Illinois Medicare Savings Programs 2026: QMB, SLMB & QI

Illinois Medicare Savings Programs (MSPs) can erase your entire Medicare Part B premium, which is $202.90 a month in 2026, if your income is limited. The most complete tier, the Qualified Medicare Beneficiary (QMB) program, wipes out that premium plus the Part A and Part B deductibles, copays, and coinsurance for a single Illinois resident with monthly income at or below $1,330.

What Are Medicare Savings Programs?

Medicare Savings Programs are Medicaid-administered benefits that pay some or all of a low-income Medicare beneficiary's Medicare premiums and cost-sharing. They are not optional budget items for states: federal guidance calls QMB, SLMB, and QI mandatory Medicaid eligibility groups, and Illinois runs them as a state Medicaid program.2

Illinois Medicaid is administered by the Illinois Department of Healthcare and Family Services (HFS), with financial eligibility determined by the Illinois Department of Human Services (DHS).1 The operative 2026 income standards are the ones in DHS's own worker manual (WAG 25-03-02). The Illinois Department on Aging also publishes a Medicare Savings Programs chart, but it labels its figures estimates and points readers back to DHS for the exact numbers.2

Illinois sets its MSP income bands at the standard poverty-level percentages, and those published bands don't include the $25 of monthly income Illinois disregards in each category.1 Illinois also keeps a resource test for all three programs: $9,950 for one person and $14,910 for a couple in 2026, and those limits don't include an additional $1,500 ($3,000 for a couple) burial allowance deduction.2 Those are the federal standards rather than absolute cutoffs, and SSA instructs staff to encourage people whose income or resources look somewhat higher to apply anyway, so apply rather than rule yourself out.2

QMB: Qualified Medicare Beneficiary

QMB is the broadest of the three programs. It covers:

• The Medicare Part A premium, if you owe one (most people pay $0 because they or a spouse paid Medicare taxes long enough while working)
• The Medicare Part B premium, which is $202.90 per month in 2026
• The Part A inpatient hospital deductible, which is $1,736 per benefit period in 2026
• The Part B annual deductible, which is $283 in 2026
• Part A and Part B coinsurance and copays on Medicare-covered items and services4,2

2026 Illinois QMB income limits: at or below $1,330/month for a single person, or $1,803/month for a couple. These are the 100% Federal Poverty Level figures in the DHS worker manual. Illinois also disregards $25 of monthly income, so add $25 to each figure before you compare your income to it.2

Resource limit: $9,950 for one person, $14,910 for a couple, not counting an additional $1,500 ($3,000 for a couple) burial allowance deduction. DHS decides which of your assets count toward it, so read the resource section below before you rule yourself out.2

For a single Illinois senior on Social Security, QMB is worth about $2,435 a year in the Part B premium alone (12 times the $202.90 monthly premium), plus the $283 Part B deductible, the $1,736 Part A hospital deductible, and Part A and Part B copays and coinsurance. Every QMB enrollee is also automatically deemed eligible for full Part D Extra Help.4,3

QMB doesn't cover Part D drug-plan copays, though through Extra Help a QMB enrollee pays no more than $12.65 per covered drug in 2026. You may also get a bill for a small Medicaid copayment, if one applies.2

SLMB: Specified Low-Income Medicare Beneficiary

SLMB covers one thing: the Medicare Part B premium. You must have both Part A and Part B to qualify.2 That single benefit is worth about $2,435 a year at the 2026 standard premium rate of $202.90 a month.4

2026 Illinois SLMB income limits: $1,331 to $1,595/month for a single person, $1,804 to $2,163/month for a couple, before the $25 disregard.1,2

Resource limit: same as QMB, $9,950 single and $14,910 couple.2

Unlike QMB, SLMB does not pay deductibles or copays. But for a beneficiary with relatively few medical claims, the Part B premium is the dominant cost, and SLMB removes it. SLMB also confers automatic Part D Extra Help, which caps covered-drug copays at $5.10 for a generic and $12.65 for a brand-name drug in 2026, with a $0 deductible and a $0 premium on a benchmark Part D plan.3

QI: Qualifying Individual

QI covers the Part B premium only, the same as SLMB, but applies at a higher income band: $1,596 to $1,794/month for a single person, $2,164 to $2,433/month for a couple in 2026, before the $25 disregard.1,2

Two structural differences from QMB and SLMB:

1. First-come, first-served. QI is paid for out of a capped annual federal allotment to each state, so enrollment is first-come, first-served, with preference for people who had QI in the last month of the previous year. QI coverage runs only as far as the state's available slots, so an eligible applicant can still be turned away once they are filled.2,5
2. Mutually exclusive with full Medicaid. If you are eligible for any full-benefit Medicaid category, including the Illinois Aid to the Aged, Blind, and Disabled (AABD) Medical program, you cannot be on QI. If you also meet the QMB or SLMB rules, you would be QMB Plus or SLMB Plus, which pair that program with full Medicaid; if not, you fall in another full-benefit dual category. Either way, that is fuller coverage, not a loss.5

As with SLMB, you must have both Part A and Part B to qualify, and QI enrollment triggers automatic Part D Extra Help. You also have to reapply for QI every year; being selected one year does not entitle you to it the next.2

The QMB Billing Prohibition

Federal law, specifically Social Security Act § 1902(n)(3)(B) (42 USC § 1396a(n)(3)(B)), prohibits any Medicare provider from billing a QMB enrollee for Medicare Part A and Part B cost-sharing. It applies to all Medicare providers and suppliers, including pharmacies and providers in Medicare Advantage plans, even when Illinois Medicaid pays nothing toward the bill.2,6

