A Medicare Savings Plan helps pay some of your Medicare costs that you cover yourself

A Medicare Savings Plan is a program run by your state that pays certain out-of-pocket costs you would otherwise pay to Medicare. It covers things like your monthly Part B premium, your deductibles, and your copayments — the amounts you owe when you see a doctor or get care. The program does not give you extra benefits or cover services Medicare does not cover. Instead, it reduces what you pay for the Medicare coverage you already have.

These plans are sometimes called may have access to Medicare Beneficiary (QMB) programs, Specified Low-Income Medicare Beneficiary (SLMB) programs, or may have access to Individual (QI) programs, depending on your income level and which costs the state will cover for you. Each state runs its own version, so the exact costs covered and the income limits vary where you live.

Key Takeaways

  • Medicare Savings Plans pay your Part B premium, deductibles, and copayments directly to Medicare or your provider on your behalf.
  • You must have Medicare Part A and Part B already, and your income must fall below a certain level that varies by state.
  • Your state Medicaid office handles enrollment, not Medicare, and the process and timeline differ by state.
  • Once enrolled, you show your Medicare card as usual — the plan pays the provider or Medicare directly, with no extra card or paperwork from you.

What costs a Medicare Savings Plan covers

The specific costs covered depend on which type of plan your state offers and your income level. The broadest version, called QMB, covers your Part B monthly premium, your Part A and Part B deductibles, and your Part A and Part B copayments. A narrower version, called SLMB, covers only your Part B premium. The QI program covers only your Part B premium as well, but has a higher income limit than SLMB.

None of these plans cover your Part D prescription drug costs, your supplemental insurance premiums, or services that Medicare does not cover. They also do not increase the amount Medicare pays for a service — they only reduce what you owe out of pocket.

Income limits and how they work

To be considered for a Medicare Savings Plan, your income must fall below a threshold set by your state. These thresholds are tied to the federal poverty level and change each year. For example, QMB income limits are usually around 135 percent of the federal poverty level, while SLMB and QI limits are higher. In 2024, the federal poverty level for a single person was around $15,000 per year, but your state's specific limit may be different.

Income includes Social Security, pensions, wages, and other regular income. Some states count only your own income; others count your spouse's income too if you are married. Your state Medicaid office will tell you the exact limit and what counts as income when you contact them.

How to explore whether a Medicare Savings Plan might be available to you

Start by contacting your state Medicaid office directly. You can find the phone number by searching "[your state] Medicaid" online or by calling 211, which connects you to local health and human services. Tell them you want information about Medicare Savings Plans and ask which programs your state offers.

When you call, have your Social Security number, your income information (such as recent pay stubs or a Social Security statement), and your Medicare number ready. The Medicaid office will tell you whether your income falls within the range for any of the programs and what documents you need to provide. Some states let you start the process by phone; others require you to mail in forms or visit an office in person.

The timeline varies by state. Some process requests within a few weeks; others take two to three months. Ask how long the process usually takes where you live and whether you can check on your status by phone.

What happens after you are enrolled

Once your state approves you, you do not need a new card or special paperwork. You continue to use your Medicare card as you always have. When you see a doctor or get care, the provider bills Medicare as usual. Your Medicare Savings Plan then pays the copayment, deductible, or premium directly to Medicare or the provider on your behalf. You may owe nothing at the time of service, or you may owe a small amount depending on your state's rules.

Your enrollment is usually good for one or two years, depending on your state. Before it expires, your state will contact you to renew. If your income or circumstances change, tell your state Medicaid office right away, because the program may no longer be right for you or you may move to a different tier.

Medicare Savings Plans versus other ways to lower your costs

If you do not meet the income limit for a Medicare Savings Plan, you may be able to lower your costs through other routes. A Medigap policy (supplemental insurance) covers some of the same out-of-pocket costs, but you pay a monthly premium for it. A Medicare Advantage plan (Part C) combines Part A and Part B into one plan run by a private insurer and often has lower copayments, but it limits which doctors you can see. Extra Help is a separate program that covers Part D prescription drug costs if your income is low.

A Medicare Savings Plan is the only one of these that is free and covers the costs Medicare itself requires you to pay. If you may have access to, it is usually the most straightforward choice.

Common reasons people do not know about Medicare Savings Plans

Many people on Medicare have never heard of these programs because Medicare itself does not advertise them — your state Medicaid office does. Medicare sends you information about Part D and Medicare Advantage plans every year, but it does not send information about Medicaid programs. This means you have to reach out to your state to learn whether you may have access to.

Another reason is that the names are confusing. The word "Medicaid" in the program names makes people think these are welfare programs, when in fact they are specifically designed for people who already have Medicare and straightforward cannot afford the costs Medicare charges. There is no shame in using them, and they exist for exactly this reason.

Frequently Asked Questions

Do I have to have Medicare Part D to get a Medicare Savings Plan?

No. A Medicare Savings Plan covers your Part A and Part B costs only. Part D is separate. You can have a Medicare Savings Plan without Part D, or you can have both. If you do have Part D, a different program called Extra Help may cover some of your prescription costs if your income is low enough.

What happens if my income goes up after I am enrolled?

Tell your state Medicaid office as soon as you know. Depending on how much your income increased and your state's rules, you may stay enrolled, move to a different tier of the program, or lose coverage. It is better to report the change yourself than to have the state discover it during a review.

Can I have both a Medicare Savings Plan and a Medigap policy?

Technically yes, but it is usually not useful. Both cover similar costs, so you would be paying a Medigap premium for coverage you already have through the Medicare Savings Plan. Most people choose one or the other.

How do I know if my state offers Medicare Savings Plans?

All states offer at least one version of a Medicare Savings Plan, though the specific programs and income limits vary. Call your state Medicaid office or 211 to find out which programs are available where you live and whether you might be may be able to access.

What if I am not sure whether I meet the income limit?

Call your state Medicaid office anyway. They will ask you questions about your income and tell you whether you may have access to. There is no penalty for asking, and the call is free. Many people are surprised to find they do may have access to.