Medical Eligibility

Medicare Recipients

The Medicare Savings Program assists individuals with payment on their Medicare expenses. This program can save people up to $1,156 each year.

Coverage Groups

  • Qualified Medicare Beneficiary:
    Pays for the Medicare Part A and Part B premium, deductibles and co-insurance.
  • Special Low-Income Medicare Beneficiary:
    Pays for the Medicare Part B premium only.
  • Qualified Individiual-1:
    Pays for the Medicare Part B premium only.

Eligibility Requirements

  • Income limit is based on the family size and adjusted income of the adults in the household. 
  • Resource limit is $6,680 for an individual and $10,020 for a couple. Resources includes items such as checking and savings accounts and certificates of deposit.

Applying

After completing the application, return it to the Department of Social Services office where you live. Please return this form as soon as you complete it so the information is current. If you need assistance completing this application, contact your local DSS office.

When you apply, you must send proof of Medicare enrollment. If you have questions concerning Medicare enrollment call 1-800-772-1213 or visit Medicare's Website.