In plain terms: if you are a QMB enrollee and receive a bill from a hospital, physician, skilled nursing facility, durable medical equipment supplier, or any other Medicare provider for a Part A or Part B deductible, coinsurance, or copay on a Medicare-covered service, do not pay it. The provider is legally prohibited from collecting it.6 Two charges fall outside that protection: Part D drug-plan copays, which Extra Help caps at $12.65 per covered drug in 2026, and a small Medicaid copayment, if one applies.2

If a bill like this has already arrived and you have been worrying about how to cover it, you are not on the hook for it. The obligation sits with the provider, not with you. Here is how to resolve it:

• Tell the provider you are a QMB enrollee and cite the federal law.
• Show the provider your Medicare and Medicaid cards (or your QMB card), or a Medicare Summary Notice that says you're in the QMB program.6
• If the billing continues, call 1-800-MEDICARE (1-800-633-4227). Medicare can confirm your QMB status and ask the provider to stop billing you and refund what you've already paid.7,6
• Contact the Illinois Senior Health Insurance Program (SHIP) at 1-800-252-8966 for free, one-on-one help with the claim.8,9

CMS tells providers to recall any QMB cost-sharing bills, including ones turned over to collections, and to refund any QMB cost-sharing they collected.6

Part D Extra Help / Low-Income Subsidy

Every QMB, SLMB, and QI enrollee in Illinois 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, full Extra Help means:

• $0 Part D premium on a benchmark plan
• $0 annual deductible
• No more than $5.10 per generic prescription
• No more than $12.65 per brand-name drug
• $0 in copays once your out-of-pocket drug costs reach the $2,100 annual cap3

The $0 premium holds only up to your region's benchmark premium. If you choose a more expensive Part D plan, you pay the difference between the benchmark and that plan's premium.3

Illinois Medicare Savings Programs: 2026 Income Limits at a Glance

These are the 100% FPL (QMB), 100 to 120% FPL (SLMB), and 120 to 135% FPL (QI) figures Illinois DHS publishes in its worker manual, WAG 25-03-02. Illinois disregards $25 of monthly income in each category, so add $25 to the limit (or subtract $25 from your income) before comparing. DHS decides what income and assets count, so these limits don't apply to your gross figures. The resource limit for all three is $9,950 single / $14,910 couple.1,2

What Counts as a Resource, and What Doesn't

The $9,950/$14,910 resource limit is not a test of everything you own at face value. To start with, it doesn't include an additional $1,500 burial allowance deduction for one person, or $3,000 for a couple.2

Federal law counts MSP resources under the Supplemental Security Income (SSI) rules, and those rules leave some things out entirely:

• Burial spaces: a plot, crypt, urn, or niche, plus items such as a headstone or vault, for you, your spouse, or immediate family. These don't count at any value.
• Burial funds: up to $1,500 each for you and your spouse, on top of the burial-space exclusion. The money has to be kept separate from your other savings and clearly set aside for burial; mix it in with other funds and none of it is excluded. The $1,500 is also reduced by certain life insurance and irrevocable burial arrangements.10

The Illinois sources behind these limits don't list which other assets, such as a home or a car, DHS leaves out of the count. So ask DHS how it will treat yours rather than adding up everything you own and stopping there. SSA tells its own staff to encourage people whose resources look somewhat higher than the limit to apply anyway, and that is the right instinct: let DHS do the counting.2

How Illinois Counts Your Income

Don't hold your gross Social Security check up against the printed threshold and stop there. The published limits don't apply to gross income, and Illinois runs the numbers differently.2

DHS publishes the MSP income limits as Federal Poverty Level figures ($1,330 a month for a single QMB applicant in 2026). Illinois automatically disregards $25 of monthly income, and DHS decides how to round the limits and what income is included.2

The practical effect: add $25 to the published limit before you decide you earn too much, so income a little above a printed figure isn't by itself a reason to stop. Federal guidance tells SSA staff to encourage people whose income looks somewhat higher than the limits to apply anyway, so let DHS do the count.2

How to Apply for Illinois Medicare Savings Programs

Illinois takes MSP applications through the same agency that handles Medicaid, DHS. The process is the same whether you want QMB, SLMB, or QI.

Effective Dates and Retroactive Coverage

• QMB: coverage applies to services you get after the end of the month in which you're found eligible. Federal law (Social Security Act § 1902(e)(8)) makes QMB prospective only, with no retroactive months, so apply as early as possible.13 Once the state buy-in takes effect, Illinois pays your Part B premium and it stops being deducted from your Social Security check.12
• SLMB and QI: the QMB bar on retroactive coverage doesn't name these programs, but no fixed retroactive window for them is spelled out either. Ask DHS whether your approval can reach back to months before you applied, and apply early even if you cannot gather every document on day one.13

Illinois-Specific Notes

Illinois is one of eight states SSA lists as Section 209(b) states, which use at least one Medicaid eligibility rule more restrictive than the Supplemental Security Income (SSI) program's.14 For the Medicare Savings Programs, the income test is the poverty-level bands in the DHS manual shown above, and the federal MSP definition counts income and resources under SSI's rules.10

Illinois's MSP resource limit of $9,950/$14,910 is more restrictive than its broader AABD Medical asset limit, which is $17,500 for one person. An applicant who qualifies for full AABD Medicaid on assets may not automatically qualify for QMB on the same count if their holdings exceed $9,950.1

If you have full AABD Medicaid alongside Medicare and also meet the QMB or SLMB rules, you are QMB Plus or SLMB Plus rather than QMB-only or SLMB-only. Check with your DHS caseworker about your dual-eligibility status.5

Where to Get Help With Illinois Medicare Savings Programs

Learn More

Find personalized help applying for Illinois 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.