Colorado Medicare Savings Programs can eliminate or sharply reduce Medicare premiums and cost-sharing for income-eligible seniors and people with disabilities. The broadest tier, QMB, covers the Part B premium and every Medicare cost-sharing charge in a single program.
What Are Medicare Savings Programs?
Medicare Savings Programs are Medicaid-administered benefits that pay a low-income Medicare beneficiary's premiums and cost-sharing. Under Title XIX of the Social Security Act, QMB, SLMB, and QI are mandatory eligibility groups, meaning every state must offer them.
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.
Because MSPs use the SSI-related income methodology, two disregards reduce countable income before the test is applied: 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 limits below already reflect the $20 disregard.
QMB: Qualified Medicare Beneficiary
QMB is the most comprehensive of the three programs. 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 ($185/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 across every Medicare-covered service
2026 Colorado QMB income limits: at or below $1,350/month for a single person, $1,823/month for a couple. These 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 home and one vehicle are fully excluded from the resource count.
For a single Colorado senior on Social Security, QMB can represent more than $3,000 in annual savings across premiums, deductibles, and copays. Every QMB enrollee is automatically deemed eligible for full Part D Extra Help.
| Household size | Monthly income limit | Resource limit |
|---|---|---|
| Single | $1,350 | $9,950 |
| Couple | $1,823 | $14,910 |
SLMB: Specified Low-Income Medicare Beneficiary
SLMB pays one benefit: the Medicare Part B premium. At the 2026 standard rate of $185/month, that is $2,220 per year returned to the beneficiary.
2026 Colorado SLMB income limits: $1,351 to $1,616/month for a single person, $1,824 to $2,188/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 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, reducing generic copays to $5.10 and brand-name copays to $12.65, with a $0 deductible and $0 premium on a benchmark Part D plan.
| Household size | Monthly income range | Resource limit |
|---|---|---|
| Single | $1,351-$1,616 | $9,950 |
| Couple | $1,824-$2,188 | $14,910 |
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, $2,189 to $2,459/month couple (2026 Colorado figures).
Two structural differences from QMB and SLMB:
- First-come, first-served. QI is funded through a capped federal allotment. Colorado allocates enrollment on a first-come, first-served basis, with a preference for prior-year QI enrollees. Because QI is not an entitlement, there is no guarantee of enrollment once the allotment is exhausted.
- Mutually exclusive with full Medicaid. Anyone who qualifies for full-benefit Medicaid is not eligible for QI. They would instead receive QMB-Plus or SLMB-Plus, which add full Medicaid benefits on top of MSP cost-sharing protection.
QI enrollment also triggers automatic Part D Extra Help.
| Household size | Monthly income range | Resource limit |
|---|---|---|
| Single | $1,617-$1,816 | $9,950 |
| Couple | $2,189-$2,459 | $14,910 |
Full Program Comparison
| Program | Single income limit | Couple income limit | What it pays | Resource limit |
|---|---|---|---|---|
| QMB | Up to $1,350/mo | Up to $1,823/mo | Part A + Part B premiums + all cost-sharing | $9,950 / $14,910 |
| SLMB | $1,351-$1,616/mo | $1,824-$2,188/mo | Part B premium only | $9,950 / $14,910 |
| QI | $1,617-$1,816/mo | $2,189-$2,459/mo | Part B premium only (capped allotment) | $9,950 / $14,910 |
Income limits reflect 100% FPL (QMB), 100-120% FPL (SLMB), and 120-135% FPL (QI) with the $20 general income disregard applied.
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. The prohibition covers Original Medicare and Medicare Advantage providers, regardless of whether they contract with Health First Colorado.
If you receive a bill for a deductible, coinsurance, or copay as a QMB enrollee:
- Inform the provider you are enrolled in QMB and cite the federal prohibition.
- Show your HCPF eligibility notice or Medicare card with QMB indicator.
