Medicare Savings Program Notice

Who qualifies: Income under ~$1,275/month (single).

What it covers:

• Medicare Part B premium ($202.90 in 2026)
• Part A deductible ($1,600 in 2026)
• Part B deductible ($240 in 2026)
• Copays for doctor visits and hospital stays

Bottom line: This is the most comprehensive program. If you qualify for QMB, you don't pay anything out of pocket for Medicare-covered services (except some costs under Part D prescription drug coverage).

Who qualifies: Income under ~$1,525/month (single).

What it covers:

• Medicare Part B premium only ($202.90 in 2026)

What it doesn't cover: Deductibles, copays, or coinsurance.

When to use this: If your income is too high for QMB but under SLMB limit. It saves you $202.90/month on Part B.

Who qualifies: Income under ~$1,715/month (single).

What it covers:

• Medicare Part B premium only

Difference from SLMB: QI covers the same thing (Part B premium) but has a higher income limit.

When to use this: If your income is above SLMB limit but below QI limit. Same savings, higher cutoff.

Who qualifies: You're disabled, working, and income under ~$2,550/month.

What it covers:

• Medicare Part A premium only

Why this exists: If you're disabled and working, returning to work means losing Medicaid. QDWI helps bridge that gap.

Important: You must be enrolled in Medicare Part A and have lost Medicaid due to earnings from work.

Step 1: Contact Your State Medicaid Office

Not Medicare. This is a STATE program run through Medicaid. Each state has a different name and process:

• Search "[Your State] Medicaid office" online
• Look for "Medicare Savings Program" or "MSP application"
• Ask to apply for QMB, SLMB, QI, or QDWI (tell them your income)

Step 2: Gather Income Documentation

Have these ready:

• Social Security benefit statement (or recent bank deposit showing benefit amount)
• Pension statements (if you get a pension)
• Interest/investment income statements
• Recent tax return (last year)
• Bank statements (proof of assets, varies by state)
• Proof of U.S. citizenship or legal residency

Step 3: Complete the Application

Most states offer:

• Online application (easiest)
• Mail-in application
• In-person at the office
• Phone application

Be honest and accurate about income. The state verifies with Social Security anyway.

Step 4: Wait for Decision

Most states respond within 30–45 days. You'll receive a notice showing:

• Approved or denied
• Which program you qualify for
• Your coverage start date
• How much the state will pay

Step 5: State Pays Directly

Once approved, the state Medicaid program pays your Part B premium directly to Medicare. You'll see it stop being deducted from your Social Security check.

What counts as "income"?

For MSP applications:

• Social Security benefits — YES
• Pensions — YES
• Interest and dividends — YES
• Rent from property — YES
• Annuities — YES
• In-kind support (family helping with food/housing) — MAYBE (ask your state)

What about assets?

Most Medicare Savings Programs DON'T have asset limits — they only care about income. But some states count certain assets. Check with your state Medicaid office.

What if I don't have documentation?

Use what you have:

• Bank statements showing regular deposits (proof of benefit amount)
• My Social Security account print-out (ssa.gov/myaccount)
• Letters from benefit issuers (pension provider, etc.)

The state can also verify directly with SSA.

Here's the secret: When you're approved for ANY Medicare Savings Program (QMB, SLMB, QI, or QDWI), the state automatically enrolls you in "Extra Help" — the federal low-income subsidy for Part D prescriptions.

What Extra Help covers:

• $0 monthly premium for Part D
• $0 annual deductible
• Small copays for generic drugs ($1–3)
• Small copays for brand drugs ($3–9)

Without Extra Help: Part D plans cost $15–50/month in premiums, plus $480 annual deductible, plus $10–60 per prescription.

With Extra Help: You pay almost nothing for prescriptions. For someone taking 5 medications monthly, this is $5,000+/year in savings.

You don't apply separately. When you get approved for MSP, Extra Help is automatic. Done.

Yes. If your income drops, you might qualify for a better program (QMB is best). Just reapply.

If your income rises slightly, you might drop out of one program but qualify for another. The state handles this.

Report changes: Let your state Medicaid office know if your income changes by more than $50–100/month.

1 year, typically. Your state will send a renewal notice, usually 30–60 days before expiration.

Renewal is usually just paperwork. If your income hasn't changed, just send back the renewal form.

If you don't renew, coverage stops and the state goes back to deducting the Part B premium from your Social Security.

Reasons for denial:

• Income too high
• Not enrolled in Medicare Part A or B
• Not a U.S. citizen or legal resident
• Incomplete application

You can appeal. The denial notice will explain how. You typically have 60 days.

If you don't have Medicare yet, enroll first. Then apply for MSP.

No. MSP is just helping you PAY your premiums. Your Medicare coverage (Parts A, B, D) remains the same.

You keep the same doctors. No changes to your Medicare plan or provider network.