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Income limits for Medicare savings programs - do Social Security benefits count differently by state?

I just turned 63 and trying to plan ahead for Medicare costs when I hit 65. My Social Security retirement will only be about $1,560/month based on the estimate I got. I've heard there are programs that help pay Medicare premiums if your income is below certain limits, but I'm confused if Social Security benefits count as income for these programs? And do different states have different rules or income limits? My neighbor mentioned something about Medicare Savings Programs but wasn't sure about the details. Really nervous about whether I'll be able to afford all the Medicare costs on top of my other expenses. Any info would be helpful!

Sofia Gomez

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Yes, there are Medicare Savings Programs (MSPs) that can help with Medicare costs, and yes, the income limits DO vary by state! These programs can help pay your Part B premiums and sometimes other Medicare costs. Your Social Security benefits DO count as income for these programs, but some states disregard certain amounts or types of income when calculating eligibility. The main MSPs are: - Qualified Medicare Beneficiary (QMB) - Specified Low-Income Medicare Beneficiary (SLMB) - Qualifying Individual (QI) The 2025 federal baseline income limits are approximately: - QMB: $1,265/month (single) - SLMB: $1,515/month (single) - QI: $1,705/month (single) But again, states can be more generous with these limits or how they count income. Your best bet is to contact your state Medicaid office to find out the specific rules where you live.

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Dylan Evans

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Thank you so much for this info! It sounds like I might qualify for one of these programs based on those income limits. Do you know if they look at gross Social Security or what hits my bank account after Medicare is taken out? And would my small 401k (about $30K) count against me for these programs?

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StormChaser

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the different programs r confusing but dont worry to much! im on ssdi and get help with my medicare. they look at wat u have coming in each month, not just ss. they also care about assets in some states but not all of them. u should call ur medicade office and ask about MSP's. i think ur income is low enough.

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Dylan Evans

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Thanks for sharing your experience. I didn't even think about SSDI vs retirement SS making a difference. Did you have to provide a lot of documentation to qualify? I'm worried about the paperwork process.

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Dmitry Petrov

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I work at a senior center and help people with these applications all the time. A few important points: 1. They look at your GROSS Social Security amount (before deductions) 2. Some states have higher limits than the federal baseline 3. Many states don't count all resources - some exclude your home, car, and burial funds 4. Some states have eliminated resource tests altogether For your 401k - that would count as a resource in states that have resource limits (typically around $9,090 for individuals in 2025), BUT several states have eliminated resource tests for MSPs. States with no resource limits for some/all MSPs include: AL, AZ, CT, DE, DC, HI, ME, MA, MS, NY, OR, VT, and WA. Also look into the Medicare Part D Extra Help program through Social Security - that's federal and helps with prescription costs.

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Dylan Evans

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This is super helpful! I'm in Nevada - do you happen to know if they have resource limits? I'll check with Medicaid office too, but it helps to know what questions to ask.

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Ava Williams

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These systems are DESIGNED to be confusing!!!! The govt WANTS to make it hard for people to get benefits they deserve! I applied for the QMB program last year and they kept asking for more and more paperwork. Then they LOST my bank statements and I had to start all over. It took FIVE MONTHS to get approved!!! Make copies of EVERYTHING and get a receipt when you turn in your application!!

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Miguel Castro

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So true! My mom went through the same thing. They rejected her first application because she forgot to sign page 4, but nobody told her until 6 weeks later! What a mess.

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Zainab Ibrahim

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I just went through this process last year. One thing to note is that different offices call these programs by different names sometimes, which makes it even more confusing. In my state they call it the "Medicare Premium Payment Program" or MPPP instead of MSP. I was having a terrible time getting through to my state Medicaid office to apply - constant busy signals and voicemails that were never returned. I ended up using a service called Claimyr (claimyr.com) that got me through to an actual human being. They have a demo video at https://youtu.be/Z-BRbJw3puU that shows how it works. It saved me weeks of frustration. Once I got through, the caseworker was actually helpful and walked me through everything. My income was about $1,600/month from Social Security and I qualified for SLMB, which pays my Part B premium. That's an extra $174.70 in my pocket each month!

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Ava Williams

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Wait, WHAT??? They actually pay your WHOLE Part B premium???

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Zainab Ibrahim

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Yes, the whole $174.70 premium. QMB also covers Medicare deductibles and coinsurance amounts. SLMB and QI only cover the Part B premium. It depends which program you qualify for based on your income and assets.

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Connor O'Neill

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my neighbor toldme she gets help with her medicare and her retirement is more than 2000 a month so you should be ok with 1560. i think they look at your total income tho not just ss. do you get any other money coming in like pensions or rent income? that would count to

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Dylan Evans

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I don't have any pension or other income right now. Just some savings that I try not to touch. I was thinking of doing some part-time work though - I wonder if that would mess up qualifying for help with Medicare?

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Sofia Gomez

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To answer your question about Nevada - yes, Nevada does have resource limits for Medicare Savings Programs. As of 2025, the resource limits in Nevada are: - Individual: $9,090 - Married couple: $13,630 Resources that count include bank accounts, stocks, bonds, and most retirement accounts including 401ks. They don't count your primary home, one car, household goods, and certain burial expenses. Regarding part-time work - yes, that would count as income. However, depending on how much you earn, you might still qualify for one of the programs. Just be aware that any earnings would be added to your Social Security when determining eligibility. One more thing - even if you don't qualify for an MSP, definitely apply for Extra Help for prescription drug costs through Social Security. The income and resource limits are higher for that program.

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Dylan Evans

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Thank you so much for the specific Nevada info! This gives me a much clearer picture. I'll definitely apply for the Extra Help program too - medications are one of my biggest concerns.

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Miguel Castro

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I've been on Medicare for 3 years now and it's definitely confusing! Just want to add that you should also check out your state's SHIP program (State Health Insurance Assistance Program). They provide free counseling on Medicare options including help with applying for assistance programs. Really helped me figure everything out.

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StormChaser

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the paperwork isnt as bad as it sounds. they asked for my ss award letter, bank statements, and id. took about an hour to fill out the forms. medicaid office helped me with the confusing parts. i think ssdi and ss retirement r treated the same for these programs but not 100% sure

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Dylan Evans

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That's reassuring to hear it wasn't too complicated! I'll gather those documents ahead of time. Thanks!

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Dmitry Petrov

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One other important thing to know: Even if you don't qualify for the Medicare Savings Programs through Medicaid, you should look into Medicare Advantage plans that have $0 premiums and include prescription coverage. Many also offer extra benefits like dental, vision, hearing, and over-the-counter allowances. Part B premiums would still apply, but many Advantage plans help reduce your overall healthcare costs. You can switch plans during the Annual Enrollment Period from October 15 to December 7 each year. Based on your income level, I'd recommend applying for both the Medicare Savings Program AND Extra Help as soon as you're eligible. You can apply for Extra Help up to 4 months before your Medicare begins.

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