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 Part A and Part B deductibles and copays on Medicare-covered services.2 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. Florida administers QMB, SLMB, and QI as limited-benefit, SSI-Related Medicaid coverage groups.3

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.3

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).3

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 Part A and Part B coinsurance and copays on Medicare-covered services2

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 $14,910.3

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).3

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. Third, QI has to be reapplied for every year: being selected one year does not entitle you to continued assistance in the next.3

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

Federal law bars every Medicare provider and supplier from billing a QMB enrollee for Medicare Part A and Part B deductibles, coinsurance, or copays on Medicare-covered items and services. This holds whether you have Original Medicare or a Medicare Advantage plan, and it holds even when Florida pays the provider nothing toward that cost-sharing.2

Two limits are worth knowing. The protection covers Medicare cost-sharing, not services Medicare does not cover at all, and a small Florida Medicaid copayment can still apply where the state charges one.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.4
• Contact Florida SHINE (Serving Health Insurance Needs of Elders) at 1-800-963-5337 for free help disputing the bill.5

A provider who bills a QMB enrollee for Medicare cost-sharing is violating federal law and its Medicare provider agreement, and may face sanctions, even when Florida Medicaid pays nothing toward that bill.6

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.3

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.7

Full Extra Help pays your Part D premium up to your region's low-income benchmark amount, so a plan priced at or below that benchmark costs you $0 a month. CMS sets the benchmark separately for each Part D region, and if you choose a plan priced above it, you pay the difference.8

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.3

What Counts as a Resource in Florida

Florida's $9,950 and $14,910 resource test counts less than many people expect, because it uses the federal SSI resource rules, which leave out the biggest assets most seniors hold.3

Excluded (do not count):

• The home you live in, and the land it sits on
• One vehicle of any value, as long as you or someone in your household uses it for transportation
• Household goods and personal effects9
• Burial funds up to $1,500 each for you and your spouse, but only if kept separate from your other resources and clearly designated for burial; mix them together and the exclusion is lost. That $1,500 shrinks by the face value of any life insurance on that person whose cash value is already excluded, and by any irrevocable burial arrangement or trust.9

Counted:

• Checking and savings account balances
• Stocks, bonds, certificates of deposit, and mutual funds
• A second home or a second vehicle
• The cash surrender value of life insurance on any one person, if the total face value of all policies on that person is more than $1,5009

Many Florida seniors count themselves out because they assume their house counts. It does not: someone with a paid-off home can qualify for QMB if their other countable assets stay under the limit.9

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 federal 2026 figures on this page already build in the standard $20-a-month general income disregard, which is why the single QMB figure lands at $1,350 rather than at the raw poverty-line amount. Florida's own DCF chart still publishes the gross poverty-line figures, $1,342 single and $1,813 couple, with the $20 disregard applied afterward.3

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

Federal rules cap how long DCF may take. The determination may not exceed 45 days from the date you applied, or 90 days if you apply for Medicaid on the basis of disability. Those are outer limits on the agency, not a promised wait, and they can be exceeded only in unusual circumstances: a delay you or an examining physician caused, an administrative or other emergency outside the agency's control, or, once the community-engagement requirement is live, the 30-calendar-day period a state must allow someone to respond to a notice of noncompliance.10 Which cap applies turns on the basis you applied under, not on whether a disability question arises in your file. Most Medicare Savings Program applicants are 65 or older and apply on the basis of age, so they are on the 45-day cap; if DCF quotes you 90 days there, it is describing its workload, not the federal standard.

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.

When Your Coverage Starts

The start date is not the same for all three programs. QMB is prospective only under federal law: a QMB determination applies to services furnished after the end of the month in which the determination is first made, so QMB coverage begins the first day of the month after your approval and cannot be granted retroactively. SLMB and QI follow the general Medicaid rule instead, under which eligibility can be made effective as early as the third month before the month you applied, up to three months of retroactive coverage, as long as you received covered services in that period and would have met the eligibility rules then.11

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.