Medicare Savings Programs help people who have Medicare pay for their medical care.
To get Medicare Savings Program benefits:
- You must be receiving Medicare Part A (hospital insurance benefits).
- Your income must be within certain limits (see below).
There are three Medicare Savings Programs. Eligibility is based on your income. Income limits are based on the Department of Health and Human Services (HSS) poverty guidelines and change each year in March to account for the last calendar year's increase in prices as measured by the Consumer Price Index. Download the Program Brochure (pdf).
Income limits listed below are for March 2023 through February 2024.
Qualified Medicare Beneficiaries (QMB)
Program pays for: Medicare premiums, deductibles and co-insurance.
Income limit is: $1,215 for an individual and $1,644 for a couple (100% of the federal poverty level).
Qualified Disabled Worker (QDW)
Program pays for: Medicare Part A premiums for some disabled workers who lost eligibility for Social Security because they are working and who are not eligible for another Medicaid program.
Income limit is: $2,430 for a single person and $3,287 for a couple (200% of the federal poverty level).
Note: Most people in Oregon are not eligible for QDW because we have the
Employed People with Disabilities Program (EPD), which provides full Medicaid benefits.
Specified Low-Income Medicare Beneficiary and Qualified Individual (SMB and SMF)
Program pays for: Medicare Part B premiums only.
Income limit is:
For SMB the income limit is $1,458 for individuals or $1,972 for a couple (120% of the poverty level). The federal government pays approximately 60% of this benefit.
For SMF the income limit is $1,641 for an individual and $2,219 for a couple (the federal government mandates services for people with incomes between 120% and 135% of the poverty level). The federal government pays 100% of this benefit.
- In most states, this program is called the Qualifying Individual (QI) program. In Oregon, this is called the SMF benefit.
- We are only allowed to serve a certain number of people each year for this program. Unfortunately if we reach our limit, we have to shut down enrollment.
Note: If you are eligible for any other Medicaid benefit offered by the state, you are not eligible for the SMF program.
How to apply
To apply for Medicare Savings Programs:
We will make a decision on your application within 45 days of the date you submit your application.