Georgia Medicare Savings Programs

Medicare isn’t free. You’ll still have some costs, such as monthly premiums, deductibles, and co-pays. If you live in Georgia and have low income, you may qualify for a Medicare Savings Program (MSP) to help pay for some or all of these “out-of-pocket” expenses. MSPs can make Medicare more affordable for people who are already enrolled—or getting ready to sign up. ## What are the Georgia Medicare Savings Programs? The Georgia Medicare Savings Programs (MSPs) are state-run Medicaid programs that help people with low income pay for their Medicare costs. These costs include: - **Premiums**: Money you pay to keep your Medicare plan - **Deductibles:** Money you pay before Medicare pays for your care - **Copays**: A set fee you pay to visit your regular doctor or a specialist There are four MSPs, each with different eligibility rules. Older adults and younger adults with disabilities who may not qualify for full Medicaid may still be able to enroll in one of the MSPs. MSPs are available in every state, but not every type of MSP is offered in every state. Most MSPs are run by a state’s Medicaid office. In Georgia, MSPs are handled by the Georgia Department of Human Services Division of Family & Children Services (DCFS), the department that runs the Medicaid program. ## What are the types of Medicare Savings Programs offered in Georgia? All four MSPs are available in Georgia: - **Qualified Medicare Beneficiary (QMB)**: This program has the lowest income limit and covers Medicare Part A and Part B premiums, deductibles, and copayments for those eligible. - **Specified Low-Income Medicare Beneficiary (SLMB):** For those eligible, SLMB covers the Medicare Part B premium ($202.90 per month in 2026). - **Qualifying Individual (QI)**: QI is a limited program and available on a first-come, first-served basis. For those eligible, QI covers the Medicare Part B premium. - **Qualified Disabled & Working Individual (QDWI)**: This program is less common than the other three MSPs. It helps pay for the Medicare Part A (Hospital Insurance) premium. Most people do not pay a premium for Part A. But if you’re younger than 65 with a disability, and you returned to work (after collecting Social Security Disability benefits while out of work), you no longer qualify for premium-free Part A. QDWI does not cover the Part B premium. **Special Needs Plans (SNPs)** You may also want to find out if you qualify for a Special Needs Plan (SNP). SNPs are a special type of Medicare Advantage (Part C) plan for people who need extra help paying for and managing their care. You may qualify for an SNP if you meet one of the following conditions: - You have both Medicare and Medicaid (including QMB). - You have a serious and disabling chronic medical condition. - You live in a nursing home, or you live at home but have high care needs and could qualify for a nursing home. Different SNPs are available in different areas of the country. Learn more by contacting Georgia DCFS at [1-877-423-4746](tel:1-877-423-4746). ## Can I get help paying for my prescription drugs in Georgia? Once you're enrolled in a Georgia Medicare Savings Program, you will be signed up for the Medicare Part D [Extra Help program](https://benefitscheckup.org/medicare-rx-extra-help-application/)[.](https://benefitscheckup.org/medicare-rx-extra-help-application/) If you meet the guidelines for Extra Help, you will have a low (or no) deductible and a low (or no) premium. In general, you will pay much less for your prescriptions with Extra Help. You can learn more and [even apply on our website](https://benefitscheckup.org/medicare-rx-extra-help-application-prepare/)[.](https://benefitscheckup.org/medicare-rx-extra-help-application-prepare/) ## How do I know if I'm eligible for an MSP in Georgia? You must either be enrolled in Medicare or expect to enroll soon. Each program has its own income limit (the most you can earn in a month to qualify) The monthly income limits for MSPs in Georgia are listed below and are effective as of March 1, 2026 (note that these limits include a $20 income disregard): Family size Maximum monthly income (at or below 100% FPL/+ $20 income disregard Individual $ 1,350 Couple $ 1,824 Source: [Medicare.gov](https://www.medicare.gov/basics/costs/help/medicare-savings-programs) **Specified Low-Income Medicare Beneficiary (SLMB):** Family size Maximum monthly income between 100-120% FPL/+ $20 disregard) Individual $ 1,616 Couple $ 2,184 Source: [Medicare.gov](https://www.medicare.gov/basics/costs/help/medicare-savings-programs) **Qualifying Individual (QI):** Family size Maximum monthly income (between 121-135% FPL/+ $20 disregard) Individual $ 1,816 Couple $ 2,455 Source: [Medicare.gov](https://www.medicare.gov/basics/costs/help/medicare-savings-programs) **Qualifying Disabled Working Individual (QDWI):** Family size Maximum monthly income (at or below 400% FPL/+ $20 disregard) Individual $ 5,405 Couple $ 7,299 Source: [Medicare.gov](https://www.medicare.gov/basics/costs/help/medicare-savings-programs) To qualify for the QMB, SLMB, and QI MSP programs in Georgia, you must also have resources no greater than $9,950 (individual) or $14,910 (couple). Resources are things you own that can be turned into money, like cash, bank accounts, or property (not your home). The resource limits for the QDWI program are $4,000 (individual) and $6,000 (couple). If you need help with your Medicare costs, you should apply for the MSPs—even if you think your income might be too high. Certain types of income are not counted, and the only way to know for certain if you qualify is to apply. ## How do I apply for the Georgia Medicare Savings Programs? Follow the steps below to apply for the Georgia MSPs. **1. Gather important documents** Before you apply, gather the following information to make your application process easier: - The amount of income you get from jobs and other sources - Asset information, such as bank and investment account balances - Medicare numbers, Social Security numbers, and birth dates of everyone applying or in your household **2. Complete an application** The quickest and easiest way to apply for the Medicare Savings Programs and other public assistance benefits is online through your [Georgia Gateway website](https://www.gateway.ga.gov/access/). All your personal information is kept 100% private and protected by special security technology. [Apply at MyAccess Benefits Portal](https://www.gateway.ga.gov/access/) **APPLY BY MAIL, PHONE,OR IN-PERSON ** You can [call or visit your local DFCS office](https://dfcs.georgia.gov/locations) to get a paper application (form 700). You can also call your Georgia SHIP for MSP application help at 1-866-552-4464 (select Option 4). SHIP counselors are available anytime Monday through Friday, between 8 a.m. and 5 p.m. ## How can I get help with my Georgia Medicare Savings Programs application? To get help with your application, you can: - [Call or visit your local DFCS office.](https://resources.hhs.texas.gov/pages/find-services) - Call Georgia SHIP at [1-866-552-4464](tel:866-552-4464). - Visit a Benefits Enrollment Center (BEC), if there’s one near you. [See if there’s one in your area](https://benefitscheckup.org/article/how-to-find-a-benefits-enrollment-center-near-you). **NCOA also has a HelpLine you can call to get free support. Call [1-800-794-6559](tel:+18007946559) anytime Monday–Friday, from 8 a.m. to 7 p.m. EST.**