Every state helps pay Medicare premiums through Medicare Savings Programs, Medicaid-funded programs that cover some or all of a Medicare beneficiary’s premiums and, in the broadest tier, deductibles and cost-sharing too. For 2026, individuals earning up to $1,350 a month can qualify for the most comprehensive help; higher earners, up to $1,816 a month, may still get their Part B premium paid. Fourteen states and the District of Columbia have gone further and eliminated asset limits entirely, so income is the only test.
The Four Programs and What They Pay
Medicare Savings Programs come in four tiers. Which one you qualify for depends on your income and, in most states, your resources.
- Qualified Medicare Beneficiary (QMB) is the broadest. It pays your Part A and Part B premiums and wipes out your responsibility for deductibles, copayments, and coinsurance on Medicare-covered services.1Centers for Medicare & Medicaid Services. Qualified Medicare Beneficiary (QMB) Program Group
- Specified Low-Income Medicare Beneficiary (SLMB) pays your Part B premium only. You need to be enrolled in both Part A and Part B.2Medicare. Medicare Savings Programs
- Qualifying Individual (QI) also pays your Part B premium only, with higher income limits than SLMB. Funding is capped, so states approve applications first-come, first-served and give priority to people who received QI the prior year.2Medicare. Medicare Savings Programs
- Qualified Disabled and Working Individuals (QDWI) pays only the Part A premium. It exists for a narrow group: people with disabilities who returned to work and lost premium-free Part A as a result.2Medicare. Medicare Savings Programs
The dollars involved are real. The standard Part B premium for 2026 is $202.90 a month, and the Part A premium for people who owe one runs up to $565 a month.3Centers for Medicare & Medicaid Services. 2026 Medicare Parts A and B Premiums and Deductibles Covering the Part B premium alone saves a beneficiary roughly $2,435 a year.
2026 Income and Resource Limits
The federal figures below apply in the 48 contiguous states. Each program includes a $20 monthly income disregard, already built into the numbers.4Social Security Administration. Medicare Savings Programs Income and Resource Limits
QMB: monthly income up to $1,350 individual / $1,824 couple; resources up to $9,950 / $14,910.
SLMB: monthly income up to $1,616 individual / $2,184 couple; resources up to $9,950 / $14,910.
QI: monthly income up to $1,816 individual / $2,455 couple; resources up to $9,950 / $14,910.
QDWI: monthly income up to $5,405 individual / $7,299 couple; resources up to $4,000 / $6,000.2Medicare. Medicare Savings Programs
What Counts as a Resource
Countable resources include checking and savings, stocks, bonds, mutual funds, and retirement accounts. Your primary home, one vehicle, burial plots, and life insurance policies with a face value under $1,500 are excluded. In states that still apply asset tests, that distinction matters: $15,000 sitting in savings can put someone over the QMB limit, while $200,000 in home equity is ignored.
Alaska and Hawaii
Alaska and Hawaii use higher income thresholds because of cost of living. For QMB in 2026, Alaska’s individual monthly limit is $1,683 and Hawaii’s is $1,550, versus $1,350 in the other states. The same lift applies across SLMB, QI, and QDWI.4Social Security Administration. Medicare Savings Programs Income and Resource Limits
States That Expand Eligibility Beyond the Federal Minimums
The federal numbers are floors, not ceilings. States can raise the income limits, ignore certain income, or drop the asset test entirely, and many have.4Social Security Administration. Medicare Savings Programs Income and Resource Limits
Fourteen jurisdictions no longer apply asset limits to Medicare Savings Programs at all: Alabama, Arizona, Connecticut, Delaware, the District of Columbia, Louisiana, Maine, Massachusetts, Mississippi, New Mexico, New York, Oregon, Vermont, and Washington. In these places, only your income is tested. Several other states have pushed their income thresholds well above the federal minimums, with some setting QI limits at 200% or 250% of the federal poverty level rather than the standard 135%.
This is where a lot of people miss out. If your income sits a little above the federal thresholds, don’t assume you’re out; call your state Medicaid office. Your state may disregard some or all spousal income, use more generous counting rules, or set a higher ceiling outright.
How to Apply
Applications go through your state Medicaid office, not through Medicare or Social Security.2Medicare. Medicare Savings Programs Most states take applications online, by mail, or in person. Have your Social Security card, Medicare card, proof of income (Social Security award letters, pay stubs), and account statements showing your resources ready. States that have dropped the asset test won’t ask for the financial account records.
Federal rules require a decision within 45 days of your application, or 90 days when eligibility turns on a disability determination.5Medicaid.gov. Medicaid and CHIP Determinations at Application If you haven’t heard back by then, follow up.
Free help is available. Your State Health Insurance Assistance Program (SHIP) offers one-on-one counseling at no cost. Find your local SHIP at shiphelp.org or call 1-877-839-2675.6SHIP TA Center. Get Medicare Help from Your Local SHIP Program
When Coverage Starts
QMB is not retroactive. Benefits begin the first day of the month after the state approves you.7Medicaid.gov. Implementation Guide – Mandatory Coverage Qualified Medicare Beneficiaries Approved in March, covered starting April 1. Anything you paid before that date stays paid, so apply as soon as you think you might qualify.
The QMB Billing Rule Providers Sometimes Forget
If you have QMB, Medicare providers are legally barred from billing you for Medicare deductibles, copayments, or coinsurance. This applies to every Medicare provider, not only those enrolled in Medicaid. Billing a QMB enrollee for Medicare cost-sharing violates the provider’s Medicare agreement.8Centers for Medicare & Medicaid Services. Prohibition on Billing Qualified Medicare Beneficiaries
If a bill for Medicare cost-sharing arrives after your QMB is active, you don’t owe it. The provider must pull the bill back and refund anything you already paid. Contact your state Medicaid office or 1-800-MEDICARE.
Automatic Extra Help for Prescription Drugs
Enrolling in any Medicare Savings Program automatically qualifies you for Extra Help, the federal subsidy for Part D prescription drug costs.9Medicare. Medicare’s Extra Help Program No separate application. Medicare mails you a purple notice confirming eligibility.
Extra Help lowers or eliminates Part D premiums, deductibles, and copayments, and it can save thousands of dollars a year on medications. If you qualify through an MSP, you skip the standalone Extra Help income and resource tests.
Keeping the Benefit Each Year
States review MSP eligibility periodically, usually once a year.10Federal Register. Streamlining Medicaid – Medicare Savings Program Eligibility Determination and Enrollment For QMB, SLMB, and QDWI, the state often handles renewal using data it already has, sometimes sending a form to confirm your income and resources.
QI is different. You have to reapply every year, and because funding is capped, submitting your renewal early matters. Prior-year enrollees get priority, but that doesn’t rescue a late renewal.2Medicare. Medicare Savings Programs