QMB Income Limits: Countable Income, Resources, and Coverage

To qualify for the Qualified Medicare Beneficiary program in 2026, your monthly income can be no higher than $1,350 if you’re single or $1,824 if you’re married, in the 48 contiguous states and Washington, D.C.¹ These QMB income limits sit at 100% of the Federal Poverty Level with a built-in $20 monthly disregard already added in. Meet them, pass a modest resource test, and have Medicare Part A, and the program pays your Part A and Part B premiums along with every deductible, coinsurance, and copayment on Medicare-covered services.²

2026 QMB Income Limits at a Glance

The published thresholds for 2026 are:

Individual: $1,350 per month
Married couple: $1,824 per month

Alaska and Hawaii use higher figures to reflect their cost of living. The numbers are refreshed each year, and Medicare Savings Program limits typically move in April when new federal poverty guidelines take effect.

The $20 disregard is why the ceiling looks a bit higher than the raw poverty guideline. That disregard has already been applied to the numbers above, so you compare your gross monthly income directly to $1,350 or $1,824.¹

How Your Countable Income Is Figured

State Medicaid agencies use the same income-counting rules as Supplemental Security Income, which distinguishes between earned income (wages and self-employment) and unearned income (Social Security, pensions, interest, and similar payments).³

If you have wages, the math turns sharply in your favor. After the $20 general disregard, the agency ignores the first $65 of monthly earnings and then counts only half of what’s left. Someone earning $1,300 a month in wages ends up with $617.50 in countable earned income. That’s why a gross paycheck that looks over the limit often isn’t, and why it’s worth applying rather than assuming.

2026 Resource Limits

Income isn’t the only test. Your countable assets in 2026 cannot exceed $9,950 for an individual or $14,910 for a married couple.⁴ Bank accounts, stocks, bonds, and mutual funds are counted.

Several categories are excluded regardless of value:

The home you live in
One vehicle, at any value
Household goods and personal effects
Burial funds up to $1,500 per person⁵
Life insurance with a combined face value under $1,500

A handful of states have dropped the resource test entirely for Medicare Savings Programs, and others have raised the limits above the federal baseline. Check with your state Medicaid office before ruling yourself out on assets.

What QMB Actually Pays For

Once you’re enrolled, QMB covers your Medicare Part A and Part B premiums (if you owe them), plus all deductibles, coinsurance, and copayments for Medicare-covered items and services.⁶ You have no legal obligation to pay those cost-sharing amounts.² You do need to have Medicare Part A to qualify, whether that’s premium-free Part A or a buy-in.⁴

Federal law prohibits Medicare providers from billing QMB enrollees for those cost-sharing amounts, and has since 1997. The rule covers both Original Medicare and Medicare Advantage plans.⁷ Providers who bill you anyway are breaching their Medicare provider agreement even when Medicaid pays nothing toward the balance.⁸ If you get a bill, show the provider your Medicare card, your Medicaid or QMB card, and your Medicare Summary Notice, which identifies QMB status. If the billing continues, call 1-800-MEDICARE (1-800-633-4227). You’re entitled to a refund for any cost-sharing you’ve already paid.⁹

Enrollment also triggers automatic Extra Help, the federal subsidy that eliminates the Part D deductible and reduces prescription drug copays. You don’t need to apply for it separately.¹⁰

If Your Income Is Too High for QMB

Two other Medicare Savings Programs use higher income ceilings and the same 2026 resource limits.⁴ They cover less, but they still help.

Specified Low-Income Medicare Beneficiary (SLMB) pays the Part B premium. Income limit: $1,616 for an individual, $2,184 for a couple.¹
Qualifying Individual (QI) also pays the Part B premium, with a limit of $1,816 for an individual and $2,455 for a couple. QI funding is capped, so benefits are awarded first-come, first-served each year.¹

SLMB and QI both bring automatic Extra Help along with them.¹⁰

How to Apply

Apply through your state Medicaid agency, which may be called the Department of Social Services or something similar. Most states take applications online, by mail, or in person.⁶ Have these ready:

Proof of identity, such as a driver’s license, state ID, or passport
Proof of citizenship or immigration status
Your Medicare card, to confirm Part A enrollment
Recent pay stubs, pension statements, and your Social Security award letter
Bank, investment, and life insurance statements
Details of any other health coverage, including premiums

One timing detail to plan around: QMB coverage is not retroactive. Eligibility starts the first day of the month after approval, not the month you applied.¹¹ Apply in March, approved in April, benefits begin May 1. Any Medicare cost-sharing during the gap is on you, which is reason enough to file as soon as you think you might qualify.

1
Social Security Administration. POMS HI 00815.023 – Medicare Savings Programs Income and Resource Limits
2
Centers for Medicare & Medicaid Services. Qualified Medicare Beneficiary (QMB) Program Group
3
Social Security Administration. Understanding Supplemental Security Income SSI Income
4
Social Security Administration. POMS HI 00815.024 – SSAs Role in Medicare Savings Programs
5
Social Security Administration. Code of Federal Regulations 416-1231
6
Medicare.gov. Medicare Savings Programs
7
CMS. Reminder of Prohibition on Billing Qualified Medicare Beneficiaries
8
Centers for Medicare & Medicaid Services. Prohibition on Billing Qualified Medicare Beneficiaries
9
Medicare.gov. 3 Tips for People in the Qualified Medicare Beneficiary (QMB) Program
10
Medicare.gov. Help With Drug Costs
11
Federal Register. Streamlining Medicaid Medicare Savings Program Eligibility Determination and Enrollment