Florida Medicare Savings Programs 2026: QMB, SLMB & QI

If you have Medicare and a limited income, Florida's Medicare Savings Programs can erase the $202.90 monthly Part B premium.1

The most complete tier, QMB, also wipes out your Medicare deductibles and copays. All three programs run through Florida Medicaid, and enrolling in any one of them automatically opens the door to Part D drug-cost help.

What Are Florida's Medicare Savings Programs?

Medicare Savings Programs are Medicaid-administered benefits that pay some or all of a low-income Medicare beneficiary's premiums and cost-sharing. QMB, SLMB, and QI are mandatory eligibility groups, so Florida is required to offer all three.

Florida runs the programs through the Florida Agency for Health Care Administration (AHCA), the state Medicaid agency, while the Florida Department of Children and Families (DCF) decides financial eligibility. You apply through DCF's MyACCESS portal. Florida uses the standard federal income tiers tied to the Federal Poverty Level (FPL) and the asset-tested methodology of Supplemental Security Income (SSI), so a resource (asset) test does apply here.2

QMB: Who Qualifies and What It Pays

QMB is the most complete program. To qualify in 2026, a single Floridian's countable monthly income must be at or below $1,350 ($1,824 for a couple), with countable resources at or below $9,950 ($14,910 for a couple).2

QMB covers:

• The full Medicare Part B premium, $202.90 a month in 2026
• The Medicare Part B deductible, $283 in 2026
• The Medicare Part A hospital deductible, $1,736 per benefit period in 20261
• The Part A premium, which most people already receive at no cost after 40 quarters of work
• All Medicare coinsurance and copays on covered services

The Part B premium alone is worth about $2,435 a year ($202.90 a month over 12 months), before you count the deductibles and coinsurance QMB also erases.1

SLMB: Help With the Part B Premium

SLMB covers one thing: the Medicare Part B premium. A single Floridian qualifies with monthly income above the QMB limit and at or below $1,616 ($2,184 for a couple), and the resource limit is the same $9,950 and $14,910.2

At the 2026 rate, that single benefit is worth about $2,435 a year ($202.90 a month). SLMB does not touch deductibles or copays, but for someone with few medical bills, wiping out the Part B premium is the savings that matters most.1

QI: The Part B Premium at a Higher Income

QI pays the Part B premium too, but at a higher income band: above the SLMB limit and up to $1,816 a month for a single person ($2,455 for a couple).2

Two things set QI apart from QMB and SLMB. First, it is funded by a capped federal allotment, so Florida enrolls people first-come, first-served and cannot guarantee a spot the way it must for QMB and SLMB. Second, you cannot hold QI and full Florida Medicaid at the same time; if you qualify for full Medicaid, you receive your Medicare cost-sharing help through that instead.2

Billed for a Copay While on QMB? Don't Pay It

Federal law bars every Medicare provider from billing a QMB enrollee for Medicare deductibles, coinsurance, or copays, under any circumstances. This holds whether you have Original Medicare or a Medicare Advantage plan, and whether or not the provider takes Florida Medicaid.2

If a hospital, doctor, or other provider sends you a cost-sharing bill:

• Tell them you are a QMB enrollee and that federal law prohibits the charge.
• Show your DCF eligibility notice or your Medicare card.
• Call 1-800-MEDICARE (1-800-633-4227) to file a complaint.
• Contact Florida SHINE (Serving Health Insurance Needs of Elders) at 1-800-963-5337 for free help disputing the bill.3

A provider who wrongly billed a QMB must recall the bill and refund anything already collected.

MSP Automatically Opens Part D Extra Help

Enrolling in QMB, SLMB, or QI automatically qualifies you for the full Part D Extra Help, also called the Low-Income Subsidy, with no separate application.2

In 2026, full Extra Help caps covered generic drugs at $5.10 and covered brand-name drugs at $12.65, and drops your cost to $0 once your out-of-pocket drug spending reaches $2,100 for the year.4

Florida's DCF sends this information to Medicare each month. If you are not already in a Part D plan, Medicare assigns you to a benchmark plan with no monthly premium.

Florida 2026 Income Limits at a Glance

These bands reflect 100% of the Federal Poverty Level for QMB, 100 to 120% for SLMB, and 120 to 135% for QI, with the standard $20 monthly income disregard already built in. The resource limit for all three is $9,950 for a single person and $14,910 for a couple.2

What Counts as a Resource in Florida

Florida's $9,950 and $14,910 resource test counts less than many people expect, because the biggest assets are excluded.2

Excluded (do not count):

• Your primary residence, regardless of its value
• One vehicle, regardless of make or value
• Household goods and personal effects
• Prepaid burial arrangements

Counted:

• Checking and savings account balances
• Stocks, bonds, certificates of deposit, and mutual funds
• A second home or a second vehicle
• Non-exempt cash-value life insurance

Many Florida seniors count themselves out because they think of their house as an asset. It is not. Someone who owns a paid-off home worth several hundred thousand dollars can still qualify for QMB, as long as their bank balances and other countable assets stay under the limit.

How Florida Counts Your Income

Medicare Savings Programs do not use the MAGI rules that regular Medicaid uses. They use the SSI-related methodology, which sets aside part of your income before comparing it to the limit. The published Florida limits already build in the standard $20-a-month general income disregard, which is why the single QMB ceiling lands at $1,350 rather than at the raw poverty-line figure.2

If you work, the SSI rules leave out even more of your earnings, so your gross wages overstate what actually counts. The practical lesson: run your real numbers, or ask DCF or Florida SHINE to run them, before deciding you earn too much to qualify.

How to Apply for a Florida Medicare Savings Program

By law, DCF must decide most Medicare Savings Program applications within 45 days, or within 90 days when eligibility rests on a disability.5

You can also apply for Part D Extra Help at the Social Security Administration (SSA); when you do, SSA forwards a referral to Florida so your Medicare Savings Program application starts from the same date.

Learn More

Find personalized help applying for a Florida Medicare Savings Program 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.