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CJ Karrer
Writer · Reviewed by Richard ChanUpdated Jun 12, 2026
6 min read
Medicare Savings Programs (MSPs) are state-administered programs designed to help low-income beneficiaries pay for Medicare premiums.
Depending on the specific program, an MSP may also help cover out-of-pocket costs like deductibles, coinsurance, and copayments.
Qualifying for any Medicare Savings Program automatically enrolls the beneficiary in the Extra Help program to assist with Medicare Part D prescription drug costs.
While Medicare serves as a critical lifeline for millions of Americans, it is far from free. Between monthly premiums, annual deductibles, and unpredictable copayments, the sheer cost of maintaining coverage can place an immense burden on a fixed income. Fortunately, if your income and savings are limited, the Medicare Savings Program (MSP) exists to step in and shoulder those costs for you.
What exactly is the Medicare Savings Program, and how do you determine if you qualify? Let’s break down the details.
The Medicare Savings Program is a Medicaid-administered initiative where your state government steps in to help pay for your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) premiums. If you meet certain strict financial criteria, the state may also cover your Part B out-of-pocket expenses, including deductibles, coinsurance, and copayments.
It is important to clarify that Medicaid and Medicare are two separate programs. While Medicare coverage is federally managed and primarily age-based, Medicaid is state-managed and based entirely on financial need. It is completely possible—and common—to participate in both programs simultaneously. Because states partially fund Medicaid, the exact eligibility limits can vary depending on where you live.
One major advantage: while MSPs are administered by Medicaid, you do not necessarily need to be fully enrolled in Medicaid to apply for or benefit from an MSP.
Furthermore, qualifying for an MSP automatically enrolls you in Extra Help (often called the "Low Income Subsidy"), a federal program that drastically reduces your prescription drug costs.
There are four distinct types of MSPs, offering different tiers of benefits depending on your income and asset levels:
The QMB program offers the most robust financial assistance. It pays your Medicare Part A premiums, your Part B premiums, and handles your out-of-pocket expenses like deductibles and copayments.
To qualify, your income must be at or below 100% of the Federal Poverty Line (FPL). Specifically, your income and resources (assets) must generally fall below the following limits:
| Your situation: | Monthly income limit:* | Resource limit: |
| Individual | $1,153 | $8,400 |
| Married couple | $1,546 | $12,600 |
* Limits are slightly higher in Alaska and Hawaii.
If your income slightly exceeds the QMB requirements, you may qualify for the SLMB program.
The SLMB program pays for your Medicare Part B premiums. However, unlike QMB, it does not cover Part A premiums or your Part B out-of-pocket expenses.
To qualify for SLMB, your income must be at or below 120% of the FPL. The general limits are:
| Your situation: | Monthly income limit:* | Resource limit: |
| Individual | $1,379 | $8,400 |
| Married couple | $1,851 | $12,600 |
* Limits are slightly higher in Alaska and Hawaii.
If you earn too much for QMB or SLMB, the QI program is your next safety net. This program is for individuals who have Part A but struggle with limited income.
Like the SLMB program, QI only covers your Part B premiums. However, there is a catch: if you already qualify for or receive standard Medicaid benefits, you cannot receive QI benefits.
Your income must be at or below 135% of the FPL to qualify. The general limits are:
| Your situation: | Monthly income limit:* | Resource limit: |
| Individual | $1,549 | $8,400 |
| Married couple | $2,080 | $12,600 |
* Limits are slightly higher in Alaska and Hawaii.
Because the QI program operates on limited federal funding, benefits are granted on a first-come, first-served basis. However, returning applicants from the previous year receive priority.
Unlike the previous three, the QDWI program is not for seniors over 65. It is designed exclusively for disabled individuals under 65 who successfully returned to the workforce but lost their premium-free Part A coverage as a result.
To qualify, you must have a disabling impairment, be actively working, and not be otherwise eligible for Medicaid.
The QDWI program solely covers your Medicare Part A premium.
Your income must be at or below 200% of the FPL. The general limits are:
| Your situation: | Monthly income limit:* | Resource limit: |
| Individual | $4,615 | $4,000 |
| Married couple | $6,189 | $6,000 |
* Limits are slightly higher in Alaska and Hawaii.
To begin, contact your state’s Medicaid office to fill out an application. You will likely need to provide identification alongside the following documentation:
Your state will review the application and mail you a Notice of Action within 45 days. If approved for QMB, your benefits trigger the following month. If approved for SLMB or QI, the state will begin covering your Part B premiums on the precise date listed in your notice.
When calculating your eligibility, the government gives you a bit of breathing room. In all states, the following are not counted toward your income limits:
Keep in mind that some states are more generous, utilizing higher income limits or excluding additional items. Because these limits are tied to the federal poverty level (FPL), the exact dollar amounts shift every year.
When evaluating your "resources" or assets, the state will count the following:
However, the government ignores several vital assets to ensure you aren't penalized for basic living essentials. Exclusions include:
Eligibility rules differ by state, and some states have completely eliminated resource limits altogether. It is always worth checking your local guidelines annually.
While an MSP provides massive relief for Part A and Part B premiums, it does not directly pay for prescription drugs.
However, there is a massive silver lining. If you are over 65 and qualify for QMB, SLMB, or QI, you automatically qualify for Extra Help (the Low-Income Subsidy program). Extra Help steps in to dramatically lower your Medicare Part D premiums, deductibles, and pharmacy copayments, ensuring your essential medications remain affordable.
If you are losing sleep over the mounting costs of healthcare, the Medicare Savings Program exists to protect you. Depending on your age and income, one of the four MSPs can alleviate the burden of Medicare premiums—and potentially your out-of-pocket costs and prescription drug fees as well. To take the first step toward financial relief, reach out directly to your state's Medicaid office.
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