If you have limited income and assets, you may qualify for a Medicare savings program to help you pay your Medicare costs.
Four types of Medicare savings programs
Qualified Medicare Beneficiary (QMB) Program:
What it helps pay for:
- Medicare Part A premiums
- Medicare Part B premiums
- Deductibles, coinsurance, copayments
Specified Low-Income Medicare Beneficiary (SLMB) Program:
What it can help pay for:
- Medicare Part B premiums
Qualifying Individual (QI) Program:
What it can help pay for:
- Medicare Part B premiums
Qualified Disabled and Working Individuals (QDWI) Program:
What it can help pay for:
- Medicare Part B premiums
Medical Savings Program qualifications
| Qualified Medicare beneficiary | Specified low-income Medicare beneficiary | Qualifying individual | Qualified disabled working individual | |||||
|---|---|---|---|---|---|---|---|---|
| Monthly income limit* | Single $1,061 |
Married $1,430 |
Single $1,269 |
Married $1,711 |
Single $1,426 |
Married $1,923 |
Single $4,249 |
Married $5,722 |
| Resource limit† | Single $7,730 |
Married $11,600 |
Single $7,730 |
Married $11,600 |
Single $7,730 |
Married $11,600 |
Single $4,000 |
Married $6,000 |
| Additional qualifications | None | None | You must reapply every year. Applications are first-come, first-served with priority given to people who received QI benefits the previous year. You are not eligible if you qualify for Medicaid. |
You’re a working disabled person under 65 years old. You lost your premium-free Part A when you went back to work. You aren’t getting medical assistance from your state. |
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*If you have income from working, you may qualify even if your income is higher than the limits listed.
†Money in checking and savings accounts, stocks, and bonds.
Paying for your Part D prescription drug costs
People with limited income may qualify for extra help to pay for their prescription drug costs. If eligible, Medicare could pay up to 100% of drug costs – including monthly prescription drug premiums, annual deductibles, and coinsurance. Additionally, those who qualify will not be subject to the coverage gap or a late-enrollment penalty.
If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, the amount of extra help you get will determine your total monthly plan premium as a member of our plan.
This table shows you what your monthly plan premium will be if you get extra help.
Download the chart:
MAPD LIS Premium summary chart: English (PDF, 193 KB) / Español (PDF, 131 KB)
PDP LIS Premium summary chart: English (PDF, 127 KB) / Español (PDF, 73 KB)
| Your level of extra help | ||||
|---|---|---|---|---|
| Plan name | 100% | 75% | 50% | 25% |
| Blue Shield 65 Plus (HMO), Blue Shield 65 Plus Choice Plan (HMO), Blue Shield Inspire (HMO), Blue Shield Vital (HMO)1* | $0 | $0 | $0 | $0 |
| Blue Shield Inspire (PPO) (Alameda County)* | $77.40 | $82.50 | $87.70 | $92.80 |
| Blue Shield Inspire (HMO) (Alameda County)* | $45 | $45 | $45 | $45 |
| Blue Shield Inspire (HMO) (Fresno and Madera counties)* | $0 | $0 | $0 | $0 |
| Blue Shield Inspire (HMO) (San Mateo County)* | $35 | $35 | $35 | $35 |
| Blue Shield Inspire (HMO) (Sacramento County)2* | $39 | $39 | $39 | $39 |
| Blue Shield RX Plus | $27.50 | $35.40 | $43.30 | $51.10 |
| Blue Shield RX Enhanced plan | $98.90 | $106.80 | $114.70 | $122.50 |
| Blue Shield Advantage Optimum Plan (HMO) (Los Angeles, Orange, Santa Clara, San Joaquin, Stanislaus, Merced, Fresno counties) | $0 | $0 | $0 | $0 |
| Blue Shield AdvantageOptimum Plan (HMO) (Santa Clara County) | $48 | $48 | $48 | $48 |
| Blue Shield Advantage Optimum Plan 1 (HMO) (San Diego County) | $0 | $0 | $0 | $0 |
| Blue Shield Advantage Optimum Plan 2 (HMO) (San Diego County) | $0 | $0 | $0 | $0 |
| Blue Shield Coordinated Choice Plan (HMO) (Los Angeles, Orange, San Bernardino, Riverside, San Diego, Fresno, Santa Clara, Merced, San Joaquin, Stanislaus counties) | $0 | $7.90 | $15.80 | $23.60 |
| Blue Shield Total Dual Plan (HMO D-SNP) (Los Angeles, Orange, San Bernardino, San Diego counties) | $0 | $7.90 | $15.80 | $23.60 |
| Blue Shield Total Dual Plan (HMO D-SNP) (Fresno, San Joaquin, Stanislaus counties) | $0 | $7.90 | $15.80 | $23.60 |
1. Los Angeles, Orange, San Diego, Kern, Riverside, San Bernardino, Ventura, San Luis Obispo, and Santa Barbara counties
2. Blue Shield Trio Medicare - Sacramento County
*This does not include any Medicare Part B premium you may have to pay.
How do I know if I qualify for extra help?
If you believe you qualify for Low-Income Subsidy (LIS) and are paying 100% of your premium, you can call:
- (800) MEDICARE or (800) 772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call (800) 325-0778, or go online to https://www.ssa.gov/benefits/medicare/prescriptionhelp.
- Your state Medicaid office
For more information about extra help, call Medicare Customer Care at (800) 776-4466 [TTY: 711]
- Hours October 1 through March 31: 8 a.m. to 8 p.m. seven days a week
- Hours April 1 through September 30: 8 a.m. to 8 p.m., weekdays (8 a.m. to 5 p.m., Saturday and Sunday)
