Medicare savings programs can help you pay Part A and Part B premiums, deductibles, copays, and coinsurance. To qualify, your income and household resources must be at or below specified limits each month.
If your household income and resources fall below certain levels, you may qualify for one of four federally funded programs to help you pay Medicare costs.
These programs were created because not everyone reaches retirement age with the same ability to manage expenses like Medicare premiums, copays, coinsurance, deductibles, and the cost of prescription drugs.
If you qualify for one or more of the Medicare savings programs, you may also qualify for the Extra Help program, which can assist with your prescription drug costs.
Keep reading to learn more about these programs and how to qualify for one.
The following four Medicare savings programs are funded by the federal government but managed by Medicaid in each state:
The income requirements for Medicare savings programs in 2025 are summarized in the following table:
| Medicare savings program | Individual monthly income limit | Married couple monthly income limit | Individual resource limit | Married couple resource limit | Helps you pay |
|---|---|---|---|---|---|
| QMB | $1,325 | $1,783 | $9,660 | $14,470 | Part A premiums, Part B premiums, deductibles, copays, coinsurance |
| SLMB | $1,585 | $2,135 | $9,660 | $14,470 | Part B premiums |
| QI | $1,781 | $2,400 | $9,660 | $14,470 | Part B premiums |
| QDWI | $5,302 | $7,135 | $4,000 | $6,000 | Part A premiums |
- Healthcare professionals cannot bill you: If you are in the QMB program, your doctors aren’t allowed to bill you for the care you receive. Instead, Medicaid will pay them directly. If you are wrongly billed for a healthcare service, make sure the doctor knows you’re in the QMB program. Then, contact Medicare to let them know you’re being billed for the service.
- You must qualify: To qualify for the QDWI program, you must be disabled, working, and under 65 years old. If you went back to work, lost your premium-free Medicare Part A coverage, and are not getting medical help from your state, you may be eligible for the QDWI program.
- You must enroll each year: If you’re enrolled in Medicaid, you won’t be able to get QI benefits. If you apply for the QI program and you’re accepted, you’ll need to reapply every year.
- There may be a delay before benefits begin: Once you’re accepted, it can take a couple of months before Medicaid begins paying your premiums. Medicaid will reimburse you for any premium payments you made while Medicaid was supposed to be paying.
What does Medicare consider my resources?
To determine your eligibility for these savings programs, Medicare considers your resources. This includes money you have in checking or savings accounts, stocks, and bonds.
Resources do not include your home, one car, any burial plots, your household furnishings, personal belongings like your clothes and jewelry, or up to $1,500 for burial expenses.
If you’re eligible for Medicare and your income and resources are at or below the limit for a Medicare savings program, you can apply by contacting the Medicaid office in your state.
You should receive an update on the status of your application within 45 days. If Medicaid denies your application, you may be able to file an appeal.
Here are some steps you can take to apply for a Medicare savings program:
- Familiarize yourself with the kinds of questions you may be asked when you apply. The form is available in multiple languages.
- Before you begin applying, gather supporting documents, such as your Social Security and Medicare cards, proof of your address and citizenship, bank statements, IRA or 401(k) statements, tax returns, Social Security awards statements, and Medicare notices.
- To apply for a program, you’ll need to contact your state Medicaid office. You can check online to find your state’s office locations or call the Centers for Medicare and Medicaid Services (CMS) at 877-267-2323.
- Once you submit your application, you should receive a confirmation or denial within about 45 days. If you’re denied, you can request an appeal. Enrollment in any of these programs must be renewed each year.
- Reach out to your State Health Insurance Assistance Program if you have any questions or need additional assistance.
If you qualify for the QMB, SLMB, or QI programs, you’ll automatically be enrolled in the Extra Help program, too. This program will help you pay all the premiums, deductibles, and coinsurance for a Medicare Part D prescription drug plan.
For example, in 2025, under the Extra Help program, you’ll pay:
- Plan premium: $0
- Plan deductible: $0
- Prescriptions:
- up to $4.90 for a generic drug
- up to $12.15 for a brand-name drug
Once your total drug costs reach $2,000, you’ll pay $0 for each covered drug.
Private companies offer Medicare Part D plans. This means each insurer will have different requirements for which documents you need to provide to show your eligibility.
Some examples of the kinds of documentation you might be asked to provide include:
- notice from Medicare saying you’re qualified (purple)
- Extra Help notice of award from Social Security
- Medicare automatic enrollment notice (green/yellow)
- notice from Medicare about a change in your copay (orange)
- proof that you have Medicaid
Medigap (Medicare supplement insurance)
Medigap plans are private insurance policies that help you pay your Medicare costs, including copays, coinsurance, and deductibles. You can choose from among 10 plans, and each plan offers the same coverage nationwide.
Starting in 2020, though, new enrollees could no longer sign up for a Medigap plan that pays the Part B premiums. To take a look at the different costs and coverage options, you can use Medicare’s plan comparison tool.
Medicaid
This program is a health safety net jointly run by federal and state agencies. It offers the same services as Medicare, plus some additional benefits like nursing home care and personal care.
PACE
The Program for All-Inclusive Care for the Elderly (PACE) can get you the medical care you need at a PACE center in your area, home, or community, so you don’t have to go to a nursing home.
Here are just a few of the services PACE beneficiaries may receive:
- adult day care
- dentistry
- home care
- hospital care
- lab work
- physical or occupational therapy
- social work counseling
- meals
- medical specialty services
PACE centers are not available everywhere. To find out whether your state operates a PACE center near you, contact your state Medicaid office.
Medicare savings programs help people with lower income pay their Medicare Part A and Part B premiums, deductibles, copays, and coinsurance.
To qualify, your monthly income must be at or below a certain limit for each program, and your household resources cannot exceed certain limits.
If you qualify for one or more of these programs, you may also qualify for Extra Help. This program helps lower the cost of your prescription drugs.
Although these programs are federally funded, they are run by state Medicaid programs. To apply, you can contact the Medicaid office in your state or complete an online application.
You can also cut your Medicare costs by applying for Medicaid, enrolling in PACE, or purchasing a Medigap policy.
Gathering the necessary documentation and filling out the appropriate applications may take some time and effort, but these savings programs make it possible for you to get the healthcare you need at a cost you can afford.