- Call 1-800-MEDICARE (1-800-633-4227) to file a complaint.
- Contact Colorado's State Health Insurance Assistance Program (SHIP) for free help disputing the bill.
Providers who have billed QMB enrollees must recall those bills from collections and refund any amounts already collected.
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, or LIS). No separate application is required.
Under the 2026 Part D benefit structure:
- $0 premium on a benchmark Part D plan
- $0 annual deductible
- $5.10 per generic prescription
- $12.65 per brand-name or preferred multi-source drug
- $0 in copays after the $2,100 annual out-of-pocket cap
For a beneficiary filling six prescriptions per month, Extra Help can reduce drug costs by $1,500 to $2,500 per year. 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
The $9,950/$14,910 resource limit excludes several major asset categories:
Not counted:
- Primary residence, regardless of value
- One vehicle, regardless of 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, CDs, and mutual funds
- A second vehicle or second home
- Non-exempt cash-value life insurance above $1,500
Many Colorado applicants incorrectly include their home or primary vehicle in the resource count and conclude they do not qualify. Neither asset counts.
How to Apply for Colorado Medicare Savings Programs
HCPF offers several application pathways:
Online via Colorado PEAK Apply at www.colorado.gov/PEAK. PEAK is the state's online portal for Medicaid and related benefit programs. Create an account, complete the benefits application, and upload supporting documents.
By phone Call the Health First Colorado Member Contact Center at 1-800-221-3943. Staff can assist with eligibility questions and application submission.
At a county human services office Paper applications are accepted at any county department of social services. Bring your Medicare card, Social Security award letter, recent bank statements, and proof of Colorado residency.
Through Social Security Applying for Part D Extra Help at SSA using Form SSA-1020 generates a mandatory referral to Colorado Medicaid under 42 USC 1320b-14. Your SSA application date becomes the protected filing date.
What to Gather Before Applying
- Medicare card (showing your Medicare Beneficiary Identifier)
- Social Security card or proof of SSN
- Most recent SSA benefit award or COLA letter
- Recent bank and investment account statements
- Pension or annuity income documentation, if applicable
- Proof of Colorado residency
Processing Timelines and Effective Dates
HCPF must process non-disability MSP applications within 45 days under 42 CFR 435.912.
- QMB: coverage begins the first day of the month after HCPF approves the application. Federal law prohibits retroactive QMB coverage; apply early.
- SLMB and QI: up to three months of retroactive coverage is available if you were eligible during those months. File as early as possible to protect your filing date.
Frequently Asked Questions
A Colorado Medicare beneficiary with monthly income at or below $1,350 (single) or $1,823 (couple) and countable resources at or below $9,950/$14,910. The primary home and one vehicle are excluded from resources. QMB pays Part A and Part B premiums plus all Medicare deductibles, copays, and coinsurance.
No. Every Colorado QMB, SLMB, and QI enrollee is automatically deemed eligible for full Part D Extra Help. HCPF transmits deeming information to CMS monthly. If you are not yet in a Part D plan, CMS will auto-assign you to a zero-premium benchmark plan.
Yes, for up to three months if you were eligible during that period. QMB has no retroactive coverage. File as early as possible to maximize the retroactive window.
Do not pay the bill. Federal law prohibits Medicare providers from billing QMB enrollees for cost-sharing. Contact 1-800-MEDICARE and Colorado SHIP for free help resolving the charge.
No. QI is not available to anyone eligible for full Medicaid. If you qualify for full Health First Colorado coverage, you would be enrolled in QMB-Plus or SLMB-Plus instead.
Often yes. The $20/month general disregard is applied to unearned income before the income test is run. An additional $65 plus half of remaining earned income is excluded for applicants with wages. Someone close to the published limits should run the actual calculation before assuming they don't qualify.
Learn More
- Colorado Medicaid Eligibility and Income Limits
- How to Apply for Colorado Medicaid
- Understanding the Personal Needs Allowance
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.