Medicare Savings Programs

Medicare Savings Programs

Medicare Savings Programs are federal and state funded assistance programs that help pay for some Medicare expenses. For those that do not qualify for Medicaid (MO HealthNet) benefits, there may still be help for “payment of Medicare premiums.” These programs require that an individual have:

• Income below 135% of the federal poverty level, and
• Resources below $7,560 for a single person or below $11,340 for a couple.

If you qualify for any Medicare Savings Program, you automatically qualify for the Prescription Drug Extra Help program. Medicare will pay the premiums for a basic prescription drug plan, and pay for most covered prescription medications (except for small co-pays). The beneficiary will not have the gap in coverage, and if they reach the out-of-pocket maximum, Medicare will pay 100% of their covered medication costs.

Income requirements are current from April 2018 – March 2019.

The chart below details the three available programs and the assistance offered:

What It’s Called	Maximum Income and Resources	What It Pays For
QMB Qualified Medicare Beneficiary	Single – $1,032 Couple – $1,392	Medicare Part A monthly premiums (when applicable) Medicare Part B monthly premiums Deductibles, copays, and coinsurance for Medicare Parts A and B, and Medicare Advantage plans.
SLMB Specified Low-Income Medicare Beneficiary	Single – $1,234  Couple – $1,666	Medicare Part B monthly premiums.
QI-1 (SLMB-2) Qualified Individual-1	Single – $1,386  Couple – $1,872	Medicare Part B monthly premiums.

To apply for any of the Medicare Savings Programs, a MO HealthNet (Medicaid) application must be completed and submitted to your local Family Support Division office. Get the application here. If you have questions about your benefits, contact your local Family Support Division office. Click here to find your county’s Family Support Division office.