Medicare Savings Programs can help people with limited income and resources. Depending on the program, the assistance may help with Medicare premiums, deductibles, copays, and coinsurance.
These programs are connected to Colorado's Medicaid program, Health First Colorado. However, getting help through a Medicare Savings Program does not always mean you have full Medicaid coverage.
Here's how the programs work and what the different terms mean.
What Are Medicare Savings Programs in Colorado?
Medicare Savings Programs, often called MSPs, help eligible people pay certain Medicare costs.
You apply through the state of Colorado. The state reviews your income, resources, Medicare status, and other eligibility information to determine whether you qualify.
There are four Medicare Savings Programs:
- Qualified Medicare Beneficiary (QMB)
- Specified Low-Income Medicare Beneficiary (SLMB)
- Qualifying Individual (QI)
- Qualified Disabled and Working Individual (QDWI)
You may also see terms such as QMB Plus, SLMB Plus, and Full-Benefit Dual Eligible (FBDE). These terms help describe people who receive both Medicare and certain Medicaid benefits.
Is a Medicare Savings Program the Same as Medicaid?
Not necessarily.
Colorado administers Medicare Savings Programs through its Medicaid system. But qualifying for an MSP does not always mean you qualify for full Health First Colorado benefits.
For example, someone may qualify for help paying the Medicare Part B premium without qualifying for full Medicaid benefits.
Other people qualify for Medicare and full Medicaid benefits. These individuals are often called Full-Benefit Dual Eligibles, or FBDEs.
This distinction is also why you may see terms such as QMB Only, QMB Plus, SLMB Only, and SLMB Plus.
What Are QMB, QMB Plus, SLMB, SLMB Plus, QI, QDWI, and FBDE?
The number of abbreviations can make these programs seem more complicated than they are. The main difference is the type of Medicare costs a program helps pay and whether the person also receives full Medicaid benefits.
Qualified Medicare Beneficiary (QMB)
QMB provides help with more Medicare costs than the other Medicare Savings Programs.
It helps pay the Medicare Part B premium. It also helps with Medicare deductibles, coinsurance, and copayments for Medicare-covered services.
Most people do not pay a Medicare Part A premium because they or a spouse paid Medicare taxes long enough while working. If someone does owe a Part A premium, QMB can help pay that premium as well.
People with QMB also have important billing protections. Medicare providers cannot bill a person with QMB for Medicare-covered deductibles, coinsurance, or copayments.
QMB Plus
QMB Plus generally describes someone who qualifies for QMB and also qualifies for full Medicaid benefits.
This means the person receives the Medicare cost-sharing protections available through QMB while also receiving Medicaid coverage for services available under their Medicaid eligibility.
Specified Low-Income Medicare Beneficiary (SLMB)
SLMB helps eligible people pay their Medicare Part B premium.
A person must have Medicare Part A and meet the program's eligibility requirements.
Unlike QMB, SLMB does not generally pay Medicare deductibles, copays, or coinsurance.
SLMB Plus
SLMB Plus generally describes someone who qualifies for help with the Medicare Part B premium through SLMB and also qualifies for full Medicaid benefits.
The "Plus" is important because it indicates that the person has additional Medicaid eligibility rather than SLMB assistance alone.
Qualifying Individual (QI)
QI also helps eligible people pay their Medicare Part B premium.
QI has some additional rules. You must apply again each year, and benefits are provided on a first-come, first-served basis. Priority is generally given to people who received QI benefits the previous year.
QI is for people who do not qualify for other Medicaid coverage or benefits.
Qualified Disabled and Working Individual (QDWI)
QDWI is different from the other Medicare Savings Programs.
It is designed for certain people with disabilities who returned to work and lost premium-free Medicare Part A because of their earnings.
For people who qualify, QDWI helps pay the Medicare Part A premium.
Full-Benefit Dual Eligible (FBDE)
FBDE is not a separate Medicare Savings Program.
A Full-Benefit Dual Eligible person has Medicare and also qualifies for full Medicaid benefits.
In Colorado, Medicaid is called Health First Colorado. Medicare generally pays first for Medicare-covered services, while Health First Colorado may help with other covered costs and services based on the person's eligibility.
