Colorado Medicare Savings Programs 2026: QMB, SLMB & QI

Colorado's Medicare Savings Programs pay the Medicare premiums, deductibles, and coinsurance that low-income seniors and people with disabilities can least afford. In 2026, the broadest tier, the Qualified Medicare Beneficiary (QMB) program, eliminates the entire $202.90 monthly Part B premium plus every Part A and Part B deductible, coinsurance, and copay for a single Coloradan who has income at or below $1,350 a month and also passes the resource test. Colorado county eligibility sites apply that resource test at $11,450 for one person and $17,910 for a couple: the federal $9,950 / $14,910 limit with $1,500 per person of set-aside burial money already folded into the published figure.

What Are Medicare Savings Programs?

Medicare Savings Programs (MSPs) are Medicaid-administered benefits that pay a low-income Medicare beneficiary's premiums and cost-sharing. Under section 1902(a)(10)(E) of the Social Security Act, QMB, SLMB, and QI are mandatory Medicaid eligibility groups, so every one of the 50 states and the District of Columbia must cover them.2,1

In Colorado, the programs are administered by the Colorado Department of Health Care Policy and Financing (HCPF), which runs the state's Medicaid program, Health First Colorado. HCPF determines financial eligibility and manages enrollment for all three MSP tiers.3,1

Because MSPs use the Supplemental Security Income (SSI) income methodology, a $20/month general income disregard is subtracted from unearned income before the test is applied. Colorado's published income limits already include this $20 disregard. Treat the figures below as the published standard rather than a hard cutoff: HCPF attaches a caveat directly above its own list, "Remember that if you have income from working, you may qualify for benefits even if your income is higher than the limits listed," and SSA instructs staff that even where income or resources appear somewhat higher than the state limits, to encourage people to apply.1 Working applicants get an additional earned-income exclusion on top of it: SSI does not count the first $65 of a month's earnings, plus one-half of everything above $65, so wages count less heavily than the raw numbers suggest.4

QMB: Qualified Medicare Beneficiary

QMB is the most comprehensive of the three programs. In 2026 it covers:

• The Medicare Part A premium, if any (most beneficiaries have premium-free Part A after 40 or more work quarters)
• The Medicare Part B standard premium, $202.90/month in 20265
• The Part A inpatient hospital deductible, $1,736 per benefit period in 20265
• The Part B annual deductible, $283 in 20265
• Part A and Part B coinsurance and copayments on Medicare-covered items and services

Those cost-sharing figures come from the Centers for Medicare & Medicaid Services (CMS).

2026 Colorado QMB income limits: at or below $1,350/month for a single person, $1,824/month for a couple. These reflect 100% of the Federal Poverty Level (FPL) with the $20 general income disregard applied. Resource limit: $11,450 for one person, $17,910 for a couple. Colorado county eligibility sites apply that figure under HCPF operational memo 25-078, effective January 1, 2026; it is the federal $9,950 / $14,910 limit with $1,500 per person ($3,000 per couple) of designated burial funds folded in, not a blanket higher asset ceiling.1 The home you live in, your household goods and personal effects, and one vehicle your household uses for transportation are not counted at all.6

For a single Colorado senior, QMB eliminates the $202.90 monthly Part B premium ($2,434.80 a year) and the $283 annual Part B deductible outright: a guaranteed $2,717.80 in yearly savings before any care is used. If the beneficiary is hospitalized, QMB also covers the $1,736 Part A deductible for that benefit period. Every QMB enrollee is also automatically deemed eligible for full Part D Extra Help.5

SLMB: Specified Low-Income Medicare Beneficiary

SLMB pays one benefit: the Medicare Part B premium. At the 2026 standard rate of $202.90/month, that is $2,434.80 per year returned to the beneficiary.5

2026 Colorado SLMB income limits: $1,351 to $1,616/month for a single person, $1,825 to $2,184/month for a couple. Resource limit: the same as QMB, $11,450 single and $17,910 couple.1

SLMB does not cover deductibles or copays. But for a beneficiary with limited medical utilization, the Part B premium is the largest recurring out-of-pocket cost, and SLMB eliminates it entirely.

