Alabama Medicare Savings Programs can cut or eliminate what a low-income Medicare beneficiary pays for premiums and cost-sharing. QMB, the broadest tier, covers the Part B premium and all Medicare deductibles and copays.
What Are Medicare Savings Programs?
Medicare Savings Programs are Medicaid-administered benefits that pay some or all of a low-income Medicare beneficiary's Medicare premiums and cost-sharing. QMB, SLMB, and QI are mandatory eligibility groups under Title XIX of the Social Security Act, meaning every state Medicaid plan must cover them.
In Alabama, all three programs are administered by the Alabama Medicaid Agency. The Agency sets policy and processes eligibility; apply through the elderly and disabled application portal or by phone.
MSPs use the SSI-related income methodology rather than MAGI rules. Two income disregards reduce what counts toward the limit: a $20/month general income disregard applied first to unearned income, and a $65 + half of remaining earned income disregard for working beneficiaries. The income bands below already reflect the $20 disregard.
QMB: Qualified Medicare Beneficiary
QMB is the most comprehensive program. It covers:
- The Medicare Part A premium (most beneficiaries have premium-free Part A after 40+ quarters of work)
- The Medicare Part B premium ($185.00/month in 2026 per CMS)
- The Part A inpatient hospital deductible ($1,736 in 2026)
- The Part B annual deductible ($257 in 2026)
- All Medicare coinsurance and copays on every Medicare-covered service
2026 Alabama QMB income limits: at or below $1,350/month for a single person, or at or below $1,821/month for a couple. These figures reflect 100% of the Federal Poverty Level with the $20 general income disregard applied.
Resource limit: $9,950 for one person, $14,910 for a couple. The primary residence and one vehicle are excluded entirely from this count.
For a single Alabama senior relying on Social Security, QMB can be worth more than $3,000 a year in saved premiums, deductibles, and copays. Every QMB enrollee is also automatically deemed eligible for full Part D Extra Help.
SLMB: Specified Low-Income Medicare Beneficiary
SLMB covers one benefit: the Medicare Part B premium. At the 2026 standard rate, that is worth $2,220 per year.
2026 Alabama SLMB income limits: $1,351 to $1,616/month for a single person, $1,822 to $2,178/month for a couple.
Resource limit: Same as QMB: $9,950 single, $14,910 couple.
SLMB does not cover deductibles or copays. But for a beneficiary with relatively few medical claims, eliminating the Part B premium is the dominant cost saving. And SLMB enrollment triggers automatic Part D Extra Help, reducing drug copays to $5.10 for generics and $12.65 for brand-name drugs, with a $0 deductible and $0 premium on a benchmark Part D plan.
QI: Qualifying Individual
QI pays the Part B premium only, the same as SLMB, but applies at a higher income band: $1,617 to $1,816/month for a single person, $2,179 to $2,451/month for a couple (2026 figures with the $20 disregard applied).
Two structural differences from QMB and SLMB:
- First-come, first-served. QI is funded through a capped federal allotment. Alabama allocates enrollment on a first-come, first-served basis, with a preference for prior-year QI enrollees. Unlike QMB and SLMB, which are entitlements, QI has no enrollment guarantee.
- Mutually exclusive with full Medicaid. Anyone eligible for full Alabama Medicaid (the Aged and Disabled category) cannot simultaneously be on QI. Those individuals would instead qualify for QMB-Plus or SLMB-Plus, which layer full Medicaid on top of MSP protections.
Like SLMB, QI enrollment triggers automatic Part D Extra Help.
The QMB Billing Prohibition
Federal law (42 USC § 1396a(n)(3)(B)) prohibits any Medicare provider from billing a QMB enrollee for Medicare cost-sharing. This applies to Original Medicare and Medicare Advantage providers alike, whether or not they participate in Alabama Medicaid.
If you are a QMB enrollee and receive a bill for a deductible, coinsurance, or copay from any Medicare provider, do not pay it. The provider cannot legally collect it.
If you receive such a bill:
- Tell the provider you are enrolled in QMB and cite federal law.
- Show your Alabama Medicaid eligibility notice or Medicare card with the QMB indicator.
- Call 1-800-MEDICARE (1-800-633-4227) to file a complaint.
- Contact the Alabama SHIP (State Health Insurance Assistance Program) at 1-800-243-5463 for free help disputing the bill.
Part D Extra Help / Low-Income Subsidy
Every QMB, SLMB, and QI enrollee in Alabama is automatically deemed eligible for full Part D Extra Help (the Low-Income Subsidy). No separate application is required.
Under the 2026 Part D benefit structure:
- $0 Part D premium on a benchmark plan
- $0 annual deductible
- $5.10 per generic prescription
- $12.65 per brand-name or preferred multi-source drug
- $0 copays after the annual out-of-pocket cap
The deeming flows automatically from the Alabama Medicaid Agency to CMS each month after MSP enrollment. If you are not already in a Part D plan, CMS will auto-assign you to a zero-premium benchmark plan.
