMB, or QI), you automatically qualify for Extra Help — the federal program that reduces Part D prescription drug costs.

Extra Help in 2025 provides:

  • Full Extra Help: Reduced Part D premiums (sometimes $0), significantly reduced deductibles, and copays as low as $1.10 for generics and $3.40 for brand-name drugs. Available to QMB, SLMB, and QI recipients, as well as those who qualify separately through the SSA.

  • The late-enrollment penalty is waived for people with Extra Help — even if they enrolled in Part D late.

This stacking of benefits makes MSPs particularly valuable. Qualifying for QMB, for example, can eliminate your Part B premium, Medicare deductibles, and most Part D costs simultaneously — potentially saving $4,000–$5,000 or more annually.

The Resource Rules: What Counts and What Doesn’t

“Resources” in the MSP context refers to assets you own. Not everything counts:

Excluded from resources (not counted):

  • Your primary home
  • One car
  • Household furniture and personal effects
  • Life insurance policies with face value of $1,500 or less
  • Up to $1,500 in burial funds per person
  • Certain prepaid burial expenses

Counted as resources:

  • Bank accounts (checking and savings)
  • Certificates of deposit (CDs)
  • Stocks, bonds, and mutual funds
  • Any real estate you own besides your primary home

Many people who believe they don’t qualify are surprised to find that their resources — once excluded items are removed — fall within the program limits. The exclusion of your home is significant: even a homeowner with a substantial property value may qualify if their liquid assets are modest.

How to Apply

Applying is free. You can apply through:

  1. Your state Medicaid office: Every state has a Medicaid agency that processes MSP applications. Search “Medicare Savings Program [your state]” or visit Medicaid.gov for state-specific contact information.

  2. Your local Social Security Administration (SSA) office: SSA can accept MSP applications and forward them to your state Medicaid agency.

  3. Medicare.gov/talk-to-someone: Medicare’s website can direct you to local help, including State Health Insurance Assistance Programs (SHIP) that offer free, unbiased help with MSP applications.

  4. Your local SHIP counselor: SHIP counselors provide free one-on-one assistance with Medicare enrollment, plan selection, and benefit programs — including MSP applications. Find your local SHIP at medicare.gov/about-us/find-local-help.

When you apply, have ready:

  • Proof of income (Social Security statements, pension statements, recent tax returns)
  • Bank and investment account statements
  • Information about any other assets

What Happens After You Apply

Processing times vary by state but typically take 30–60 days. If approved:

  • For QMB, SLMB, or QI: Your state sends your Part B premium savings directly to Medicare (or adjusts your Social Security deduction). You should see the change reflected in your Medicare or Social Security statement within 1–3 months.

  • Retroactive coverage: In many states, MSP benefits can be applied retroactively — you may receive a refund for Part B premiums paid in recent months. Ask your state Medicaid office about retroactivity rules.

  • Renewal: MSPs are not permanent — you must renew annually. Your state will send you a renewal notice. Failing to renew means your benefits lapse even if you still qualify.

Are You Leaving Money on the Table?

Studies suggest millions of Medicare beneficiaries who qualify for MSPs are not enrolled. The programs are underutilized for several reasons:

  • Many people don’t know the programs exist
  • Some believe they earn “too much” without checking the actual limits
  • Some assume owning a home disqualifies them
  • The application process can seem daunting

If your monthly income is below roughly $1,700 (individual) or $2,300 (couple), it’s worth checking. Even if you don’t qualify for the full QMB program, the SLMB or QI programs could save you over $2,200 per year on Part B premiums alone.

IRMAA: The Higher-Income Supplement Surcharge

While MSPs help lower-income beneficiaries, the opposite effect applies to higher earners. The Income-Related Monthly Adjustment Amount (IRMAA) adds a surcharge to both Part B and Part D premiums for beneficiaries whose income exceeds certain thresholds.

In 2025, the Part B IRMAA surcharge ranges from $74 to $443.90 per month above the standard premium, depending on income. If your income has recently dropped significantly (retirement, divorce, death of spouse), you can appeal the surcharge using Form SSA-44 or by calling SSA.

Key Takeaways

  • Medicare Savings Programs pay Part B premiums, deductibles, and cost-sharing for eligible lower-income Medicare beneficiaries
  • QMB is the most comprehensive: it covers Part A and B premiums, deductibles, and all cost-sharing
  • MSP eligibility is based on both income and resources — your home is not counted
  • Qualifying for any MSP (QMB, SLMB, QI) automatically qualifies you for Part D Extra Help
  • Application is free through your state Medicaid office, local SSA office, or SHIP counselor
  • An estimated 1–2 million eligible beneficiaries are not enrolled — if your income is modest, check whether you qualify

For help comparing your Medicare coverage options more broadly, see our guides on Medicare Advantage vs. Original Medicare and Medigap plans.