What Is an MSP Medicare Savings Program?
An MSP, or Medicare Savings Program, is a state-run program that helps people with limited income and resources pay certain Medicare costs. Depending on the specific MSP, it may help pay Medicare Part A and Part B premiums, deductibles, coinsurance, and copayments. Your state determines eligibility and which MSP you qualify for, so rules and limits can vary by state.
What does MSP mean in Medicare?
MSP stands for Medicare Savings Program. These programs are administered by state Medicaid agencies and are designed to help eligible Medicare beneficiaries with some out-of-pocket Medicare costs.
An MSP is not the same as a Medicare Medical Savings Account, often called an MSA. An MSP is financial assistance through your state, while an MSA is a type of Medicare Advantage plan.
What costs can a Medicare Savings Program help pay?
The costs an MSP can help with depend on which program your state approves you for. In general, MSPs may help pay:
- Medicare Part A premiums, if you owe one
- Medicare Part B premiums
- Medicare deductibles
- Medicare coinsurance
- Medicare copayments
Not every MSP pays every type of cost. Some programs only help with the Part B premium, while others provide broader help with Medicare cost sharing.
What are the main types of Medicare Savings Programs?
The four main Medicare Savings Programs are:
- Qualified Medicare Beneficiary (QMB) Program: Helps pay Medicare Part A and Part B premiums and Medicare deductibles, coinsurance, and copayments. If you are in QMB, providers generally should not bill you for Medicare-covered deductibles, coinsurance, or copayments.
- Specified Low-Income Medicare Beneficiary (SLMB) Program: Helps pay the Medicare Part B premium.
- Qualifying Individual (QI) Program: Helps pay the Medicare Part B premium. The QI program has limited funding, and you generally must apply each year.
- Qualified Disabled and Working Individual (QDWI) Program: Helps pay the Medicare Part A premium for certain working people with disabilities who meet the program rules.
Who may qualify for an MSP?
You may qualify for a Medicare Savings Program if you have Medicare and meet your state’s income and resource rules. Resources generally include things like money in bank accounts, stocks, and bonds, but states may count resources differently.
Federal limits are published for these programs, but Medicare notes that some states use higher income or resource limits, and some states may not count certain resources for QMB, SLMB, or QI. Alaska and Hawaii may also have higher limits. Because of these differences, it is important to apply even if you are not sure you qualify.
How do you apply for a Medicare Savings Program?
You apply for Medicare Savings Programs through your state, usually through the State Medical Assistance office, also called the Medicaid office. When you apply, your state reviews your information and decides which MSP you qualify for, if any.
You can also apply for Medicare Extra Help and an MSP at the same time in some situations. Social Security may send information to your state to start an MSP application unless you choose not to have that done on the Extra Help application.
What limitations should you know about?
Medicare Savings Program rules are not identical in every state. Eligibility, income counting, resource counting, and application procedures can vary. The QI program is also handled differently than some other MSPs because states approve applications on a first-come, first-served basis, with priority for people who had QI benefits the previous year.
An MSP can reduce Medicare costs, but it does not replace Medicare coverage. You should continue using your Medicare card and any Medicaid or QMB card your state gives you when you receive care.
From First Meeting to Medicare Enrollment
We begin by helping you understand how Medicare works and how the different pieces fit together. We walk through Original Medicare, Parts A and B, Medicare Advantage, Medicare Supplement insurance, and Part D prescription drug coverage, including how formularies, drug tiers, and plan rules can affect your costs.
We also explain dental, vision, and hearing coverage, along with other products that may help fill gaps in your healthcare plan. Depending on your needs, that may include short-term in-home healthcare coverage, hospital indemnity insurance, or coverage designed to provide additional financial support following a cancer diagnosis, heart attack, or stroke.
Once you understand the landscape, we move into the planning stage. That is when we review your doctors, hospitals, prescription drugs, current coverage, and other personal details so we can begin evaluating the Medicare plan options that fit your situation.
Official Sources
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Medicare Savings Programs | Medicare
Verifies what Medicare Savings Programs are, what costs they may help pay, the main MSP types, state application process, and key QMB and QI rules. -
Get help with costs | Medicare
Verifies that state-run programs can help lower Medicare costs and that people should contact their State Medical Assistance office for details. -
Fact sheet Save money on your Medicare costs
Verifies that Medicare Savings Programs can help with premiums, deductibles, and related Medicare costs, and that states decide eligibility. -
Qualified Medicare Beneficiary (QMB) Program Group | CMS
Verifies that the QMB group provides Medicare coverage of Part A and Part B premiums and cost sharing for eligible low-income Medicare beneficiaries. -
CMS Guidance: Reporting Expectations for Dual-Eligible Beneficiaries, Updated
Verifies the MSP categories used for partial dual-eligible beneficiaries, including QMB, SLMB, QDWI, and QI.
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