Alabama Medicare Savings Programs: 2026 Income Limits at a Glance
| Program | Single monthly income limit | Couple monthly income limit | What it pays |
|---|---|---|---|
| QMB | Up to $1,350 | Up to $1,821 | Part A + Part B premiums + all cost-sharing |
| SLMB | $1,351-$1,616 | $1,822-$2,178 | Part B premium only |
| QI | $1,617-$1,816 | $2,179-$2,451 | Part B premium only (capped allotment) |
Income limits reflect 100% FPL (QMB), 100-120% FPL (SLMB), and 120-135% FPL (QI) with the $20 general income disregard applied. Resource limit for all three: $9,950 single / $14,910 couple.
What Counts as a Resource and What Does Not
The $9,950/$14,910 resource limit is less restrictive than it looks because several major assets are excluded:
Excluded (do not count):
- Primary residence, regardless of equity or value
- One vehicle, regardless of make or value
- Household goods and personal effects
- Prepaid burial arrangements and a burial fund up to $1,500 per person
Counted:
- Checking and savings account balances
- Stocks, bonds, certificates of deposit, mutual funds
- A second vehicle or second home
- Non-exempt cash-value life insurance above the $1,500 face-value threshold
Many Alabama seniors rule themselves out of MSP because they think of their home as a resource. The home does not count. A QMB applicant in a paid-off house worth $200,000 can still qualify as long as their bank and investment balances stay within the limit.
How to Apply for Alabama Medicare Savings Programs
1. Online through the Alabama Medicaid elderly and disabled application portal
Apply at eanddapplication.medicaid.alabama.gov. This is the Alabama Medicaid Agency's dedicated portal for elderly and disabled applicants. Complete the application and upload supporting documents.
2. By phone
Call the Alabama Medicaid Agency at 1-800-362-1504. Staff can walk you through the application by phone.
3. Through the Social Security Administration
Applying for Part D Extra Help (Form SSA-1020) at your local Social Security office automatically generates a referral to Alabama Medicaid. SSA is required by federal law (42 USC § 1320b-14) to forward the application to the state, with the SSA application date as the protected filing date.
Documents to Gather Before You Apply
- Medicare card (showing your Medicare Beneficiary Identifier / MBI)
- Social Security card or proof of Social Security number
- Most recent SSA benefit award or COLA letter
- Recent bank and investment account statements
- Pension or annuity statements, if applicable
- Proof of Alabama residency (utility bill, lease, or mortgage statement)
Determination Timeline and Effective Dates
The Alabama Medicaid Agency must process non-disability MSP applications within 45 days under 42 CFR § 435.912.
- QMB: coverage begins the first day of the month after the month Alabama approves the application. Federal law prohibits retroactive QMB coverage. Apply as early as possible.
- SLMB and QI: up to three months of retroactive coverage is available under 42 CFR § 435.915 if you were eligible during those months. File early to protect the retroactive window.
How the Income Disregards Work
The most common reason eligible Alabama seniors skip MSP: they look at gross income, see it above the threshold, and stop. The SSI-related income methodology runs the numbers differently.
$20 general income disregard: $20 per household per month is excluded from unearned income (Social Security, pensions, VA compensation) before counting income. This is already reflected in the published income limits above.
$65 + half of earned income: For applicants with wages or self-employment income, the first $65 is excluded, then half of the remainder is excluded. A part-time worker earning $700/month gross has $700 - $65 = $635; half of $635 = $317.50 counted from earned income. Combined with the $20 disregard on unearned income, many seniors have significantly lower countable income than their gross figures suggest.
Run the actual disregard math before concluding you don't qualify.
Frequently Asked Questions
An Alabama Medicare beneficiary with monthly income at or below $1,350 (single) or $1,821 (couple) and countable resources at or below $9,950/$14,910. The primary home and one car are excluded from the resource count. QMB pays Part A and Part B premiums plus all Medicare deductibles, coinsurance, and copays.
No. Federal law prohibits QI enrollment for anyone who qualifies for full Medicaid. If you qualify for full Alabama Medicaid (the Aged and Disabled category), you would instead be eligible for QMB-Plus or SLMB-Plus, which combine MSP protections with the full Medicaid benefit.
No. Every Alabama QMB, SLMB, and QI enrollee is automatically deemed eligible for full Part D Extra Help. The Alabama Medicaid Agency sends deeming information to CMS monthly. If you are not already in a Part D plan, CMS will assign you to a zero-premium benchmark plan.
Do not pay the bill. Federal law prohibits any Medicare provider from billing QMB enrollees for Medicare cost-sharing. Call 1-800-MEDICARE and contact Alabama SHIP at 1-800-243-5463 for free help.
Yes, for up to three months if you were eligible during that window. QMB does not allow retroactive coverage; it starts the month after the Alabama Medicaid Agency approves the application. Apply early to maximize the retroactive window for SLMB and QI.
Learn More
- Alabama Medicaid Eligibility and Income Limits
- How to Apply for Alabama Medicaid
- Understanding the Personal Needs Allowance
Find personalized help applying for Alabama Medicare Savings Programs at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.