Georgia QI Program: Medicaid Help With Part B (2026)

The Georgia Qualifying Individual (QI) program pays your Medicare Part B premium, $202.90 a month in 2026, if your income falls between 120% and 135% of the Federal Poverty Level.1 QI is the third tier of Georgia's Medicare Savings Programs, a set of Medicaid-administered benefits that help Medicare beneficiaries with limited income. For a single Georgian in 2026, the QI income band runs from above $1,616 up to $1,816 a month, and the resource limit is $9,950 ($14,910 for a couple), the same as the other Medicare Savings Programs.2 This guide covers who qualifies, the 2026 income and resource limits, how QI compares to its sibling programs (SLMB and QMB), and how to apply through Georgia's Division of Family and Children Services.

In This Guide

• Who Qualifies for the Georgia QI Program?
• What QI Pays For, and What It Does Not
• How to Apply for QI in Georgia
• QI Compared to SLMB and QMB
• How the Georgia QI Program Is Funded: The Federal Block Grant
• Moving Between MSP Tiers and Into Full Medicaid
• Frequently Asked Questions
• Learn More

Who Qualifies for the Georgia QI Program?

QI eligibility turns on three things: you must be entitled to Medicare, your income must fall in the QI band, and you must not already be on full Georgia Medicaid.2

Medicare Entitlement

You must be entitled to Medicare Part A, whether premium-free or premium-paying. Most QI applicants are 65 or older with premium-free Part A. Some are under 65 with Medicare based on 24 months of Social Security Disability Insurance (SSDI) or on End-Stage Renal Disease.

2026 Income Limits (120% to 135% FPL)

Your countable monthly income must be above 120% of the Federal Poverty Level (at or below that line, you fall into SLMB instead) and at or below 135% of the Federal Poverty Level. These bands are built on the 2026 Federal Poverty Level of $15,960 a year, about $1,330 a month, for one person, plus the standard $20 general income disregard.3,2

Georgia applies the same income disregards used for QMB and SLMB. The standard $20 general income disregard is already built into the limits above, and an additional earned-income disregard applies if you work.2

2026 Resource Limit

QI carries a resource (asset) limit of $9,950 for a single person and $14,910 for a couple in 2026, the same limit that applies to QMB and SLMB.2 Countable resources include bank accounts, stocks, bonds, and other liquid assets. Standard exclusions apply: your primary home, one vehicle, household goods, and burial funds are not counted toward the limit. That $9,950 / $14,910 is the federal standard rather than an absolute cutoff, and SSA instructs staff to encourage people to apply for the MSPs even when income or resources appear somewhat higher than the limits, so file rather than screen yourself out.1

A common misconception is that QI has no asset test. Some consumer guides describe QI as income-tested only. That is not what the federal rules say: the Social Security Administration's Medicare Savings Program resource limits ($9,950 single / $14,910 couple for 2026) apply to QI just as they do to QMB and SLMB.2 Note that the Medicare Part D Low-Income Subsidy that QI triggers has its own, higher resource limits, which is a separate threshold from the MSP resource limit.1

Not Already on Full Medicaid

QI cannot be held at the same time as full Georgia Medicaid. Federal law allows QI funds to be used only for beneficiaries who are not otherwise eligible for full medical assistance under the state plan. If a QI beneficiary later qualifies for full Medicaid, for example through an institutional or waiver pathway after a move to nursing-facility care, they transition off QI and onto full dual coverage. The reverse is also true: someone who loses full Medicaid can apply for QI if their income falls in the QI band.

Citizenship and Residency

QI applicants must be a U.S. citizen or a qualified non-citizen, and a Georgia resident. DFCS requires documentation of identity and residency.

What QI Pays For, and What It Does Not

Medicare Part B Premium

QI pays the standard Medicare Part B premium, $202.90 a month in 2026 (about $2,435 a year), through the Medicare buy-in process.1 Georgia's Department of Community Health (DCH) transmits enrollment data to the federal Centers for Medicare and Medicaid Services (CMS), which stops the Part B premium deduction from the beneficiary's Social Security check. Buy-in typically takes a few months to take effect, and premiums deducted between QI approval and buy-in activation are reimbursed.

Because QI activates the State Buy-In under Section 1839(b)(3) of the Social Security Act, an enrolled beneficiary is also exempt from the Medicare Part B Late Enrollment Penalty surcharge for as long as the MSP enrollment lasts.2

Medicare Part D Extra Help (Automatic)

QI enrollment automatically enrolls you in the Medicare Part D Low-Income Subsidy, known as Extra Help, at the full level (Georgia's version is detailed in our Part D Extra Help guide). Extra Help removes the premium for a benchmark Part D plan, removes the Part D deductible, and reduces prescription copays to fixed amounts set each year by CMS. For QI beneficiaries who take several medications, this automatic Extra Help is often the most valuable part of the benefit.

