Medicare Savings Programs (QMB, SLMB, QI)
Your next step
Apply through Washington Connection
This is usually the higher-leverage first door for someone on Medicare with a low income, because approval also gets you Extra Help automatically.
Save this application
Save it to your account to check off documents, add dates, and get renewal reminders. Free, and we take no referral fees.
The steps
- Not started
- Gathering documents
- Submitted
- Being reviewed
- Approved
Documents to gather
- Medicare card or Medicare number
- Proof of monthly income (Social Security award letter, pensions, wages)
- Proof of identity and Washington residency
Do not type Social Security, bank, or Medicare numbers here. This checklist is only a reminder of what to gather for the agency.
How to apply
- Washington Connection Open
- DSHS Customer Service Center 1-877-501-2233
HCA 1-800-562-3022 extension 16129 can mail you a paper application. SHIBA offers free Medicare counseling at 1-800-562-6900.
- Form HCA 13-691, Application for Medicare Savings Programs Open
Fax to 1-888-338-7410 or mail to DSHS, CSD Customer Service Center, PO Box 11699, Tacoma, WA 98411-6699.
- Drop box at a local DSHS Community Services Office Open
Talk to a person
Free help is available. These lines are staffed by people who do this every day.
- SHIBA, free Medicare counseling: 1-800-562-6900
- Community Living Connections: 1-855-567-0252
- SHIBA, free Medicare help: 1-800-562-6900
This is general information, not legal or financial advice. The agency that runs each program makes the final decision.