Medicare Savings Programs in Florida: How to Get Help Paying Medicare Costs

If your income and assets are limited, you may qualify for a Medicare Savings Program (MSP) -- a Florida Medicaid program that helps pay Medicare premiums and cost-sharing. Millions of eligible beneficiaries nationwide are not enrolled in these programs, leaving significant financial assistance unclaimed. Here is what is available in Florida.

The most comprehensive MSP -- QMB pays:

• Medicare Part A premium (if applicable)
• Medicare Part B premium ($170.10/month in 2022)
• Part A and Part B deductibles
• Part A and Part B coinsurance and copayments

2022 income limits (Florida):

• Individual: Up to $1,153/month
• Couple: Up to $1,546/month

Asset limits: $8,400 (individual) / $12,600 (couple) -- certain assets are excluded (home, one car, burial funds)

Important QMB protection: Providers who accept Medicare cannot bill QMB enrollees for Medicare cost-sharing. If a provider bills you for copays or coinsurance and you are a QMB enrollee, you can report this to 1-800-MEDICARE.

SLMB pays the Medicare Part B premium only.

2022 income limits (Florida):

• Individual: Up to $1,379/month
• Couple: Up to $1,851/month

Asset limits: Same as QMB ($8,400 / $12,600)

QI also pays the Part B premium -- similar to SLMB but with slightly higher income limits. QI is funded by limited federal grants, so enrollment is on a first-come, first-served basis.

2022 income limits (Florida):

• Individual: Up to $1,549/month
• Couple: Up to $2,080/month

Asset limits: Same as QMB and SLMB

QDWI pays the Part A premium for working disabled individuals under 65 who lost premium-free Part A when they returned to work.

2022 income limits: Up to $4,615/month (individual)

In addition to MSPs, qualifying low-income beneficiaries can receive Extra Help -- a federal program that reduces Part D drug costs:

• Reduced or eliminated Part D premium
• Reduced deductible (or no deductible)
• Reduced copays ($3.95 for generics, $9.85 for brand-name drugs in 2022)
• No coverage gap (donut hole)

Automatic Extra Help: QMB, SLMB, and QI enrollees automatically qualify for Extra Help -- no separate application needed.

Income limit for Extra Help: Up to 150% of the Federal Poverty Level (~$1,719/month for individuals in 2022).

Apply for MSPs: Contact the Florida Department of Children and Families (DCF):

• Online: myflorida.com/accessflorida
• Phone: 1-866-762-2237
• In person: Local DCF service center

Apply for Extra Help: Contact Social Security:

• Online: ssa.gov/extrahelp
• Phone: 1-800-772-1213
• In person: Local Social Security office

Free help applying: Florida SHINE counselors can help you apply for MSPs and Extra Help at no cost. Call the Elder Helpline at 1-800-963-5337.

The asset test for MSPs excludes:

• Your primary home (regardless of value)
• One vehicle
• Burial funds up to $1,500 per person
• Life insurance with face value up to $1,500
• Personal belongings and household goods

We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.