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What are the Medicare Savings Programs (MSP)?

There are 3 Medicare Savings Programs:

  • Qualified Medicare Beneficiary Program (QMB)
  • Specified Low Income Medicare Beneficiary Program (SLMB)
  • Qualified Individual (QI)

All 3 MSP Programs will pay your Part B premium if you are eligible.

The QMB Program will also pay for the Part A premium if you are not eligible for free Medicare Part A and you Medicare Part A and B copayments and deductibles.

Who qualifies for these programs:

  • You must be age 65 or older;
  • You must have or be eligible for Medicare Part A and B benefits;
  • If you are not eligible for free Medicare Part A benefits, you must be a U.S. citizen or legal resident and have lived in the United States for at least five years.

To qualify for one of the three Medicare Savings Programs, you must meet specific income and resource limits.

  Monthly Income** Resource Limit* Benefits
Qualified Medicare Beneficiary (QMB) 100% FPL

$1,032 – single person

$1,392 – married couple

$7,560 – single person

$11,340 – married couple

• State pays Medicare Part A and B premiums

• State pays Medicare deductibles and coinsurance

Specified Low Income Medicare Beneficiary (SLMB) 120% FPL

$1,234 – single person

$1,666 – married couple

$7,560 – single person

$11,340 – married couple

• State pays Medicare Part B premium
Qualified Individual (QI) 135% FPL

$1,386 – single person

$1,872 – married couple

$7,560 – single person

$11,340 – married couple

• State pays Medicare Part B premium

* Resource limits include $1,500 burial allowances for a single person and $3,000 for a married couple.

Countable resources include: cash, money in bank accounts, stocks and bonds.

** Monthly income limits include a $20 standard deduction.

  • The MSP Program income limits do not count in-kind support..
  • The MSP Program resource limits do not count  life insurance of any value, your home, the number of cars you own.
What is the Medicare Part D Low Income Subsidy Program “Extra Help”?

This program provides financial assistance with Medicare Part D Prescription Drug Coverage.

Persons who qualify for this financial assistance program are enrolled into Medicare Part D Prescription Drug Plans (PDP) and Medicare Advantage Prescription Drug Plans (MAPD).

Who is eligible for the Medicare Part D Extra Help?
  • Persons who qualify for full Medi-Cal automatically qualify for this program and pay $1.25 for generics and $3.70 for brand name drugs.
  • Persons who are enrolled into any of the Medicare Savings Programs also automatically qualify for this program and receive financial help with their prescriptions.
  • Persons who meet the Medicare Part D Extra Help income and resource limits and apply for the program.
What are the income and resource limits to qualify for the Medicare part D Extra Help Program?

The two charts below outline the Medicare Part D Extra Help income and resource limits to receive the Medicare Part D Full Subsidy and the Partial Subsidy levels of assistance.

Full LIS Extra Help

Income Limits** Asset Limits* Benefits
$1,386/month (individual)

$1,872/month (married couple)

$9,060 (individual)

$14,340 (married couple)

• $0 annual deductible„

• Copays $3.35 generic; $8.35 brand


Partial LIS Extra Help

Income Limits** Asset Limits* Benefits
$1,538/month (individual)

$2,078/month (married couple)

$14,100 (individual)

$28,150 (married couple)

• $83 annual deductible„

• You pay 15% of drug costs

„„• After total drug costs are greater than $7,508.75 you pay $3.35 generic; $8.35 brand

*Asset limits include $1,500 per person for burial expenses. The home you live in, your cars, and life insurance policies are not counted as resources.

**Income limits include the $20 monthly income disregard. In-kind support is not counted towards the income limit.

How does having Medicare Part D Extra Help change my Medicare Part D coverage?
  • You will receive financial assistance with your Part D covered prescriptions.
  • You will be able to change your Part D drug plan on a monthly basis.
  • If you are disenrolled from your Part D drug plan or Medicare Advantage plan, you will have access to a safety net program called LI Net Humana. This program will provide you with access to prescription drugs even though you are not in a Part D plan. Call the Center for Health Care Rights for more information about how the LI Net program works.
  • If you are disenrolled from your Part D plan, Medicare will assign you to a new Part D plan if you do not select a plan.