The Qualified Medicare Beneficiary (QMB) program and the Specified Low-Income Medicare Beneficiary (SLMB) program are both Medicare Savings Programs run through your state’s Medicaid agency, and the practical difference between QMB vs. SLMB comes down to two things: how much of your Medicare costs they cover, and how much income you can have to qualify. QMB pays your Part A and Part B premiums plus deductibles, coinsurance, and copayments. SLMB pays only your Part B premium. QMB is for people at or below 100% of the federal poverty level; SLMB is for people between 100% and 120%.1Medicare. Medicare Savings Programs
What QMB Covers
QMB is the most generous of the Medicare Savings Programs. If you qualify, your state pays your Medicare Part B premium, your Part A premium (if you don’t already get Part A premium-free), and the deductibles, coinsurance, and copayments you would otherwise owe on services Medicare covers.1Medicare. Medicare Savings Programs
That last piece matters most. Under Original Medicare, you’re normally responsible for the Part B deductible, 20% coinsurance on most outpatient services, and potentially large Part A cost-sharing during a hospital stay. QMB wipes those charges out. You must be entitled to Medicare Part A to qualify; most people get Part A premium-free based on their own or a spouse’s work history, but if you’re paying that premium out of pocket, QMB covers it too.
QMB also comes with federal billing protections. Every Original Medicare and Medicare Advantage provider is prohibited from billing you for Part A or Part B deductibles, coinsurance, or copayments once you’re enrolled in QMB.2CMS. Prohibition on Billing Qualified Medicare Beneficiaries This applies even when Medicaid pays the provider nothing for the cost-sharing amount, and you cannot volunteer to pay it. If a provider or collector bills you anyway, tell them you’re in QMB. If the billing continues, call 1-800-MEDICARE (1-800-633-4227); Medicare can confirm your enrollment directly with the provider, ask them to stop, and request a refund of anything you’ve already paid.
What SLMB Covers
SLMB is narrower. If you qualify, your state pays your Medicare Part B premium and nothing else. In 2026, the standard Part B premium is $202.90 per month, so SLMB is worth about $2,435 a year.3CMS. 2026 Medicare Parts A and B Premiums and Deductibles You still owe your Part B deductible, coinsurance, and any Part A cost-sharing on your own. You must have both Part A and Part B to qualify.
SLMB coverage can be applied retroactively. If you’re approved, your state can reimburse Part B premiums you paid up to three months before your application month, as long as you would have been eligible during that period.4CMS. Program Overview and Policy
The billing protections QMB offers do not apply to SLMB, because SLMB doesn’t cover cost-sharing to begin with. You remain responsible for deductibles, coinsurance, and copayments like any other Medicare beneficiary.
2026 Income and Resource Limits
The programs use the same resource limits, and their income limits sit right next to each other. QMB picks up where nothing does; SLMB picks up where QMB leaves off.1Medicare. Medicare Savings Programs
- QMB monthly income: up to $1,350 individual, $1,824 couple.
- SLMB monthly income: $1,350 to $1,616 individual, $1,824 to $2,184 couple.
- Resource limit (both): $9,950 individual, $14,910 couple.
The federal figures run slightly higher in Alaska and Hawaii, and some states use more generous thresholds or have eliminated the asset test entirely. If your income or resources are close to the federal limits, check with your state Medicaid office before assuming you’re out.
Countable resources include cash, checking and savings accounts, stocks, bonds, mutual funds, CDs, and retirement accounts like IRAs. Your primary home is excluded while you or your spouse live in it, one vehicle is typically excluded regardless of value, and modest burial funds and small life insurance policies are also excluded.
A Benefit Both Programs Share
Enrollment in either QMB or SLMB automatically qualifies you for the Medicare Part D Low-Income Subsidy, known as Extra Help, which lowers your prescription drug premiums, deductibles, and copayments.5Medicare. Help With Drug Costs You don’t apply separately. Medicare sends you a notice and enrolls you in a Part D plan if you don’t already have one, and you can switch plans if you want a different one. Extra Help stays in place through the end of the calendar year even if your income changes mid-year.
If Your Income Is Too High for SLMB
The Qualifying Individual (QI) program covers the Part B premium for people whose income falls between 120% and 135% of the federal poverty level. In 2026, that means up to $1,816 per month for an individual or $2,455 for a couple, with the same $9,950 and $14,910 resource limits.1Medicare. Medicare Savings Programs QI funding is capped each year and awarded first-come, first-served, so applying early in the year matters. QI enrollees also get Extra Help automatically.
How to Apply
You apply through your state’s Medicaid agency. Most states let you apply online, by mail or fax, in person, or by phone.1Medicare. Medicare Savings Programs Your local State Health Insurance Assistance Program (SHIP) can walk you through the process at no charge.
You’ll generally need proof of income (pay stubs, Social Security benefit letters, pension statements), proof of resources (bank and investment statements), your Medicare card number, and proof of address such as a utility bill or state ID.6CMS. Medicare Savings Program Application Instructions Non-citizens also need proof of eligible immigration status.
Federal rules require your state to decide within 45 days, or 90 days when eligibility depends on a disability determination.7CMS. Ensuring Timely and Accurate Medicaid and CHIP Eligibility Determinations at Application If you don’t hear back in that window, contact the agency. If you’re denied, you have the right to appeal, and the denial notice will explain how to request a hearing. If your income later drops, tell your state Medicaid agency; someone on SLMB whose income falls below 100% of the poverty level may be able to move to QMB and gain full cost-sharing protection.