Spotlight on Medicare Savings Programs (MSPs)

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The Center for Medicare Advocacy is pleased to highlight the newly formed Aging & Disability Health Policy Lab, an independent, nonpartisan group focused on advancing practical state and federal policies to make health care and HCBS more accessible for older adults and people with disabilities. CMA partnered with the Aging & Disability Health Policy Lab on a series of guest Alerts on the Medicare Savings Programs (MSPs) called Spotlight on MSPs, which will culminate in a CMA webinar featuring the Aging & Disability Health Policy Lab on June 16, 2026, registration to follow!

Spotlight on MSPs: What are the Medicare Savings Programs?

The Medicare Savings Programs (MSPs) are types of Medicaid coverage that help more than ten million older adults and people with disabilities with limited income pay their out-of-pocket costs for Medicare Parts A and B. In 2026, the MSPs save an individual at least $2,450^[1] – money that can go toward essentials like food, housing, medications, or transportation. MSP enrollees also automatically get the Part D low-income subsidy (LIS), or Extra Help, which reduces their Medicare drug costs. Despite these benefits, millions of eligible individuals are not yet enrolled.^[2]

There are three main MSPs: Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualifying Individual (QI). Coverage and financial eligibility depend on the specific MSP.

Most states use the federal income and resource limits for the MSPs – income up to $1,816 for an individual and $2,455 for a couple and resources of $9,950 for an individual and $14,910 for a couple^[3] in 2026—but some states have more generous eligibility standards.  Applicants should contact their local state health insurance assistance program for additional info. In most states, MSP applications go through local Medicaid or social services offices.
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[1] Centers for Medicare & Medicaid Services (CMS), “2026 Medicare Parts A & B Premiums and Deductibles,” Nov. 14, 2025, https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
[2]  Sarah Kotb et al., “Medicare Savings Program Take-Up Estimates and Profile of Enrolled and Unenrolled Individuals,” JAMA Network Open 8, no. 10 (2025): e2535408–e2535408, https://doi.org/10.1001/jamanetworkopen.2025.35408; Kyle J. Caswell and Timothy A. Waidmann, “Medicare Savings Programs Enrollees and Eligible Non-Enrollees,” MACPAC, June 2017, https://www.macpac.gov/wp-content/uploads/2017/08/MSP-Enrollees-and-Eligible-Non-Enrollees.pdf; Matthew Niedzwiecki et al., “Medicare Savings Programs: Findings on Eligibility and Enrollment Trends Final Report,” Office of the Assistant Secretary for Planning and Evaluation, January 10, 2025, https://aspe.hhs.gov/sites/default/files/documents/f9311ce78b51111648aa10aca69c953c/medicare-savings-programs-final-report.pdf; Popham et al., “Take-Up Rates in Medicare Savings Programs and the Part D Low-Income Subsidy Among Community-Dwelling Medicare Beneficiaries Age 65 and Older,” National Council on Aging, June 2020, https://assets.ncoa.org/ffacfe7d-10b6-0083-2632-604077fd4eca/f0edeaa4-0e3f-4405-a4f4-6991259d4696/2021-CBA-Take-Up-Rates-in-Medicare-Savings-Programs-June-2020-Issue%20Brief_4-27.pdf.  
[3] Medicaid.gov. “Seniors & Medicare and Medicaid Enrollees | Medicaid.” 2026. https://www.medicaid.gov/medicaid/eligibility-policy/seniors-medicare-and-medicaid-enrollees; CMS, “2026 SSI, Spousal Impoverishment, and Medicare Savings Program Resource Standards, December 9, 2025. https://www.medicaid.gov/federal-policy-guidance/downloads/cib12092025.pdf.

Spotlight on MSP’s: The Medicare Savings Programs Improve Access to Medical Care and Overall Health

Studies consistently demonstrate that the Medicare Savings Programs (MSPs) improve access to medical care and overall health among low-income older adults and people with disabilities. For example:

• Qualified Medicare Beneficiaries (QMBs), individuals enrolled in the most comprehensive MSP which covers Part A and B Medicare premiums and cost-sharing, are less likely to avoid or delay visiting their doctor because of cost.[1]
• Individuals who did not have QMB because their incomes were just above the program limits used 55 percent fewer outpatient evaluation and management services and filled fewer medications per year than QMBs. [2] 
• Research has also connected enrollment in the Part D low-income subsidy (LIS), which MSP enrollees automatically receive, to improved uptake up of oral anti-cancer therapies.[3]
• Loss of Medicaid coverage after Medicare eligibility leads to worse health, increased mortality, higher out-of-pocket expenses, and less use of preventive care compared to those who retain Medicaid or regain it after a temporary loss.^[4]

These findings suggest that improving participation in the MSPs can enable low-income Medicare beneficiaries to start treatment sooner and better adhere to medical treatment – both necessary ingredients for better health outcomes.

