Cut Medicare Costs: How to Qualify for Savings Programs Help in 2025

Paying for Medicare can be expensive, especially with premiums, deductibles, and copays adding up each year.

In 2025, four Medicare Savings Programs (MSPs) are available to help older adults and people with disabilities reduce these costs.

These programs, run by state Medicaid offices, can cover Part A and B premiums, copayments, and other medical expenses if you qualify.
 

The Four Medicare Savings Programs

1. Qualified Medicare Beneficiary (QMB) Program

• Covers Part A and Part B premiums, deductibles, coinsurance, and copayments.

• Provides the broadest coverage of all MSPs.
   

2. Specified Low-Income Medicare Beneficiary (SLMB) Program

• Pays only for Part B premiums.
   

3. Qualifying Individual (QI) Program

• Also covers Part B premiums.

• Annual reapplication required.

• Enrollment is first-come, first-served due to limited funding.
   

4. Qualified Disabled and Working Individual (QDWI) Program

• Assists certain disabled individuals who lost premium-free Part A after returning to work.

• Covers Part A premiums.

 

Eligibility for Medicare Savings Programs

Eligibility rules vary by state, but there are three main factors:

1. Income and Resources

• Applicants must meet income and asset limits set by their state.

• Your home, car, and personal items are not counted as assets.

 

2. Medicare Enrollment

• You must already be enrolled in Medicare Part A and/or Part B.

You may have access to support you didn’t know about. Find out more here!

 

3. State Determination

• Applicants cannot choose their program.

• Your state Medicaid office will determine which MSP you qualify for based on your income, assets, and personal situation.

 

How to Apply for MSPs in 2025

• Online: Through your state Medicaid website.

• By Mail: Submit the application form provided by Medicaid.

• In Person: Visit your local Medicaid or Social Services office.

• With Help: Work with a Veterans Service Organization (VSO), a senior center, or a community health advocate.
   

Documents You May Need:

• Proof of income (pay stubs, benefit letters, tax returns).

• Proof of Medicare enrollment.

• Resource information (bank statements, investment accounts, property ownership).

If you’re not ready to file a full application, you may be able to submit an “Intent to File” form, which protects your start date while you gather the required paperwork.

 

Important Note: MSPs vs. Medicaid

• MSPs only cover Medicare costs (premiums, deductibles, copayments).

• Medicaid provides full health coverage for low-income individuals.

• You may qualify for both depending on your income and health needs.

 

Medicare and AI: New Changes in 2025

In addition to the MSPs, a new federal pilot program called the Wasteful and Inappropriate Service Reduction (WISER) program will launch in January 2025.

• States like Ohio will test the use of AI tools in Medicare prior authorization decisions.

• AI will help decide whether certain medical treatments (like pain management injections or incontinence therapies) get approved.

• While officials say all AI decisions will be reviewed by a human, advocates warn that oversight has been inconsistent.

Critics also argue that AI contractors may profit from denying claims, raising concerns about fairness.

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