Medicare Savings Programs (MSP)
Medicare Savings Programs (MSP) help people with limited income and resources pay for some or all of their Medicare premiums and may also pay their Medicare deductibles and co-insurance. In some cases, Medicare Savings Programs may also pay Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) deductibles and co-insurance. Medicare Savings Programs are a group of programs Colorado residents can apply for if they have Medicare. Medicare Buy-In is one of the benefits of the Medicare Savings Programs.
Things To Note
- We will pay the Medicare Part B premiums for members on any regular Medicaid program, or those on the Medicare Savings Program. We will not pay the Part B premiums for any member on a Non-Medicaid Medical Assistance program including OAP-State Only, Colorado Indigent Care Program (CICP), or Child Health Plan Plus (CHP+).
- Nearly all Medicare recipients get Part A for free. If you do not get Part A for free, we will pay your Part A premiums if you are in the Qualified Medicare Beneficiary (QMB) tier of the Medicare Savings Program.
- If you get Part A free, we can still pay the Part B premiums even if you have refused or terminated Part B.
- For most members, Part B Buy-In will begin the first month the member is eligible.
- For members who are on Long-Term Care Medicaid and have income over the Specified Low-Income Medicare Beneficiary (SLMB) limit ($1,197/month for an individual in 2015), Part B Buy-In will begin the third month the member is eligible. For these members we will not pay the first two months’ Part B premiums.
- Part B Buy-In should kick in within a month after the county eligibility worker has approved the member’s application. If it takes longer than a month, something is wrong and you should contact the county or the State Buy-In Officer.
- Please see our Medicare/Medicaid Frequently Asked Questions for more helpful information.
There are four different types of Medicare Savings Programs - QMB, SLMB, QI-1, and QDWI. The different income limits for each program are listed below. Remember that if you have income from working, you may qualify for benefits even if your income is higher than the limits listed.
Effective Date: April 1, 2015
- Qualified Medicare Beneficiary (QMB) Program
Individual monthly income limit: $1,001
Married couple monthly income limit: $1,348
- Specified Low-Income Medicare Beneficiary (SLMB)
Individual monthly income limit: $1,197
Married couple monthly income limit: $1,613
- Qualifying Individual (QI-1)
Individual monthly income limit: $1,345
Married couple monthly income limit: $1,813
- Qualified Disabled and Working Individuals (QDWI)
Individual monthly income limit: $1,982
Married couple monthly income limit: $2,675
In addition to the income requirements, one or more of the following must apply:
You're a working disabled person under 65
You lost your premium-free Part A when you went back to work
You aren't getting medical assistance
You meet the income and resource limits required by your state
The resource limits for QMB, SLMB and QI-1 Medicare Savings Programs are $8,780 for one person and $13,930 for a married couple. The resource limits for the QDWI program are $4,000 for one person and $6,000 for a married couple.
Countable resources include:
- Money in a checking or savings account
- Money in an IRA, annuity or trust
Countable resources don't include:
- Your home
- One car
- Burial plot
- Up to $1,500 for burial expenses if you have put that money aside
- Other household and personal items
Benefits and Services
- Qualified Medicare Beneficiary (QMB) Program provides Medicare benefits plus pays for your:
- Part A premiums
- Part B premiums
- Deductibles and co-insurance
With QMB, you might still have to pay your Medicaid co-payments. Visit the Benefits and Services Overview page for a list of Medicaid co-pays.
- Specified Low-Income Medicare Beneficiary (SLMB) Program pays for your:
- Part B premiums only
- Qualifying Individual-1 (QI-1) Program pays for your:
- Part B premiums only
- Qualified Disabled and Working Individuals (QDWI) Program pays for your:
- Part A premiums only
With SLMB, QI-1 and QDWI, you are still responsible for your Medicare deductibles and co-insurance.
How To Apply
- First, you must be eligible for or receiving Medicare.
- Second, contact your county of residence's Department of Human Services to apply.
Where Do I Get These Services?
- If you have QMB, you can visit any doctor who accepts both Medicare and Medicaid coverage.
- If you have SLMB, QI-1 or QDWI, you can visit doctors who accept Medicare.
- These programs do not provide Medicaid benefits; this means that even if a doctor accepts Medicaid and provides you medical services, Medicaid will not pay for any claims.
Helpful Tips For Members
- Use your formal, legal name. No nicknames or initials. Be consistent.
- If you change your name, make sure Social Security updates all three (3) of their databases:
- Numident (where the social security card lives)
- Title 2 (where Medicare lives)
- Title 16 (where SSI – Supplemental Security Income – lives)
- Make sure Social Security has your correct date of birth before you apply for Social Security benefits. Sometimes, Social Security will not correct a person’s date of birth after a person has started receiving benefits.
- State data must match federal data before buy-in can take place. Make sure your name and date of birth you put on your application matches the name and date of birth that Medicare has.
- Also see our Medicare/Medicaid Frequently Asked Questions for more helpful information.
If you have more questions about this program please contact our Medicaid Customer Contact Center.
Program Contact: Sharon.Brydon@state.co.us, 303-866-5402