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 Kentucky 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. Whether you’re already enrolled in Medicare or getting ready to sign up, an MSP can help make your health care costs more affordable. ## What are the Medicare Savings Programs? 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 Kentucky, MSPs are handled by the Department for Medicaid Services (DMS), part of the Cabinet for Health and Family Services (CHFS). ## What are the types of Medicare Savings Programs offered in Kentucky? There are four types of MSPs available in Kentucky: - **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)**: For certain working people with disabilities, this MSP pays the Medicare Part A premium for up to 48 months. **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 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. Call [1-800-633-4227](tel:1-800-633-4227) to see if an SNP plan is available where you live and if you qualify. ## Can I get help paying for my prescription drugs in Kentucky? Once you're enrolled in a Medicare Savings Program, you will be signed up for the Medicare Part D [Extra Help program](https://benefitscheckup.org/medicare-rx-extra-help-application/). If you meet the guidelines for Extra Help, you will have a low (or no) deductible, a low (or no) premium, and no coverage gap. In general, you will pay much less for your prescriptions. You can learn more about Extra Help and even [apply on our website](https://benefitscheckup.org/medicare-rx-extra-help-application-prepare/). ## How do I know if I'm eligible for an MSP in Kentucky? You must either be enrolled in Medicare or expect to enroll soon. Each Medicare Savings Program has its own income limit (the most income you can earn in a month to qualify). The monthly income limits for MSPs in Kentucky are listed below and are effective as of April 1, 2026: **Qualified Medicare Beneficiary Program (QMB):** 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 an MSP in Kentucky, you must also have assets no greater than $9,950 (individual) or $14,910 (couple). Assets are things you own that can be turned into money, like cash, bank accounts, or property (not your home). [Learn more about MSP income limits](https://www.ncoa.org/article/medicare-savings-programs-eligibility-coverage). 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 Medicare Savings Programs in Kentucky? Follow the steps below to apply for the Kentucky MSPs. **1. Gather important documents**. Before you apply, have the following information handy to make your application process easier: - The amount of income you get from jobs and other sources - Your assets, such as bank account and investment account balances - Medicare numbers, Social Security numbers, and birth dates of everyone applying or in your household **2. Complete an application**. To apply to the Kentucky Medicare Savings Programs, choose one of the options below: - Apply by phone: Call your local CHFS office ([find your office here](https://prd.webapps.chfs.ky.gov/Office_Phone/index.aspx)). For TTY/TDD Users: If you are deaf or hard of hearing, please call [1-877-486-2048](tel:1-877-486-2048). - Apply by mail or in person: [Download and print the form](https://www.chfs.ky.gov/agencies/dms/MAPForms/Map205English.pdf), fill it out, and mail it or drop it off at your local CHFS office. ## How can I get help with my Medicare Savings Programs application? To get help with your Kentucky MSP application, you can: - Call Medicaid Member Services at [1-855-459-6328](tel:1-855-459-6328). - Call your local CHFS office ([find your office here](https://prd.webapps.chfs.ky.gov/Office_Phone/index.aspx)). - Call the Kentucky statewide SHIP Hotline at [1-877-293-7447](tel:1-877-293-7447). - Visit a Benefits Enrollment Center (BEC), if there’s one near you. [See if there’s one in your area.](http://benefitscheckup.org/map) **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.**