QMB Plus and SLMB Plus are examples of situations where someone may receive Medicare Savings Program assistance along with full Medicaid benefits.
Who May Qualify for a Medicare Savings Program in Colorado?
Eligibility depends on several factors. These can include:
- Your income
- Your resources
- Your Medicare eligibility
- Whether you are single or married
- The Medicare Savings Program you are applying for
Colorado also has rules about which income and resources count when determining eligibility.
Countable resources may include money in checking or savings accounts, stocks, bonds, and certain retirement accounts, annuities, or trusts.
Some property generally does not count. This may include your primary home, one vehicle, household belongings, and certain money set aside for burial expenses.
What Are the Income and Resource Limits in Colorado?
Income and resource limits can change each year. Colorado may also use eligibility rules that differ from the general federal guidelines published by Medicare.
Colorado has published current resource limits for QMB, SLMB, and QI. However, at the time this article was updated, we could not locate a current Colorado HCPF publication listing the state's updated annual income limits for these programs.
Medicare publishes federal income guidelines, but it also advises people that they may qualify in their state even if their income or resources are higher than the federal limits.
For that reason, don't assume you are not eligible based only on a number you find online.
Colorado makes the final decision about your eligibility when you apply.
Looking ahead: Colorado generally updates Medicare Savings Program income limits after new federal poverty guidelines are released early each year. We expect updated 2027 Colorado income limits to become available in early 2027. This article will be updated when Colorado publishes the new limits.
What If My Income Is Close to the Limit?
It may still be worth applying.
Eligibility can involve more than comparing your total monthly income with a number on a chart. Some income may be treated differently when Colorado determines eligibility.
The same is true for resources. Not everything you own necessarily counts toward the resource limit.
If your income or resources are close to the limits, applying allows Colorado to review your individual situation and determine whether you qualify.
Does a Medicare Savings Program Help with Prescription Drug Costs?
People who qualify for QMB, SLMB, or QI also qualify for Medicare's Extra Help program.
Extra Help assists people with limited income and resources with costs related to Medicare Part D prescription drug coverage.
People who receive full Medicaid benefits also generally qualify automatically for Extra Help.
This means someone who qualifies for help with Medicare medical costs may also receive assistance with their prescription drug costs.
Do I Have to Renew My Benefits?
Yes. Medicare Savings Program and Health First Colorado eligibility must be renewed.
The renewal process and information you are asked to provide can depend on your coverage and individual circumstances.
Pay close attention to letters or other requests you receive from Health First Colorado or your county. You may be asked to confirm information or provide documents so Colorado can determine whether you remain eligible.
Colorado's published renewal materials indicate that people receiving Medicare Savings Program benefits must provide resource information as part of their annual Medical Assistance renewal.
If you receive a request for information at another time, follow the instructions and deadline in the notice you receive.
How Do I Apply for a Medicare Savings Program in Colorado?
Medicare Savings Program eligibility is determined by the state.
Colorado residents can apply for medical assistance through Colorado PEAK. You can also contact your county Department of Human or Social Services for help with an application.
When you apply, Colorado reviews your information to determine whether you qualify and which type of assistance applies to you.
You can apply for a Medicare Savings Program during the year. You do not have to wait for Medicare's Annual Enrollment Period.
Should I Apply Even If I'm Not Sure I Qualify?
It may be worth applying if your income or resources are close to the eligibility limits.
Medicare itself encourages people to apply even if they aren't sure they qualify. States can have different rules about what income and resources count.
The state of Colorado makes the final eligibility determination.
The Bottom Line
Medicare Savings Programs can help eligible Colorado residents with some of their Medicare costs.
QMB, SLMB, QI, and QDWI provide different types of assistance. QMB Plus and SLMB Plus help describe situations where a person also qualifies for full Medicaid benefits. FBDE refers to someone who has Medicare and receives full Medicaid benefits.
The terminology can be confusing, and eligibility rules can change. Don't rule yourself out based only on an income or resource figure you find online.
If you think you may qualify, checking your eligibility using current Colorado rules is the best way to find out what assistance may be available.