Medicare Savings Programs

For many older adults, especially those with chronic conditions, out-of-pocket Medicare costs can add up quickly. In Virginia, there are Medicare Savings Programs (MSPs) that can help pay for Medicare costs.

You may qualify for a Virginia MSP if you are enrolled in Medicare—or are about to enroll—and you have a limited income.

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 Virginia, MSPs are handled by the Department of Medical Assistance Services (DMAS).

There are four Medicare Savings Programs in Virginia:

• Qualified Medicare Beneficiary (QMB): This program has the lowest income limit and covers your Medicare Part A and Part B premiums, deductibles, and copayments.

• Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI-1): These programs have slightly higher income limits and cover your Medicare Part B Premium ($202.90 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.

How do I know if I'm eligible for an MSP?

You must either be enrolled in Medicare or expect to enroll soon. Each Medicare Savings Program has its own income limit (the most money you can earn in a month to qualify). The monthly income limits for MSPs in Virginia are listed below and are effective as of January 13, 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: Virginia Health Care Foundation

Specified Low-Income Medicare Beneficiary (SLMB):

Family size Maximum monthly income ( between 100-120% FPL/+ $20 disregard)

Individual $ 1,616

Couple $ 2,184

Source: Virginia Health Care Foundation

Qualifying Individual (QI):

Family size Maximum monthly income (between 121-135% FPL/+ $20 disregard)

Individual $ 1,816

Couple $ 2,455

Source: Virginia Health Care Foundation

Qualifying Disabled Working Individual (QDWI):

Family size Maximum monthly income (at or below 200% FPL/+ $20 disregard)

Individual $ 2,680

Couple $ 3,627

Source: Virginia Health Care Foundation

To qualify for an MSP in Virginia, 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.

You should apply to the Virginia Medicare Savings Programs if you need help, 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.

While there is an income limit, Virginia does not have a limit on resources or assets, such as bank account balances, stocks, investment properties, etc.

How do I apply for a Medicare Savings Program in Virginia?

Follow the steps below to apply for the Virginia 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

The quickest and easiest way to apply for the Medicare Savings Programs and other public assistance benefits is through the Virginia CommonHelp portalonline application. All your personal information is kept 100% private and protected by special security technology.

Apply Online

Click on the button above and then click “Apply for Health Care Benefits.” If you do not have an account, click “Click here to create an account” and follow the steps. Once you set up your CommonHelp account, you can log in and start your application.

APPLY BY PHONE

Call the Cover Virginia Call Center toll-free at 1-855-242-8282 to complete an MSP application.

APPLY BY MAIL

Download and fill out Virginia's Medicare Savings Program application form and mail it to the Cardinal Care (Medicaid) Office:

Cardinal Care Correspondence Center

P.O. Box 1820

Richmond, VA 23218

Download Application

How can I get help with my application?

• Visit a Benefits Enrollment Center (BEC), if there’s one near you. See if there’s one in your area.

• Call the Cover Virginia Call Center toll-free at 1-855-242-8282.

• Call the Virginia Insurance Counseling & Assistance Program (VICAP) at 1-800-552-3402.

NCOA also has a HelpLine that you can call to get free support. To get started today, call [1-800-794-6559](tel:+18007946559).

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 the Virginia Insurance Counseling and Assistance Program (VICAP) at 1-800-552-3402 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 Virginia?

Once you're enrolled in a Medicare Savings Program, you will be signed up for the Medicare Part D Extra Help program. 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. You can learn more about Extra Help and even apply on our website.