California Medicare Savings Programs can eliminate or reduce your Medicare costs through four separate income-based programs administered by DHCS under Medi-Cal. All four programs restored their asset test on January 1, 2026, after the pandemic-era suspension ended, and California's income limits differ from the federal-floor figures most states use.
What Are Medicare Savings Programs?
Medicare Savings Programs (MSPs) are state Medicaid programs that help low-income Medicare beneficiaries pay Medicare's premiums, deductibles, and cost-sharing. In California, MSPs are administered by California DHCS through Medi-Cal. Qualifying automatically stops Social Security from deducting the Part B premium from your monthly check.
There are four distinct programs, each covering a different scope of Medicare costs.
The Four Programs: What Each One Covers
| Program | What It Pays | Monthly Income Limit (Individual) | Monthly Income Limit (Couple) |
|---|---|---|---|
| QMB (Qualified Medicare Beneficiary) | Part A premium, Part B premium, deductibles, coinsurance, and copayments | $1,330 | $1,804 |
| SLMB (Specified Low-Income Medicare Beneficiary) | Part B premium only | $1,596 | $2,165 |
| QI (Qualifying Individual) | Part B premium only | $1,796 | $2,436 |
| QDWI (Qualified Disabled and Working Individual) | Part A premium only | $2,660 | $3,608 |
Source: California DHCS Medicare Savings Programs page, verified June 2026.
QMB: The Most Valuable Program
QMB is the broadest MSP. It pays the Part A premium (if you don't have premium-free Part A), the Part B premium ($185/month in 2026), plus Medicare deductibles, coinsurance, and copays. QMB beneficiaries are also protected from balance billing by Medicare-participating providers.
Income limit: $1,330/month for one person; $1,804/month for a couple.
California publishes these as gross income limits before applying the standard $20/month general income disregard that Social Security and Medicaid both recognize. In practice, a person with $1,340/month in Social Security income may still qualify after the $20 disregard is applied. If you are close to the limit, apply and let DHCS run the calculation.
QMB and cost-sharing protections. Medicare providers who participate in Medicare (virtually all do) cannot charge a QMB beneficiary more than the Medicare-approved amount. If a provider attempts to bill a QMB beneficiary for a copay or deductible, the beneficiary can dispute it. The Medicare Rights Center can assist with billing complaints at 1-888-466-9050.
SLMB: Part B Premium Help for Middle-Income Seniors
SLMB pays the Part B premium only. At $185/month in 2026, that's $2,220 per year that SLMB keeps in your pocket.
Income limit: $1,596/month for one person; $2,165/month for a couple.
SLMB does not cover deductibles, coinsurance, or copays. For that broader protection, see QMB above or explore Medigap coverage separately.
QI: Part B Premium Help at Higher Incomes
QI also pays the Part B premium only, at an income band just above SLMB. Unlike QMB and SLMB, QI enrollment is funded through an annual federal appropriation. States enroll beneficiaries on a first-come, first-served basis each year. If you qualify for QI, apply early in the calendar year.
Income limit: $1,796/month for one person; $2,436/month for a couple.
One important note: QI enrollment does not count against the Medicaid estate recovery program. California's estate recovery rules do not apply to MSP-only enrollment.
QDWI: Part A Premium Help for Working Disabled Individuals
QDWI is designed for people who lost premium-free Medicare Part A because they returned to work. It pays the Part A premium ($285/month in 2026 for those with fewer than 30 quarters of work credit).
Income limit: $2,660/month for one person; $3,608/month for a couple.
The QDWI income limit is set at 200% of the federal poverty level. The 2026 SSI Federal Benefit Rate is $994/month per individual. QDWI is a narrower program serving a smaller population, primarily those in the Social Security Ticket to Work or extended Medicare period after disability.
The Reinstated Asset Limit: What Changed on January 1, 2026
For two years, California suspended the asset test for MSPs under the same AB 116-era policy that suspended Medi-Cal asset limits broadly. On January 1, 2026, the asset test was reinstated.
Current asset limits (all four MSP programs):
- Individual: $130,000
- Couple: $195,000 (i.e., $130,000 plus $65,000 for the second person)
These figures mirror the reinstated non-MAGI Medi-Cal asset limits. Exempt assets include the primary residence, one vehicle, household goods and personal effects, irrevocable burial trusts, and term life insurance. IRAs in required minimum distribution status are treated as income rather than a countable asset.
Three populations remain exempt from the asset test entirely: Pickle Amendment recipients, Disabled Adult Children (DAC) under SSA § 1634(c), and Disabled Widow(er)s (DWW) under SSA § 1634(b). If you fall into one of these categories, the asset limit does not apply to you.
If your countable assets were above the prior no-limit rule but are below $130,000, you still qualify. If you previously qualified and now find your assets close to $130,000, a California Health Advocates counselor or HICAP can review your situation.
How to Apply in California
California MSPs are processed through the Medi-Cal application system. Applications can be submitted:
- Online: myBenefits California (formerly MyBenefits.ca.gov)
- In person: Your county Department of Health and Social Services (DHSS), also called the county welfare office
- By phone: Contact your county DHSS directly; some counties accept applications by phone
After submitting, DHCS determines which program you qualify for based on your income and assets. Approval for QMB, SLMB, or QI generates an automatic notice to Medicare; the Part B premium deduction stops from your Social Security check within one to two months of approval.
You do not need to enroll separately in each program as your income or situation changes. DHCS will reassign you to the most beneficial program you qualify for at your annual redetermination.
Medicare Counseling: HICAP
California's State Health Insurance Assistance Program (SHIP) is called HICAP (Health Insurance Counseling and Advocacy Program). HICAP counselors provide free, unbiased help with MSP enrollment, Medicare plan selection, billing complaints, and appeals. Reach HICAP at 1-800-434-0222 or through the California Department of Aging at aging.ca.gov.
Frequently Asked Questions
California's QMB income limit for 2026 is $1,330/month for an individual and $1,804/month for a couple. These are gross income limits before the $20 general income disregard, meaning your effective qualifying income may be up to $20 higher.
Yes. SLMB, QI, and QMB all pay the Part B premium ($185/month in 2026). QMB also covers Medicare deductibles, coinsurance, and copays. QDWI covers the Part A premium only.
Yes, as of January 1, 2026. The reinstated limit is $130,000 for one person and $195,000 for a couple. This applies to all four MSP programs. Certain populations (Pickle Amendment recipients, DAC, DWW) are exempt from this limit.
Yes. If you qualify for full Medi-Cal (such as through the Aged and Disabled FPL Program) and Medicare, you are a dual eligible. MSP enrollment is typically automatic for full dual eligibles. Your Medi-Cal case worker can confirm which program you're enrolled in.
Apply through myBenefits California online, or at your county Department of Health and Social Services office. HICAP counselors (1-800-434-0222) can guide you through the application and help document income and assets.
Yes. QMB beneficiaries are protected under federal law from being charged Medicare deductibles, coinsurance, and copays by Medicare-participating providers. If a provider bills you those amounts, you can file a complaint with your State Medical Assistance (Medicaid) office or contact the Medicare Rights Center at 1-888-466-9050.
Learn More
- Medi-Cal Eligibility and Income Limits
- Personal Needs Allowance Explained
- Medicaid Estate Recovery Explained
Find personalized help with California Medicare Savings Programs enrollment and Medi-Cal eligibility 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.