SLMB enrollment also triggers automatic Part D Extra Help, which caps generic copays at $5.10 and brand-name copays at $12.65.7 Full Extra Help also zeroes out the Part D annual deductible8 and pays the whole premium of any plan priced at or below your region's low-income benchmark, so a benchmark plan costs $0 a month.8

QI: Qualifying Individual

QI covers the Part B premium only, the same as SLMB, at a higher income band: $1,617 to $1,816/month single, $2,185 to $2,455/month couple in 2026. The resource limit is again $11,450 single / $17,910 couple.1

Three structural differences from QMB and SLMB:

1. You must apply every year. Selection for QI in one year does not entitle you to continued assistance in any following year, so a QI enrollee reapplies annually to stay in the program.1
2. First-come, first-served. QI is funded through a capped federal allotment, and federal statute says outright that QI is not an entitlement. Colorado selects qualifying individuals in the order they apply and must stop once the state's allocation is spent, so an otherwise-eligible QI applicant can be turned away for want of funding. A QMB or SLMB applicant cannot: those groups carry no funding cap and must be served with reasonable promptness.9,1
3. Mutually exclusive with full Medicaid. Anyone who qualifies for full-benefit Medicaid is not eligible for QI.1 If your income and resources also fall inside the QMB or SLMB band, you would be enrolled in QMB-Plus or SLMB-Plus, which add full Medicaid benefits on top of MSP cost-sharing protection. If they do not (Health First Colorado's long-term-care pathway, for instance, reaches income up to $2,982 a month, well above every MSP limit), you get full Medicaid without an MSP.3

QI enrollment also triggers automatic Part D Extra Help.

Colorado Medicare Savings Programs: Full Comparison

Income limits reflect 100% FPL (QMB), 100-120% FPL (SLMB), and 120-135% FPL (QI) with the $20 general income disregard applied. The $11,450 / $17,910 resource figure is the federal $9,950 / $14,910 limit with the $1,500-per-person burial set-aside folded into the published number, so someone who was told they had "too many assets" against the bare federal figure should re-check against what Colorado county sites actually apply.1

The QMB Billing Prohibition

Federal law (section 1902(n)(3)(B) of the Social Security Act, 42 U.S.C. 1396a(n)(3)(B)) prohibits any Medicare provider or supplier, pharmacies included, from billing a QMB enrollee for Medicare Part A or Part B cost-sharing: deductibles, coinsurance, and copayments. It holds even when Health First Colorado pays the provider nothing toward that cost-sharing.10 The protection covers Original Medicare and Medicare Advantage providers alike.11

If you receive a bill for a deductible, coinsurance, or copay as a QMB enrollee:

• Do not pay it. Inform the provider you are enrolled in QMB and cite the federal prohibition.
• Show your HCPF eligibility notice or Medicare card with the QMB indicator.
• Call 1-800-MEDICARE (1-800-633-4227), the official CMS beneficiary line, to file a complaint.12
• Contact Colorado SHIP, the State Health Insurance Assistance Program, for free help disputing the bill.

A provider who bills you anyway is violating its Medicare provider agreement, or its obligations under Medicare Part C, and may face sanctions. CMS's instruction to providers is to bill the state to determine what the state owes, not to bill you.10

Part D Extra Help / Low-Income Subsidy

Every Colorado QMB, SLMB, and QI enrollee is automatically deemed eligible for full Part D Extra Help, also called the Low-Income Subsidy (LIS). No separate application is required.1

Under the 2026 Part D benefit structure, full Extra Help means:

• $0 premium on a Part D plan priced at or below your region's low-income benchmark (a costlier plan leaves you the difference)8
• $0 annual deductible8
• No more than $5.10 per generic prescription7
• No more than $12.65 per brand-name or preferred multi-source drug7
• $0 in copays once out-of-pocket drug costs reach the $2,100 annual cap7

Those figures come from the Social Security Administration and CMS. The deeming flows from HCPF to CMS monthly. If you are not already in a Part D plan, CMS will auto-assign you to a zero-premium benchmark plan.

Resource Counting: What's Excluded

MSP resource counting follows the SSI rules, which leave several major asset categories out of the countable total.4

Not counted:

• The home you live in, and the land it sits on6
• Household goods and personal effects6
• One vehicle, regardless of value, if you or someone in your household uses it for transportation6
• Up to $1,500 per person set aside and clearly designated for burial expenses, kept separate from your other money. This is the allowance HCPF has already folded into the $11,450 / $17,910 figure ($3,000 for a couple). HCPF's own page states the exclusion as applying "if you have put that money aside," so it is the set-aside that earns the higher published limit, not Colorado policy raising the ceiling for everyone.1,4

Counted:

• Checking and savings account balances
• Stocks, bonds, CDs, and mutual funds
• A second vehicle or a second home
• The cash surrender value of life insurance, but only if the total face value of all policies on one person is more than $1,500. At or below $1,500 of face value, no cash surrender value counts.6

Two things trip Coloradans up here. Many include their home or primary vehicle in the count and conclude they do not qualify; neither asset counts. And HCPF's public MSP webpage still displays the 2025 resource figures of $11,160 and $17,470, a chart that has not been refreshed rather than a different rule. The 2026 numbers county eligibility sites apply are $11,450 and $17,910.1

How to Apply for Colorado Medicare Savings Programs

Where to Get Help

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Find personalized help applying for Colorado 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.