Kentucky Medicare Savings Programs 2026: QMB, SLMB & QI

Kentucky's Medicare Savings Programs can hand the $202.90 Medicare Part B premium back to your Social Security check every month. For the lowest-income tier, they also wipe out every Medicare deductible and copay. The programs count your income and a modest amount of savings, but they never count the home you live in or one vehicle.1

What Are Kentucky 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. QMB, SLMB, and QI are mandatory eligibility groups under federal Medicaid law, so every state must offer all three.2

In Kentucky, all three are administered by the Cabinet for Health and Family Services (CHFS) through its Department for Medicaid Services (DMS), the state Medicaid agency.2

The programs exist because Medicare does not cover its own costs. In 2026 the Part B standard premium is $202.90 per month, the Part B annual deductible is $283, and the Part A inpatient hospital deductible is $1,736 per benefit period, plus coinsurance on most claims. Before any prescription is filled, an uninsured Medicare beneficiary can face thousands of dollars a year in out-of-pocket costs. A Kentucky Medicare Savings Program absorbs those costs for residents who qualify.1

Kentucky counts income under the Supplemental Security Income (SSI)-related methodology, which applies a $20 general income disregard to unearned income (Social Security, pensions, VA compensation) before comparing it to the limit. The income figures below already build in that $20 disregard, so a resident whose gross Social Security benefit runs a little above the published ceiling can still qualify once the disregard is applied. If you or your spouse work, additional SSI earned-income disregards lower your countable income further.2,3

QMB: Qualified Medicare Beneficiary

QMB is the most comprehensive tier. It covers:

• The Medicare Part A premium (most beneficiaries have premium-free Part A after 40 or more quarters of work)
• 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
• All Medicare coinsurance and copays on every Medicare-covered service1

2026 Kentucky QMB income limits: at or below $1,350/month for a single person, or at or below $1,824/month for a couple. These figures reflect 100% of the Federal Poverty Level with the $20 general income disregard applied. The resource limit is $9,950 for one person or $14,910 for a couple.2

For a Kentucky retiree living on Social Security, QMB erases the Part B premium ($202.90 a month, or $2,434.80 a year), the $283 Part B deductible, and the $1,736 Part A hospital deductible, plus every Medicare copay and coinsurance charge. That $202.90 returned each month is money that can cover a week of groceries or a utility bill. Every QMB enrollee is also automatically deemed eligible for full Part D Extra Help.1

SLMB: Specified Low-Income Medicare Beneficiary

SLMB covers one benefit: the Medicare Part B premium. At the 2026 standard rate of $202.90 a month, that is $2,434.80 returned to your Social Security check over the year.1

2026 Kentucky SLMB income limits: more than the QMB limit and up to $1,616/month for a single person, or up to $2,184/month for a couple. The resource limit is the same $9,950 single or $14,910 couple.2

SLMB does not cover deductibles or copays. But for a beneficiary with relatively few medical claims, eliminating the Part B premium is the dominant saving. SLMB enrollment also triggers automatic Part D Extra Help, which cuts covered drug copays to $5.10 for generics and $12.65 for brand-name drugs in 2026.4

QI: Qualifying Individual

QI pays the Part B premium only, the same as SLMB, but applies at a higher income band: more than the SLMB limit and up to $1,816/month for a single person, or up to $2,455/month for a couple (2026 figures with the $20 disregard applied). The resource limit is again $9,950 single or $14,910 couple.2

Two structural differences set QI apart from QMB and SLMB:

1. First-come, first-served. QI is funded through a capped federal allotment. Kentucky allocates enrollment first-come, first-served, with a preference for prior-year QI enrollees. Unlike QMB and SLMB, which are entitlements, QI carries no enrollment guarantee, though Kentucky has generally not exhausted its allotment in recent years.
2. Mutually exclusive with full Medicaid. Anyone eligible for full Medicaid cannot also be on QI. Those residents qualify instead for QMB-Plus or SLMB-Plus, which layer full Kentucky Medicaid on top of the Medicare Savings Program protections.2

Like SLMB, QI enrollment triggers automatic Part D Extra Help.