[1] Alex D. Federman et al., “Avoidance Of Health Care Services Because Of Cost: Impact Of The Medicare Savings Program,” Health Affairs 24, no. 1 (2005): 263–70, https://doi.org/10.1377/hlthaff.24.1.263.
[2] Eric T. Roberts et al., “Medicaid Coverage ‘Cliff’ Increases Expenses And Decreases Care For Near-Poor Medicare Beneficiaries,” Health Affairs (Project Hope) 40, no. 4 (2021): 552-61, https://doi.org/10.1377/hlthaff.2020.02272
[3] Yi-Ting Chou et al., “The Association Between Medicare Low-Income Subsidy and Anticancer Treatment Uptake in Advanced Lung Cancer,” Journal of the National Cancer Institute 112, no. 6 (2020): 637-46, https://doi.org/10.1093/jnci/djz183.
[4] Maryssa Pallis et al., “Long-Term Changes in Health Care Use and Outcomes Among Groups Maintaining Versus Losing Medicaid Upon Medicare Enrollment,” Milbank Quarterly, 104, no. 2 (February 27, 2026): 7-15, https://doi.org/10.1111/1468-0009.70076; Susan Silberman et al., Standing Back from the Medicare Cliff: Research and Policy Options to Help Low-Income Older Adults (National Council on Aging and LeadingAge LTSS Center @UMass Boston, 2024), 7-10, https://assets.ncoa.org/ffacfe7d-10b6-0083-2632-604077fd4eca/467f43a0-d595-483b-8fdb-be068ab9cbbf/2024_Medicare_Cliff_Report.pdf.

Spotlight on MSP’s: The Medicare Savings Programs Improve Economic Security

Expanding access to the Medicare Savings Programs (MSPs) can improve the economic security of older adults and people with disabilities with limited incomes. The $202.90 Medicare Part B premium is usually withheld from Social Security checks, taking more than 15% of the monthly income of an individual living at or below the federal poverty line.[1] Enrolling in an MSP stops this deduction, enabling individuals to keep more of their income for food, rent, utilities, and other necessities. This reduces financial strain and supports independence.[2]

Since MSP enrollees automatically get the Part D Low-Income Subsidy (LIS), or Extra Help, which lowers their Medicare prescription drugs costs, they can save about $8,000 each year on medical and prescription expenses combined,[3] making a significant difference in their overall financial security and overall quality of life.

[1] Medicaid.gov. “Seniors & Medicare and Medicaid Enrollees | Medicaid.” 2026. https://www.medicaid.gov/medicaid/eligibility-policy/seniors-medicare-and-medicaid-enrollees.
[2] See CMS Office of Burden Reduction & Health Informatics. “Navigating the Medicare Savings Program (MSP) Eligibility Experience.” Centers for Medicare & Medicaid Services, April 2022. https://www.cms.gov/files/document/navigating-medicare-savings-program-msp-eligibility-experience-journey-map.pdf; CMS, “Streamlining Medicaid; Medicare Savings Program Eligibility Determination and Enrollment,” Federal Register, Vol. 88, No. 182 (September 21, 2023): 65230, 65235,  https://www.federalregister.gov/documents/2023/09/21/2023-20382/streamlining-medicaid-medicare-savings-program-eligibility-determination-and-enrollment.
[3] In 2026, Part B premium coverage totals almost $2,436 annually. The Part D LIS benefit is estimated to be worth about $5,700 per year. Social Security Administration, “Understanding the Extra Help With Your Medicare Prescription Drug Plan,” January 2026, https://www.ssa.gov/pubs/EN-05-10508.pdf.

Loss of MSP Coverage is Associated with Higher Mortality Among Medicare Beneficiaries

New research suggests that enrollment in the Medicare Savings Programs (MSPs) can save lives by ensuring they receive vital medications. A July 2025 study published in the New England Journal of Medicine found that the loss of Medicaid – and with it the loss of the Part D Low-Income Subsidy (LIS) – led to higher death rates among low-income Medicare beneficiaries.[1]

It’s compelling new evidence that maintaining enrollment in the MSPs is, literally, a matter of life and death.

[1] Eric T. Roberts et al., “Loss of Subsidized Drug Coverage and Mortality among Medicare Beneficiaries,” New England Journal of Medicine 392, no. 20 (2025): 2025-34, https://doi.org/10.1056/NEJMsa2414435.