The Medicare Savings Programs (MSPs) are mandatory Medicaid eligibility groups that assist low-income Medicare beneficiaries with some or all of their Parts A and B premiums and cost-sharing. State Medicaid agencies determine whether or not an individual is eligible for Medicaid coverage, including the MSPs.

The federal MSP income and resource standards (hereafter “limits”) are set by federal law and appear in subsection C.

States can, however, effectively raise these limits for the Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualified Individuals (QI) eligibility groups above the federal statutory limits by disregarding amounts or certain types of income and resources. Some states have used this authority to effectively eliminate resources tests when determining eligibility for these MSP eligibility groups.

Be familiar with the MSP income and resource limits in the claimant’s state of residence to assist you with screening whom to refer to the state. Even if the individual’s income or resources appear somewhat higher than the state limits, encourage them to apply for the MSPs.

NOTE: CMS rounds up to the nearest dollar when computing the monthly income limits.