Medicare Savings Program
Medicare Savings Programs (MSPs), also known as Medicare Buy-In Programs or Medicare Premium Payment Programs, fundamentally act as a bridge between Medicare and Medicaid. Types of MSPs Eligibility Income and Asset Limits (Federal Guidelines 2025) While states have the freedom to disregard certain income or assets, the general guidelines are based on a percentage of […]
Published
Key takeaways
- QMB offers the broadest help, paying Medicare Part A and B premiums, deductibles, coinsurance and copayments; providers may not bill QMB beneficiaries for these costs.
- Income and asset limits vary by program and state, and some states have removed asset limits; QMB, SLMB and QI beneficiaries automatically qualify for Part D Extra Help.
Medicare Savings Programs (MSPs), also known as Medicare Buy-In Programs or Medicare Premium Payment Programs, fundamentally act as a bridge between Medicare and Medicaid.
Types of MSPs
- Qualified Medicare Beneficiary (QMB) Program
- Has the most coverage, including:
- Medicare Part A premiums (if you don’t qualify for premium-free Part A)
- Medicare Part B premiums
- Medicare Part A and Part B deductibles
- Medicare Part A and Part B coinsurance and copayments
- Providers are prohibited from billing QMB beneficiaries for Medicare Part A or B deductibles or co-insurance, similar to a Medicare Supplement (Medigap) policy.
- Specified Low-Income Medicare Beneficiary (SLMB) Program
- Pays for Medicare Part B premiums.
- Qualifying Individual (QI) Program
- Pays for Medicare Part B premiums.
- Priority is often given to those who received the benefit from the previous year. Additionally, those who are eligible for full Medicaid benefits cannot qualify for QI.
- Qualified Disabled Working Individual (QDWI) Program
- Covers Medicare Part A premiums only.
- Specifically for those with disability under age 65 who are not eligible for Medicaid.
Eligibility
- Medicare Part A
- Must be eligible for Medicare Part A.
- Limited Income and Assets
- Income and asset limits vary by program and by state.
Income and Asset Limits (Federal Guidelines 2025)
While states have the freedom to disregard certain income or assets, the general guidelines are based on a percentage of the Federal Poverty Level (FPL) and updated yearly.
| Program | Individual Monthly Income Limit | Married Couple Monthly Income Limit | Individual Asset Limit | Married Couple Asset Limit |
| QMB | $1,325 (100% FPL) | $1,783 (100% FPL) | $9,660 | $14,470 |
| SLMB | $1,585 (120% FPL) | $2,135 (120% FPL) | $9,660 | $14,470 |
| QI | $1,781 (135% FPL) | $2,400 (135% FPL) | $9,660 | $14,470 |
| QDWI | $5,302 (400% FPL) | $7,135 (400% FPL) | $4,000 | $6,000 |
- Income Disregards
- MSPs include a $20 general income disregard, wherein the first $20 of monthly income is not counted.
- Excluded Assets
- Assets, including the following, are not counted
- Primary home
- One car
- Household goods and personal effects
- Burial plots
- Up to $1,500 per person in burial funds
- Life insurance with a cash value of less than $1,500
- Assets, including the following, are not counted
- State Flexibility
- Some states may have higher income or asset limits than the federal guidelines. Moreover, states like California, Alabama, Arizona, Connecticut, Delaware, Louisiana, Mississippi, New Mexico, New York, Oregon, Vermont, and the District of Columbia have removed the asset limit for MSPs.
Low-Income Subsidy-LIS
- Beneficiaries of QMB, SLMB, or QI programs automatically qualify for Medicare’s Extra Help (Low-Income Subsidy – LIS) program, lessening the burdens of prescription drug costs under Medicare Part D, including:
- Monthly Part D plan premiums
- Annual Part D deductibles
- Part D copayments and coinsurance
This article follows our editorial standards. We cite primary sources, note study limitations, and update articles when the evidence changes.
