If you are enrolled in Medicare Parts A and B and have limited income you may be able to get assistance with your health care costs through a Medicare Savings Program (MSP)
If eligible, you will receive help paying the Medicare Part B premium, (currently $164.90) and automatically get Extra Help, the federal program that helps with prescription drug (Part D) costs such as monthly premium, drug deductible and prescription copays.
The two MSP programs listed below offer separate benefits. You cannot choose which program to apply for – you will be enrolled in the MSP that corresponds to your income.
Due to changes in New York law “expanding Medicare Savings Program eligibility,” New Yorkers previously not eligible for MSP may now qualify effective January 1, 2023.
New 2023 New York Monthly Income Limits (*)
|QI (i)||Up to $2,260||Up to $3,057|
|QMB (ii)||Up to $1,677||Up to $2,268|
(*) Eligibility is based on your income after subtracting for eligible health insurance premium deductions such as i) Medicare Supplement, ii) Part D drug plan, iii) dental, iv) vision, and iv) long term care premiums.
- (QI) Once enrolled as a Qualified Individual with individual monthly income at or below $2,260 you will no longer have the Medicare Part B premium deducted from your Social Security check. And you may receive up to three months of retroactive reimbursement for Part B premiums paid before your MSP effective date and within the same year of the effective date.
- (QMB) If your individual monthly income is at or below $1,677 you would be enrolled in the Qualified Medicare Beneficiary Program and, like QI, will no longer have the Medicare Part B premium deducted from your Social Security check.
- This program also pays for Medicare Parts A and B deductible and cost sharing however no retroactive Part B reimbursements are available to QMB enrollees.
- Once enrolled in QMB, consider a Medicare Advantage DUAL (Medicare / Medicaid) plan. On top of the benefits described above, these plans include additional benefits like dental, vision and even an allowance for healthy food. Ask your local agent about the Medicare Advantage DUAL plans we represent for individuals in the QMB program.
Your local agent can help you with the request. Start by downloading the form below. Then, along with a copy of your Medicare ID card, we’ll need documents to confirm your date of birth, residency and income. If you are paying another health insurance premium, such as i) Medicare Supplement, ii) Part D drug plan, iii) dental, iv) vision, and iv) long term care premiums, we’ll need some proof of that expense. Your local agent will work with you in getting this to your county’s Department of Social Services and follow up with you during the approval process which can takes up to 45 days.
(i) Qualified Individual income eligibility at 186% of 2023 Federal Poverty Level
(ii) Qualified Medicare Beneficiary income eligibility at 138% of 2023 Federal Poverty Level
New York State Department of Health link
New York Health Access link
Medicare Rights link