Help with Medicare Costs in West Virginia for Low-Income Seniors
The Three Programs That Pay Your Medicare Bills
West Virginia participates in three Medicare Savings Programs that pay different portions of your Medicare costs depending on your income. All three are administered by the Department of Human Services and use the same application.
QMB — for singles earning up to $1,350/month or couples up to $1,824/month. Pays Part A and B premiums, all deductibles, coinsurance, and copays. The most comprehensive tier.
SLMB — for singles earning $1,351–$1,616/month or couples $1,825–$2,184/month. Pays the Part B premium only ($202.90/month in 2026).
QI — for singles earning $1,617–$1,816/month or couples $2,185–$2,455/month. Also pays the Part B premium. Funded through a capped federal grant.
All three tiers require resources below $9,950 (individual) or $14,910 (couple). Your primary home is excluded up to the $752,000 equity limit, and one vehicle is excluded regardless of value.
All three automatically qualify you for Extra Help with prescription drug costs — $0 Part D deductible, $0 premium on benchmark plans, generic copays capped at $5.10, and brand-name copays capped at $12.65.
How Much Can You Actually Save?
The numbers are substantial. A QMB enrollee on Original Medicare saves:
- $202.90/month in Part B premiums = $2,434.80/year
- $1,736 Part A deductible per benefit period
- $283 Part B annual deductible
- 20% coinsurance on every outpatient visit, lab test, and imaging study
Add Extra Help's prescription savings, and a low-income senior with several chronic conditions can save $5,000 to $10,000 or more per year compared to paying everything out of pocket.
Even at the QI level — the least generous tier — you're still recovering $2,434.80 in Part B premiums and getting capped prescription copays. That's real money on a $1,700/month income.
How Couples Are Evaluated
If both spouses live together, caseworkers combine both spouses' income and resources and compare them against the couple thresholds, even if only one spouse has Medicare. The couple limits are higher than single limits across all tiers.
An adult child's income never counts toward a parent's eligibility, regardless of living arrangements. Non-MAGI rules exclude adult children from the assistance group entirely. If your mother earns $1,400/month and lives in your house, her caseworker evaluates her as an individual (or as a couple with her spouse, if applicable) — your $75,000 salary is invisible to the calculation.
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Get the West Virginia — Medicare Savings Program Eligibility Checklist
Everything in this article as a printable checklist — plus action plans and reference guides you can start using today.
Free Resources to Help You Navigate
WV SHIP (State Health Insurance Assistance Program): Free, unbiased Medicare counseling. They can screen your eligibility, explain your options, and help with plan selection. Call 1-877-987-4463.
Legal Aid of West Virginia: Free legal representation for low-income seniors facing benefit denials, terminations, or fair hearings. Call 1-866-255-4370.
DoHS Customer Service Center: General intake, phone applications, and status inquiries. Call 1-877-716-1212.
Medicare.gov and BenefitsCheckUp.org: Online eligibility screening tools that estimate which programs you might qualify for. These use federal baselines — they'll point you to the state for the actual application.
What SHIP Can't Do for You
SHIP counselors provide essential screening and plan advice, but they don't manage the administrative process. They can't collect and organize your financial documents, format verification uploads for WV PATH, track caseworker interactions, or manage the 60-to-90-day SSA premium reimbursement window after approval.
They also get heavily booked during Medicare Annual Open Enrollment (October 15 through December 7), which creates wait times for families dealing with mid-year MSP applications.
Where to Start
Apply through WV PATH at wvpath.wv.gov, mail Form DFA-QSQ-1 to your county DoHS office, or call 1-877-716-1212. You don't have to know which tier you qualify for — caseworkers evaluate you for all three from one application.
The West Virginia Medicare Savings Programs guide includes eligibility worksheets for singles and couples, a document preparation checklist, and a caseworker communication log for tracking your application through the system.
Get Your Free West Virginia — Medicare Savings Program Eligibility Checklist
Download the West Virginia — Medicare Savings Program Eligibility Checklist — a printable guide with checklists, scripts, and action plans you can start using today.