Start Here: AD Care & Medicare Savings Programs (MSP)

Throughout the year at the Resource Center, the two assistance programs we receive the most questions on are probably Medicare and Medicaid. Medicare is federal health insurance for individuals 65 and older, and some people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that helps cover medical costs for some people with limited income and resources.  This article is meant to help you understand the assistance programs available when an individual is dual eligible. 

Dual eligibility means someone is eligible for Medicare based on age (or disability) while also being eligible for Medicaid based on income and assets. Medicaid programs can be quite different from state to state in eligibility and benefits, because Medicaid is a joint federal and state endeavor. 

Aged and Disabled Care (AD-Care)

This is also referred to as Michigan’s “full benefit” Medicaid program. It pays the recipient’s Medicare Part A premiums (for the few who have this cost), Part B premiums, and the deductibles and copayments for both parts. Because AD-Care recipients automatically qualify for “Extra Help” (for more information read our Understanding the Low-Income Subsidy article) at its highest benefit level, their Part D premiums are fully paid under qualifying plans and their Part D copayments are significantly reduced. 

Applicants for AD-Care must be age 65 or older, blind, or disabled. Monthly income must not exceed 100% of the federal poverty level plus $20 for an exempted amount. Assets must not exceed $9,660 for individuals and $14,470 for married couples.

Assets include cash, bank and credit union accounts, CDs, stocks and bonds, second homes, and other items. The following are considered exempted assets: the primary residence, personal belongings and household goods, one vehicle, life insurance not exceeding a total face value of $1,500, and certain burial arrangements. Giving away or selling assets below their value can make a person ineligible for benefits. 

Medicare Savings Program (MSP)

There are three programs designed specifically for helping low-income adults with the costs of Medicare’s Part A and Part B: QMB, SLMB, and ALMB (QI). Each is described below. Income limits are tied to the federal poverty levels which are updated annually and become effective each April 1st. MSP’s specifically help to cover the costs associated with Medicare, including: 

• Premiums and Deductibles: MSP’s help to pay for Medicare premiums, deductibles, and co-payments, reducing the financial burden on beneficiaries.
• Income Eligibility: To qualify, individuals must meet specific income and asset limits. The asset limits (for 2025) are the same for all three programs:  $9,660 for one person and $14,470 for a married couple.
• There are Three MSP Categories:
  • Qualified Medicare Beneficiary (QMB): Covers Medicare Part A and B premiums, deductibles, and co-payments. The monthly income limits represent 100% of the federal poverty level plus $20 for an exempted amount.
  • Specified Low-Income Medicare Beneficiary (SLMB): Helps with Medicare Part B premiums. The monthly income limits represent 120% of the federal poverty level plus $20 for an exempted amount.
  • Additional Low-Income Medicare Beneficiary (ALMB) aka Qualifying Individual (QI): Assists with Medicare Part B premiums for those with slightly higher incomes than SLMB beneficiaries. Coverage is available on a first come, first served basis until funding is exhausted.   

Applications for these programs are made through your local DHHS (Department of Health and Human Services) office. Individuals can complete paper applications but are encouraged to apply online at MI Bridges.  Upon qualifying (and meeting a deductible when required), a person receives a “mihealth” card that serves as proof of coverage.