Medicare Savings Programs
4.2.1.7 Types of Medicare Savings Programs
There are four Medicare Savings Programs (MSP):
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The Qualified Medicare Beneficiary (QMB), Service Limited Medicare Beneficiary (SLMB), and Qualified Individuals (QI) programs are available to people eligible for Medicare who meet all other requirements.
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The Qualified Working Disabled (QWD) program is limited to people who are blind or have a disability.
Qualified Medicare Beneficiary (QMB)
People who are enrolled or are eligible to enroll in Medicare Part A may receive help with Medicare costs through the QMB program. QMB pays Medicare Part A and Medicare Part B premiums. It also pays for both Medicare Part A and Part B deductibles, coinsurance and copayments.
To qualify for QMB, a person must be entitled to Medicare Part A, have monthly income at or below 100% FPG, and meet the asset limit. See the MSP Financial Eligibility subchapter for more information. People who meet QMB requirements may receive QMB only, or may receive QMB in addition to Medical Assistance (MA).
QMB enrollees automatically qualify for Extra Help paying for Medicare Part D prescription drug coverage.
QMB Begin and End Dates
QMB eligibility begins the first day of the month after the month eligibility is determined. QMB eligibility cannot begin in or before the month of application.
Service Limited Medicare Beneficiary (SLMB)
People enrolled in Medicare Part B may receive help with Medicare premium costs through the SLMB program. SLMB pays Medicare Part B premiums. Medicare calls SLMB the Specified Low-Income Medicare Beneficiary (SLMB) Program.
To qualify for the SLMB program, a person must be eligible for Medicare Part A and have monthly income at or below 120% FPG and meet the asset limit. See the MSP Financial Eligibility subchapter for more information. People who meet SLMB requirements may receive SLMB only, or may receive SLMB in addition to MA.
SLMB enrollees automatically qualify for Extra Help paying for Medicare Part D prescription drug coverage. SLMB also offers retroactive coverage. See MSP Retroactive Eligibility for more information.
Qualified Individuals (QI)
People enrolled in Medicare Part B may receive help with Medicare premium costs through the QI program. QI pays Medicare Part B premiums. A limited amount of money is available for the QI program, and benefits are available on a first-come, first-served basis. Medicare calls QI the Qualifying Individuals (QI) program.
To qualify for QI, a person must be eligible for Medicare Part A and have monthly income at or below 135% FPG and meet the asset limit. See the MSP Financial Eligibility subchapter for more information.
QI enrollees automatically qualify for Extra Help paying for Medicare Part D prescription drug coverage. QI also offers retroactive coverage. See MSP Retroactive Eligibility for more information.
QI and Medical Assistance
Generally, a person cannot be enrolled in QI and ongoing MA eligibility. However, a person may have overlapping QI and MA coverage if a person enrolled in QI requests retroactive MA eligibility.
QI and MinnesotaCare Eligibility
MSP are not a barrier to MinnesotaCare eligibility. A person eligible for QI and only enrolled in Medicare Part B may be eligible for MinnesotaCare if they are required to pay a premium for Medicare Part A.
Qualified Working Disabled (QWD)
Some employed people under age 65 with disabilities may lose their Retirement, Survivors, and Disability Insurance (RSDI) and premium-free Medicare benefits because their income exceeds Substantial Gainful Activity (SGA) limits. QWD may pay Medicare Part A premiums for these individuals. Medicare calls QWD the Qualified Disabled and Working Individuals (QDWI) program.
To qualify for QWD, a person must meet a blind or disabled basis and be eligible to enroll in Medicare Part A with a premium under the Qualified Working Disabled Adult provisions of the Social Security Act. The person must also have monthly income at or below 200% FPG, meet the asset limit, and not be otherwise eligible for MA. See the MSP Financial Eligibility subchapter for more information. People cannot be enrolled in both QWD and MA.
QWD also offers retroactive coverage. See MSP Retroactive Eligibility for more information.
Legal Citations
Code of Federal Regulations, title 42, section 400.200
Minnesota Statutes, section 256B.057
United States Code, title 42, section 1396a(a)(10)(E)
United States Code, title 42, section 1396d(p)
United States Code, title 42, section 1396d(s)