An elderly female hand holds a mock United States government Medicare Health Insurance card.

Medicare Savings Programs

What are the Medicare Savings Programs (MSPs)?

There are three different programs: QMB, SLMB, and QI. They are called “buy-in programs” because they pay the Part B premium for people with limited incomes who otherwise might not be able to afford Medicare.
They are part of federal Medicaid, administered by the state Medi-Cal agency.

How Does One Apply?

  • People with full Medi-Cal are usually automatically enrolled in QMB if eligible.
  • Everyone else must complete a paper application and submit it to the County Medi-Cal processing office in Concord. HICAP has applications and envelopes.

What are the Criteria for Qualifying?

  • Individuals must be eligible for, although not necessarily enrolled in, both Medicare A and B. It’s possible to apply for Medicare via the Social Security Administration while also applying for the MSP program at the County.
  • Asset limits for the MSPs are higher than for Medi-Cal and are the same for all three MSPs ($9,900 single, $15,600 married). If monthly withdrawals of principal and interest are being taken, tax-qualified accounts (IRAs, 401Ks, etc.) are not counted as assets although the withdrawals are counted as income.
  • Income is gross income before the Part B premium is deducted from their social security check.
  • Unlike Medi-Cal, people can’t “spend down” their countable income by buying other health insurance such as dental, etc.

Medicare Savings Programs income limits for 2022:

Program Income Limits
Qualified Medicare Beneficiary (QMB) $1,133 single; $1,526 couple
Specified Low Income Beneficiary (SLMB) $1,359 single; $1,831 couple
Qualified Individual (QI) $1,529 single; $2,060 couple

What are the Other Benefits?

  • All programs automatically provide full Low-Income Subsidy (LIS) for drug costs for the year.
  • Recipients can change drug or Medicare Advantage plans quarterly.

Qualified Medicare Beneficiary (QMB)

  • This is the only program that pays the Part A premium. It also pays the Part B premium and all Medicare Parts A and B deductibles and copays. Although it is against the law for providers to bill QMB recipients for Medicare deductibles and co-pays, it may be best to use providers who take both Medicare and Medi-Cal.
  • Allows immigrants and others with very low incomes who don’t qualify for free Part A to get it at no cost.
  • Someone can conditionally apply for Part A contingent upon being approved for QMB.
  • Those with Medi-Cal should still apply for QMB if they don’t get free Part A because only QMB, not Medi-Cal, pay the Part A premium.

Specified Low-Income Medicare Beneficiary (SLMB) & Qualifying Individual (QI)

  • Only pays Part B premium. Does not pay for any other Part B coinsurance or for Part A. QI program allows a slightly higher income

HICAP can help you understand eligibility: HICAP counseling appointments.

This project was supported, in whole or in part, by grant numbers 2101CAMISH, 2101CAMIAA, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects with government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official ACL policy.

Support provided by the California Department of Aging.