Alert

Wilcox Building Construction Notice: The west doors of the Wilcox Building, located at 301 Wilcox Street in Castle Rock, will be limited to ADA/ramp access ONLY from August 9 to 25.   All other visitors to the Wilcox Building will need to use the alternate entrances during construction.

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Human Services

Medicare Savings Program (MSP)

Medicare Savings Programs (MSP) help people with limited income and resources pay for some or all of their Medicare premiums and may also pay their Medicare deductibles and co-insurance. In some cases, Medicare Savings Programs may also pay Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) deductibles and co-insurance.  Medicare Savings Programs are a group of programs Colorado residents can apply for if they have Medicare.The State of Colorado may pay your Medicare Part B premium.  Your income and resources cannot exceed a certain amount each month.

To apply, you have to turn in an application. Every year your eligibility will be reviewed to be sure you are still able to receive the monthly payment.

If your premium is approved by the State of Colorado, it may take a couple of months before Social Security stops taking the money out of your Social Security check.

Medicare Savings Program (MSP) Information

More Information

How do I apply?

To be eligible for MSP, you must be eligible for or receiving Medicare.

There are several ways to apply:

Electronically:

By phone:

  • Contact the Colorado Department of Health Care Policy and Financing Member Contact Center at 1-800-221-3943 (State Relay: 711)

Paper:

  • Print, complete and sign a paper application and;
    • Mail it to our office at 4400 Castleton Court, Castle Rock, CO 80109
    • Drop it off at our office Monday-Friday between 8:00am and 5:00pm or anytime using the secure drop box in front of our office
    • Fax it to 877-285-8988
    • Email it to [email protected]

What are the income guidelines?

There are four different types of Medicare Savings Programs – QMB, SLMB, QI-1, and QDWI. The different income limits for each program are listed below. Remember that if you have income from working, you may qualify for benefits even if your income is higher than the limits listed.

All sources of income will need to be verified.

  • Qualified Medicare Beneficiary (QMB) Program
    • Individual monthly income limit: $1,094
    • Married couple monthly income limit: $1,472
  • Specified Low-Income Medicare Beneficiary (SLMB)
    • Individual monthly income limit: $1,308
    • Married couple monthly income limit: $1,762
  • Qualifying Individual (QI-1)
    • Individual monthly income limit: $1,469
    • Married couple monthly income limit: $1,980
  • Qualified Disabled and Working Individuals (QDWI)
    • Individual monthly income limit: $2,167
    • Married couple monthly income limit: $2,924
    • In addition to the income requirements, one or more of the following must apply:
      • You’re a working disabled person under 65
      • You lost your premium-free Part A when you went back to work
      • You aren’t getting medical assistance
      • You meet the income and resource limits required by your state
  • Low Income Subsidy (LIS)
    • Individual monthly income limit: $1,610
    • Married couple monthly income limit: $2,178

What are the resource limits?

The resource limits for QMB, SLMB and QI-1 Medicare Savings Programs are $9,470 for one person and $14,960 for a married couple. The resource limits for the QDWI program are $4,000 for one person and $6,000 for a married couple.  The resource limits for the Low Income Subsidy (LIS) program are $14,790 for one person and $29,520 for a married couple.

All resources/assets will need to be verified. Some examples of resources that may be requested are below.

Countable resources include:

  • Money in a checking or savings account
  • Stocks
  • Bonds
  • Money in an IRA, annuity or trust

Countable resources don’t include:

  • The home you reside in
  • One car
  • Burial plot
  • Up to $1,500 for burial expenses if you have put that money aside
  • Furniture
  • Other household and personal items

What benefits and services are provided?

  • Qualified Medicare Beneficiary (QMB) Program provides Medicare benefits plus pays for your:
    • Part A premiums
    • Part B premiums
    • Deductibles and co-insurance

With QMB, you might still have to pay your Health First Colorado co-pay. Visit the Benefits and Services Overview page for a list of Health First Colorado co-pays.

  • Specified Low-Income Medicare Beneficiary (SLMB) Program pays for your:
    • Part B premiums only
  • Qualifying Individual-1 (QI-1) Program pays for your:
    • Part B premiums only
  • Qualified Disabled and Working Individuals (QDWI) Program pays for your:
    • Part A premiums only

With SLMB, QI-1 and QDWI, you are still responsible for your Medicare deductibles and co-insurance.

Where do I get these services?

  • If you have QMB, you can visit any doctor who accepts both Medicare and Health First Colorado coverage.
  • If you have SLMB, QI-1 or QDWI, you can visit doctors who accept Medicare.
    • These programs do not provide Health First Colorado benefits, this means that even if a doctor accepts Health First Colorado and provides you medical services, Health First Colorado will not pay for any claims.

Other Information

  • MSP will pay the Medicare Part B premiums for members on regular Health First Colorado (Colorado’s Medicaid program), or those on the Medicare Savings Program. It will not pay the Part B premiums for any member on a Non-Medicaid Medical Assistance program including OAP-State Only or Child Health Plan Plus (CHP+).
  • Nearly all Medicare recipients get Part A for free. If you do not get Part A for free, we will pay your Part A premiums if you are in the Qualified Medicare Beneficiary (QMB) tier of the Medicare Savings Program.
  • If you get Part A free, we can still pay the Part B premiums even if you have refused or terminated Part B.
  • For most members, Part B Buy-In will begin the first month the member is eligible.
  • For members who are on Long-Term Care Health First Colorado and have income over the Specified Low-Income Medicare Beneficiary (SLMB) limit, Part B Buy-In will begin the third month the member is eligible. For these members we will not pay the first two months’ Part B premiums.
  • Part B Buy-In should kick in within a month after the county eligibility worker has approved the member’s application. If it takes longer than a month, something is wrong and you should contact the county or the State Buy-In Officer.
  • Please see our Medicare/Medicaid Frequently Asked Questions for more helpful information.