$174.70/month

Medicare is not free. There are out-of-pocket costs people with Medicare have to pay,
including premiums, deductibles, and co-payments. If you have a chronic condition,
these costs can add up quickly. Managing them can be difficult if you have low income.

In Florida, there are Medicare Savings Programs (MSPs) that help some Medicare
enrollees pay their out-of-pocket costs. You may qualify for an MSP if you are enrolled
in Medicare–or are about to enroll–and you have limited income.

What are the Medicare Savings Programs?

Medicare Savings Programs (MSPs) are state programs that help people with low
income pay for their Medicare costs. There are four MSPs, each with different income
and resource eligibility limits. Older adults and younger adults with disabilities who may
not qualify for full Medicaid may still be able to enroll in one of the MSPs.

MSPs are available in every state, but not every type of MSP is offered in every state.
Most MSPs are administered by a state’s Medicaid office. In Florida, MSPs are
administered by the Agency for Health Care Administration (AHCA).

What are the types of Medicare Savings Programs offered in Florida?

There are three types of MSPs available in Florida:

• Qualified Medicare Beneficiary (QMB): This program has the lowest income limit and covers Medicare Part A and Part B premiums, deductibles, and copayments for those eligible.
• Specified Low-Income Medicare Beneficiary (SLMB): For those eligible, SLMB covers the Medicare Part B premium.
• Qualifying Individual (QI): QI is a limited program and available on a first-come, first-served basis. For those eligible, QI covers the Medicare Part B premium.

Special Needs Plan (SNP)

You may also want to find out if you qualify for a Special Needs Plan (SNP). SNPs are a special type of Medicare Advantage plan offering benefits tailored to a specific Medicare population. 

You may qualify for an SNP if you meet one of the following conditions:

• You have both Medicare and Medicaid (including QMB).
• You have a serious and disabling chronic medical condition.
• You live in a nursing home, or you live at home but have high care needs and
could qualify for a nursing home.

Different SNPs are available in different areas of the country. Learn more by contacting
Florida SHINE (Serving Health Insurance Needs of Elders) at 1-800-963-5337.

Can I get help paying for my prescription drugs in Florida?

Once you're enrolled in a Medicare Savings Program, you will be signed up for the
Medicare Part D Extra Help program. If you meet the guidelines for Extra Help, you will
have a low (or no) deductible, a low (or no) premium, and no coverage gap.

In general, you will pay much less for your prescriptions. You can learn more about Extra Help and even apply on our website.

How do I know if I'm eligible for an MSP in Florida?

In general, you must either be enrolled in Medicare or expect to enroll soon. Each Medicare Savings Program has its own income limit (the maximum amount of income you can earn in a year to qualify). Current MSP income limits are:

•  Qualified Medicare Beneficiary: Your net countable income must be at or below 100% of the Federal Poverty Level (FPL).
•  Specified Low-Income Medicare Beneficiary: Your net countable income must be below 120% of the FPL.
• Qualifying Individual: Your net countable income must be below 135% of the FPL.

Learn more about MSP income limits. If you need help with your Medicare costs, you should apply for the MSPs—even if you think your income might be too high. Certain types of income are not counted, and the only way to know for certain if you qualify is to apply.

How do I prepare to apply for the Medicare Savings Programs?

Before you apply, it may be helpful to gather the following information to make your application process easier:

• The amount of income you get from jobs and other sources
• Your assets, such as bank account and investment account balances
• Medicare numbers, Social Security numbers, and birth dates of everyone applying or in your household

How do I apply for the Medicare Savings Programs in Florida?

Apply by Mail

To apply for the Medicare Savings Programs in Florida, you must fill out an application form and mail or fax it to your local DCF Family Resource Center.

For assistance with applying, contact the DCF Customer Call Center at 1-850-300-4323 (Florida Relay 711 or TTY 1-800-955-8771). You can also contact Florida SHINE at 1-800-963-5337 (1-800-955-8770 TTY).

How can I get help with my application?

• Contact your local DCF Family Resource Center.
• Contact Florida SHINE at 1-800-963-5337.

● Visit a Benefits Enrollment Center (BEC), if there’s one near you. See if there’s
one in your area.

NCOA also has a HelpLine you can call to get free support. To get started today, call 1-855-534-1245.