Delaware Medicare Savings Programs pay Medicare premiums and cost-sharing for income-eligible beneficiaries. QMB, the most comprehensive tier, wipes out the monthly Part B premium and all Medicare cost-sharing in one program.
What Are Delaware Medicare Savings Programs?
Medicare Savings Programs (MSPs) 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; every state plan must cover them.
DMMA administers all three programs. Financial eligibility uses the SSI-related income methodology, which applies a $20/month general income disregard on unearned income and a $65 plus half of remaining earned income disregard for working beneficiaries. The income bands below reflect the $20 disregard.
QMB: Qualified Medicare Beneficiary
QMB is the broadest program. It covers:
- The Medicare Part A premium (most beneficiaries have premium-free Part A)
- The Medicare Part B premium ($185.00/month standard in 2026 per CMS)
- The Part A inpatient hospital deductible
- The Part B annual deductible
- All Medicare coinsurance and copays
2026 Delaware QMB income limit: at or below approximately $1,350/month for a single person (100% FPL with the $20 disregard). The couple limit is approximately $1,823/month.
QMB also confers automatic Part D Extra Help.
The QMB Billing Prohibition
Federal law at 42 USC §1396a(n)(3)(B) prohibits any Medicare provider from billing a QMB enrollee for Medicare cost-sharing. If you are a QMB enrollee and receive a bill for a deductible, coinsurance, or copay, do not pay it. Tell the provider you are a QMB enrollee, and if the problem persists, call 1-800-MEDICARE (1-800-633-4227) or contact the Delaware Medicare Assistance Bureau (DMAB) at 1-800-336-9500 for free help.
SLMB: Specified Low-Income Medicare Beneficiary
SLMB covers one benefit: the Medicare Part B premium, worth $2,220/year at the 2026 standard rate.
2026 Delaware SLMB income limits: approximately $1,351 to $1,616/month for a single person, $1,824 to $2,178/month for a couple.
SLMB does not pay deductibles or copays, but it does confer automatic Part D Extra Help.
QI: Qualifying Individual
QI covers the Part B premium only, at a higher income band: approximately $1,617 to $1,816/month single, $2,179 to $2,437/month couple (2026).
Two key differences from QMB and SLMB:
- First-come, first-served. QI is funded through a capped federal allotment and is not an entitlement. Delaware enrolls on a first-come, first-served basis with preference for prior-year QI enrollees.
- Mutually exclusive with full Medicaid. If you qualify for full Delaware Medicaid, you cannot enroll in QI. You would qualify for QMB-Plus or SLMB-Plus instead, which add full Medicaid on top of the MSP benefit.
2026 Income Limits at a Glance
| Program | Single monthly income limit | Couple monthly income limit | What it pays |
|---|---|---|---|
| QMB | ~$1,350 | ~$1,823 | Part A + Part B premiums + all cost-sharing |
| SLMB | ~$1,351-$1,616 | ~$1,824-$2,178 | Part B premium only |
| QI | ~$1,617-$1,816 | ~$2,179-$2,437 | Part B premium only (capped allotment) |
Confirm exact figures with DMMA at the time of application.
Part D Extra Help
Every QMB, SLMB, and QI enrollee in Delaware is automatically deemed eligible for full Part D Extra Help (also called the Low-Income Subsidy). No separate application is needed.
Under the 2026 Part D benefit structure, Extra Help typically provides:
- $0 Part D premium on a benchmark plan
- $0 annual deductible
- Low fixed copays per prescription
CMS automatically assigns unenrolled Extra Help recipients to a zero-premium benchmark Part D plan. You can switch plans during annual open enrollment without losing Extra Help status.
Resources That Count and Resources That Do Not
The MSP resource test excludes several major assets:
Excluded (do not count):
- Primary residence, regardless of value
- One vehicle, regardless of value
- Household goods and personal effects
- Prepaid burial arrangements
Counted:
- Checking and savings accounts
- Stocks, bonds, CDs
- Second vehicle or investment property
- Non-exempt cash-value life insurance
Many Delaware seniors rule themselves out of MSP because they assume their home is a resource. It is not. An applicant with a paid-off house qualifies for QMB or SLMB on the basis of income and liquid assets alone.
How to Apply for Delaware Medicaid
1. Online via ASSIST at assist.dhss.delaware.gov. ASSIST handles Medicaid and related benefits in one place.
2. In person at DMMA or through the Delaware Aging and Disability Resource Center (DARC). Bring your Medicare card, Social Security award letter, and recent bank statements.
3. Through Social Security. Applying for Part D Extra Help at SSA using Form SSA-1020 generates a referral to Delaware Medicaid. SSA is required by federal law to forward the application, and your SSA application date serves as your protected filing date.
Documents to Gather
- Medicare card (showing Medicare Beneficiary Identifier)
- Social Security card or SSN proof
- Most recent SSA award or COLA letter
- Recent bank and investment account statements
- Pension or annuity statements, if applicable
- Proof of Delaware residency
Retroactive Coverage
- QMB: starts the first day of the month after DMMA approves the application. No retroactive QMB coverage under federal law.
- SLMB and QI: up to three months retroactive under 42 CFR §435.915. File early to maximize the retroactive window.
Frequently Asked Questions
A Delaware Medicare beneficiary with monthly income at or below approximately $1,350/month (single) and countable resources within the MSP resource limit. The primary home and one vehicle are excluded. QMB pays Part A and Part B premiums plus all Medicare cost-sharing.
No. Every Delaware QMB, SLMB, and QI enrollee is automatically deemed eligible for full Part D Extra Help. DMMA transmits the deeming information to CMS monthly. If you are not 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. Contact 1-800-MEDICARE or the Delaware Medicare Assistance Bureau (DMAB) at 1-800-336-9500 for help resolving the issue.
No. QI is not available to beneficiaries who qualify for full Medicaid. If you qualify for full Delaware Medicaid, you would instead qualify for QMB-Plus or SLMB-Plus.
Yes, for up to three months if you were eligible during that window. QMB has no retroactive coverage. File SLMB and QI applications early to maximize your retroactive period.
Learn More
- Delaware Medicaid: A Guide for Seniors and Families
- How to Apply for Delaware Medicaid
- Delaware Medicaid Spousal Impoverishment Rules
Find personalized help applying for Delaware 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.