What QI Does Not Pay

QI is a Part B premium subsidy plus automatic Extra Help. It does not pay the costs below, and providers can lawfully bill QI beneficiaries for them:

• The Medicare Part A inpatient hospital deductible, $1,736 per benefit period in 2026.1
• The Medicare Part B annual deductible, $283 in 2026, and the 20% Part B coinsurance on most outpatient services.1
• Part A skilled-nursing-facility coinsurance, $217 per day for days 21 through 100 in 2026.1

QI does not include the federal balance-billing protection that QMB carries under Section 1902(n) of the Social Security Act. It also does not cover long-term services and supports such as nursing-facility custodial care, Home and Community-Based Services (HCBS) waiver services, or personal-care attendant services. Those require full Medicaid through Georgia's Aged, Blind and Disabled (ABD) pathway, which is mutually exclusive with QI.

How to Apply for QI in Georgia

Georgia processes QI applications through the Division of Family and Children Services (DFCS) using the Georgia Gateway portal, the same way it handles QMB and SLMB.2 You do not specify which Medicare Savings Program you want; DFCS determines the correct tier from your income.

For free help applying, contact GeorgiaCares, Georgia's State Health Insurance Assistance Program (SHIP), at 1-866-552-4464.7

QI Compared to SLMB and QMB

For most Georgians, QI and the Specified Low-Income Medicare Beneficiary (SLMB) program deliver the same benefit: they both pay the Part B premium and trigger Extra Help. The difference is the income band and how the program is funded. Across all four Medicare Savings Programs, the Qualified Medicare Beneficiary (QMB) program sits at the bottom of the income scale and covers far more.

The practical takeaway: a Georgian whose income drops to or below 100% of the Federal Poverty Level should move to QMB, which adds coverage of Medicare deductibles and coinsurance plus the balance-billing protection that QI lacks.2 Between QI and SLMB, the day-to-day benefit is identical; only the income band differs.

How the Georgia QI Program Is Funded: The Federal Block Grant

QI's one structural oddity is its funding. The Qualified Medicare Beneficiary and Specified Low-Income Medicare Beneficiary programs are funded through regular Medicaid, with Georgia paying its share under the federal matching rate (the FMAP). QI is funded entirely by a separate federal block grant under Section 1933 of the Social Security Act, with no state share, and that grant is capped each year.

In theory, a capped grant could be exhausted, in which case new applicants would be deferred and prior-year QI recipients would keep priority for the new year's funds. In practice, this has not happened in Georgia since the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 made QI permanent. Georgia has consistently received enough federal QI funding to cover qualified applicants, and DCH does not maintain a QI waiting list. The practical advice for a Georgian is straightforward: apply when you are eligible, and do not try to time your application around the federal fiscal year.

Moving Between MSP Tiers and Into Full Medicaid

Your QI status is not fixed. As your income changes, DFCS moves you between tiers, usually at your yearly review:

• Income drops below 120% FPL: you move to SLMB. The benefit is identical, so you notice no practical change.
• Income drops to or below 100% FPL: you move to QMB, gaining coverage of Medicare cost-sharing and balance-billing protection. Report the drop to DFCS within 10 days.2
• Income rises above 135% FPL ($1,816/month single in 2026): you lose MSP eligibility. You may still qualify for the Part D Low-Income Subsidy through the Social Security Administration, which reaches somewhat higher up the income scale than the Medicare Savings Programs, with somewhat higher copays than the MSP-linked Extra Help.2

When Health Changes and Long-Term Care Is Needed

The QI-versus-full-Medicaid choice matters most when a beneficiary develops a need for long-term care. QI does not pay for nursing-facility custodial care or HCBS waiver services. To get those, a Georgian must qualify for full Medicaid, which in Georgia runs through the Aged, Blind and Disabled pathway or the Elderly and Disabled Waiver Program. The institutional and waiver income limit is $2,982 a month for 2026 (300% of the Supplemental Security Income Federal Benefit Rate), with a resource limit of $2,000 for an individual.8

That $2,000 resource limit for full Medicaid is far lower than the $9,950 QI resource limit, so a QI beneficiary with savings above $2,000 generally has to spend down to qualify for full Medicaid coverage of long-term care.2,8 Georgians whose income exceeds the limit may use the Aged, Blind and Disabled Medically Needy spend-down pathway.9 Because this planning is complex and the figures change, anyone weighing a long-term-care transition should consult a Georgia elder-law attorney before spending down.

Learn More

Find personalized help comparing Georgia's 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.