The QMB Billing Prohibition

Federal law (Social Security Act § 1902(n)(3)(B), codified at 42 U.S.C. § 1396a(n)(3)(B)) prohibits any Medicare provider from billing a QMB enrollee for Medicare cost-sharing, including deductibles, coinsurance, and copays. This applies to Original Medicare and Medicare Advantage providers alike, whether or not they participate in Kentucky Medicaid, even when Medicaid pays nothing toward that cost-sharing. Providers must accept the Medicare and any Medicaid payment as payment in full.5

If you are a QMB enrollee and receive a bill for a deductible, coinsurance, or copay from any Medicare provider, do not pay it. The provider cannot legally collect it. Instead:

• Tell the provider you are enrolled in QMB and cite the federal prohibition.
• Show your Kentucky Medicaid eligibility notice or your Medicare card.
• Call 1-800-MEDICARE (1-800-633-4227) to file a complaint.
• Contact Kentucky SHIP at 1-877-293-7447 for free help disputing the bill.

The provider must recall any improper bill from collections and refund anything already collected.

Part D Extra Help / Low-Income Subsidy

Every QMB, SLMB, and QI enrollee in Kentucky is automatically deemed eligible for full Part D Extra Help (the Low-Income Subsidy). No separate application is required. CHFS sends deeming information to the Centers for Medicare & Medicaid Services (CMS) each month after your Medicare Savings Program enrollment.2

Under the 2026 Part D benefit rules, full Extra Help caps your out-of-pocket cost at $5.10 per generic prescription and $12.65 per brand-name or preferred multi-source drug, with $0 premium and $0 deductible on a benchmark plan. Once your out-of-pocket drug spending reaches $2,100 for the year, you pay $0 for covered drugs the rest of the year.4

If you do not automatically qualify through a Medicare Savings Program because your income is above 135% but below 150% of the Federal Poverty Level, you can apply for Extra Help directly with the Social Security Administration on Form SSA-1020. Social Security forwards the application to CHFS, which then screens you for a Medicare Savings Program as well.4

Kentucky Medicare Savings Programs: 2026 Limits at a Glance

These income limits reflect 100% of the Federal Poverty Level for QMB, 100 to 120% for SLMB, and 120 to 135% for QI, each with the $20 general income disregard applied. All three share the same $9,950 single / $14,910 couple resource limit.2

What Counts Toward the Resource Limit

Kentucky does apply a resource (asset) test to these programs, unlike a handful of states that waive it. Counted resources include checking and savings accounts, stocks, bonds, certificates of deposit, annuities, trusts, and life insurance.2

But several of the assets people worry about most do not count:

• Your primary home, of any value.
• One vehicle, of any value.
• Household goods and personal effects.
• Up to $1,500 per person set aside for burial expenses.2

Many Kentuckians rule themselves out on the assumption that a house or a car disqualifies them. It does not. A paid-off home and a car sit entirely outside the $9,950 limit, and only after the income disregard is applied is your income measured against the ceiling.2

Where to Get Help in Kentucky

How to Apply for Kentucky Medicare Savings Programs

Determination Timeline and Effective Dates

CHFS processes non-disability Medicare Savings Program applications under the federal 45-day standard (90 days when a disability determination is needed), set by 42 CFR § 435.912.7

• QMB: coverage begins the first day of the month after Kentucky approves the application. Federal law does not allow retroactive QMB coverage, so apply as early as possible.
• SLMB and QI: up to three months of retroactive coverage is available under 42 CFR § 435.915 if you were eligible during those months. File early to protect the retroactive window.8

CHFS attempts to renew coverage each year using existing electronic data. If it cannot confirm eligibility, it sends a renewal packet; return it promptly to avoid a gap in coverage.

Learn More

Find personalized help applying for Kentucky 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.