Medicare Savings Program

What is the Medicare Savings Program?

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The Medicare Savings Program can provide assistance with premium costs, copayments, deductibles and coinsurance for individuals who are entitled to Medicare and meet program requirements.

How do I apply for the Medicare Savings Program?

Submit application HCA 18-005 or the Application for Medicare Savings Programs HCA 13-691 using any of the following methods:

Applications can also be initiated by the Social Security Administration.

Learn more: Medicare Savings Program | Washington State Health Care Authority

Do I need to complete an interview to apply for or renew my Medicare Savings Program Benefits?

No, an interview is not required, but you must still submit an application or renewal form. Once we receive this, it will be processed in the order received. You will then receive a letter in the mail when your application or renewal is complete.

If you need in-person assistance to apply for or renew your coverage, you may go into a local Community Services Office or call (877) 501-2233.

Who is eligible for the Medicare Savings Program?

Washington residents who:

  • Are entitled to Medicare Part A.
  • Meet income requirements in WAC 182-517-0100.
  • Meet citizenship or immigration status requirements.

Are there income or resource limits for the Medicare Savings Program?

Income: There are income limits for single individuals and married couples. 

Current income limits for all MSPs are found at the Health Care Authority website here. Income limits are adjusted every year.

Resources: Currently there are no resource limits for the Medicare Savings Program.  

How does my spouse’s income affect my Medicare Savings Program?

When a married person applies for the Medicare Savings Program, eligibility is determined using the income of the applicant and their spouse.   

What coverage does the Medicare Savings Program cover?

The Medicare Savings Program coverage is based on a tiered program. The tier for which you are eligible is determined based on your monthly, countable income. Approval for the Medicare Savings Program is based on several factors. Please complete an application to see if you are eligible.

Tier coverages are:
Qualified Medicare Beneficiary Program

  • Pays Medicare Part A and Medicare Part B premiums.
  • Pays deductibles.
  • Pays copayments, except for prescriptions.

Specified Low-Income Medicare Beneficiary Program

  • Pays Medicare Part B premiums.

Qualified Individual Program:

  • Pays Medicare Part B premiums.

Qualified Disabled Working Individual Program:

  • Pays Medicare Part A premiums.

Once I am approved for a Medicare Saving Program, how long does it take for the premiums to be paid by DSHS?

It can take up to 90 days for the state and Social Security Administration’s systems to match up so your Medicare Part B premium can be billed to the state.

After 60 days, check to see if your Medicare Part B premium is still billed to you or is being deducted from your SSA benefits. If you’re still paying for the premium, contact the Health Care Authority’s Medicare Buy-In unit at 800-562-3022 ext. 16129.

What expenses are not paid by the Medicare Savings Programs?

The Medicare savings programs do not pay for the following expenses:

  • Medicare Part D premiums.
  • Medicare Part D prescription drug copayments.
  • Medigap policies.
  • Medicare Part C premiums.
  • Expenses incurred with a provider who is not contracted with Medicaid.

How do I get assistance with Part D prescriptions?

For questions about Medicare Prescription Drug Program (Medicare Part D) or specific drug plans, contact either of the following:

  1. Medicare at 1-800-MEDICARE.
  2. The Statewide Health Insurance Benefits Advisor HelpLine at 1-800-562-6900.

Whom do I contact if I have questions about my Medicare Savings Program or what is covered in my plan?

You may go into a local Community Services Office or call 877- 501-2233. 

Whom do I contact if I received a medical bill I think should be covered by DSHS?

Medical Assistance Customer Service Center

Online: Secure contact form 
Email: Ask Medicaid 
Phone: 1-800-562-3022 
Client line: 7 a.m. – 5 p.m. Pacific, Monday – Friday (except state holidays)
TRS: 711 through Washington Relay 

How do I get a replacement Provider One Card?

There are several ways to request a replacement: 

There’s no charge for a new card. It takes seven to 10 days to get it in the mail. Your old card will stop working when you ask for a new one, but you may still be able to receive medical services while waiting for a replacement card. Your provider will need your name and date of birth to verify your Apple Health enrollment.