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Help Paying Medicare Costs

Medicare Savings Programs

There are four different Medicare Savings Programs to help people pay their Medicare costs. If you have Medicare Part A (hospital insurance benefits) you may qualify for one of these programs. Which program you qualify for depends on your income. There are no asset limits for these programs in Oregon.

Who is eligibleProgramsHow to applyMedicare help


Medicare is a national health insurance program for people who are age 65 and older or meet other requirements.


Who is eligible

  • You must have Medicare Part A (hospital insurance benefits).
  • Your income must be within certain limits. Income limits go up each year in March.

Programs

Qualified Medicare Beneficiary (QMB) Program

  • Helps pay for: Medicare Part A and Part B premiums, deductibles and co-insurance.
  • Monthly income limit*: $1,255 for an individual and $1,704 for a couple (100% of the federal poverty level).

Qualified Disabled Working Individual (QDWI) Program

  • Helps pay for: Medicare Part A premiums only.
  • Monthly income limit*: $2,510 for a single person and $3,407 for a couple (200% of the federal poverty level).
  • Note: This program is for disabled workers who lost Social Security disability benefits because they are working and are not eligible for another Medicaid program. Most people in Oregon are not eligible for QDWI because we have the Employed Persons with Disabilities (EPD) program. EPD provides full Medicaid benefits.

Specified Low-Income Medicare Beneficiary (SLMB) Program

  • Helps pay for: Medicare Part B premiums.
  • Monthly income limit*: $1,506 for individuals or $2,044 for a couple (120% of the poverty level).

Qualifying Individual (QI) Program (also called SMF benefit)

  • Helps pay for: Medicare Part B premiums.
  • Monthly income limit*: $1,695 for an individual and $2,300 for a couple (the federal government mandates services for people with incomes between 120% and 135% of the poverty level).

We are only allowed to serve a certain number of people each year for the SMF benefit. Unfortunately, we must shut down enrollment if we reach our limit. If you are eligible for any other Medicaid benefit offered by the State of Oregon, you are not eligible for the SMF benefit.

Note: In most states, this program is called the Qualifying Individual (QI) program. In Oregon, this is called the SMF benefit.

*Income limits change each year in March. These income limits are for March 2024 through February 2025.

How to apply

There are several ways to apply for Medicare Savings Programs: 

  • Contact your local ODHS office
  • Call the Aging and Disability Resource Connection (ADRC) at 855-673-2372. 
  • Apply online at one.oregon.gov.
  • If you would like an application mailed to you, call the ONE Customer Service Center at 800-699-9075. 
We will let you know if you are approved within 45 days of the date you apply. 

Need Medicare help?

Trained volunteers from the Senior Health Insurance Benefits Assistance Program (SHIBA) can help you understand your Medicare options. SHIBA is a free, statewide service through the Oregon Department of Human Services (ODHS). 

Visit the SHIBA websiteContact SHIBA

Resources

Health care and medical assistance ADRC of Oregon