Medicare Savings Program

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If you have limited income you may be able to get help to pay your Medicare costs

Medicare Savings Program Application – DOH–4328 (PDF)
How to complete the MEDICARE SAVINGS PROGRAM APPLICATION

Qualified Individual (QI):

Gross Monthly Income Limits: 135% FPL + 20%

$1,469 - single person

$1,980 - married & living together

  • Pay Medicare Part B premium
  • Must have Medicare part A in order to be eligible for program
  • QI's - 3 month retroactive not in to previous calendar year

Specified Low Income Medicare Beneficiary Program (SLIMB):

Gross Monthly Income Limits: 120% FPL + $20

$1,308 - single person

$1,762 - married & living together

  • Pays the Medicare part B premium
  • Must have Medicare part A in order to be eligible for program
  • SLIMB's - 3 months retroactive

Qualified Medicare Beneficiary (QMB):

Gross Monthly Income Limits: 100% FPL +$20

$1,094 - single person 

$1,472 - married & living together
 

  • Pays the Medicare Part A and Part B premiums
  • Pays the Medicare Part A and Part B Deductibles & Co insurances
    • Providers cannot charge copays for Medicare-covered services
  • QMB’s - has no retroactivity - effective 1st of following month

 

  • Still working? 
    you might still qualify for MSP benefits - Work Income is counted at less than half.
     
  • Paying a health insurance premium? 
    Subtract premiums to help qualify—Medigap, Medicare Advantage, Dental, Vision and more.

     
  • Need help paying prescription drug (Part D) costs? 
    You automatically qualify for the Extra Help program if you have Medicaid or MSP.
     

This snap shot provides general information only
These amounts may increase each year. If your income is slightly higher, you should still apply.
The standard $20 Monthly income disregard has been included in the MSP guidelines. Effective 4/17/2021

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For questions and application assistance -

Call Clinton County HIICAP
Health Insurance  Information Counseling & Assistance Program
OFA: (518)565-4620 & JCEO: (518)561-6310

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This product was funded in part by The Administration for Community Living

 

This snap shot provides general information only. Contact the appropriate agency mentioned for information on your individual circumstances.
NY Connects Clinton County 800-342-9871 518-565-4620

Clinton County Office for the Aging
 

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