Kentucky's Medicare Savings Programs pay Medicare premiums and cost-sharing for residents with limited income and resources, and every enrollee automatically qualifies for Part D Extra Help. Administered by the Kentucky Department for Medicaid Services, there are three programs to know: QMB, SLMB, and QI.
What Are Kentucky Medicare Savings Programs?
A Medicare Savings Program is a Medicaid-funded benefit that pays some or all of a Medicare beneficiary's out-of-pocket Medicare costs. Federal law requires every state to offer all three programs; in Kentucky they are administered by the Cabinet for Health and Family Services (CHFS) through its Department for Medicaid Services (DMS).
The programs exist because Medicare does not fully cover what it costs. The 2026 Part B standard premium is $202.90 per month. Add the $283 Part B deductible, the $1,736 Part A inpatient hospital deductible, and coinsurance on every claim, and an uninsured Medicare beneficiary can face thousands of dollars a year in out-of-pocket costs before any prescription drug spending. The Kentucky Medicare Savings Programs absorb those costs for residents who qualify.
Income is counted under the SSI-related ABD methodology, not MAGI. That means two disregards apply before the income test:
- $20 general income exclusion per household per month, taken from unearned income (Social Security, pensions, VA compensation) first.
- $65 + half of remaining earned income for applicants who work.
The income limits published by SSA already build in the $20 disregard. A Kentucky resident whose gross Social Security benefit exceeds the published ceiling by less than $20 will still qualify once the disregard is applied.
QMB: Qualified Medicare Beneficiary
QMB is the most comprehensive Kentucky Medicare Savings Program. It pays both Part A and Part B premiums and covers all Medicare cost-sharing, including deductibles, coinsurance, and copays.
| Individual | Couple | |
|---|---|---|
| Monthly income limit | approximately $1,350 | approximately $1,824 |
| FPL band | at or below 100% FPL | at or below 100% FPL |
| Part B premium paid | $202.90/month | $202.90/month per enrollee |
| Part A deductible paid | $1,736 per benefit period | $1,736 per benefit period |
| Part B deductible paid | $283/year | $283/year |
| Coinsurance and copays | Covered | Covered |
| Resource limit | $9,950 | $14,910 |
The figures above reflect the federal QMB income ceiling (100% FPL plus the $20 general income disregard) as published in SSA POMS HI 00815.023. Kentucky does not set state-specific QMB income limits above the federal floor.
The QMB Billing Prohibition
Federal law (42 USC § 1396a(n)(3)(B)) prohibits any Medicare provider, whether Original Medicare or Medicare Advantage, from billing a QMB enrollee for any Medicare cost-sharing. This applies even to providers who do not participate in Medicaid.
If a provider sends a QMB a bill for a deductible, coinsurance, or copay:
- Do not pay it. Tell the provider you are enrolled in QMB.
- Show your QMB identification card or KY Medicaid eligibility letter.
- Call 1-800-MEDICARE (1-800-633-4227) to report the violation.
- Contact Kentucky SHIP at 1-877-293-7447 for help disputing the bill.
The provider must recall any improper bill from collections and refund any payment already collected. If the bill has gone to collections, you can dispute it under the Fair Credit Reporting Act on the basis that the debt is invalid under federal law.
SLMB: Specified Low-Income Medicare Beneficiary
SLMB pays the Part B premium only. At $202.90 per month in 2026, that is $2,434.80 per year returned to the enrollee's Social Security check.
| Individual | Couple | |
|---|---|---|
| Monthly income limit | approximately $1,616 | approximately $2,184 |
| FPL band | 100% to 120% FPL | 100% to 120% FPL |
| Benefit | Part B premium ($202.90/month) | Part B premium per enrollee |
| Resource limit | $9,950 | $14,910 |
SLMB enrollees are automatically deemed eligible for full Part D Extra Help. No separate application to SSA is required. The practical effect: $0 Part D premium on a benchmark plan, $0 deductible, and $5.10 generic / $12.65 brand-name drug copays in 2026.
SLMB and QI also carry up to three months of retroactive coverage under 42 CFR § 435.915, if the applicant met eligibility criteria in those prior months. File as early as possible to protect the retroactive window.
QI: Qualifying Individual
QI pays the Part B premium only, for residents with income between approximately 120% and 135% FPL.
| Individual | Couple | |
|---|---|---|
| Monthly income limit | approximately $1,816 | approximately $2,455 |
| FPL band | 120% to 135% FPL | 120% to 135% FPL |
| Benefit | Part B premium ($202.90/month) | Part B premium per enrollee |
| Resource limit | $9,950 | $14,910 |
Two important QI-specific rules:
- QI is funded by a capped federal allotment. Kentucky allocates QI on a first-come, first-served basis, with priority given to enrollees from the prior year. In practice, Kentucky has not exhausted its annual allotment in recent years, so eligible applicants have been approved. But QI is not a legal entitlement the way QMB and SLMB are.
- QI is mutually exclusive with full Kentucky Medicaid. If you are already enrolled in a full Medicaid program (including KY's HCBS waiver programs), you cannot be on QI. You would instead qualify for QMB-Plus or SLMB-Plus, which combine MSP cost-sharing protection with full Medicaid benefits.
Full Comparison: All Three Kentucky Medicare Savings Programs
| Program | Income band (individual) | Income band (couple) | What it pays | Resource limit |
|---|---|---|---|---|
| QMB | up to ~$1,350/month | up to ~$1,824/month | Part A + Part B premiums, all deductibles, coinsurance, copays | $9,950 / $14,910 |
| SLMB | ~$1,350 to ~$1,616/month | ~$1,824 to ~$2,184/month | Part B premium only | $9,950 / $14,910 |
| QI | ~$1,616 to ~$1,816/month | ~$2,184 to ~$2,455/month | Part B premium only | $9,950 / $14,910 |
All three programs share the same resource limit. All three auto-enroll you in Part D Extra Help. The income bands are the practical distinction.
What Counts as a Resource?
Counted resources include cash, bank accounts, stocks, bonds, non-qualified retirement accounts in payout status, a second home, and a second vehicle.
Excluded resources include:
- Primary home of any value (no equity cap for MSP purposes).
- One vehicle of any value.
- Household goods and personal effects.
- Burial spaces and burial funds up to $1,500 per person.
- Life insurance with combined face value at or below $1,500 per person.
Many Kentuckians have more excluded resources than they realize. A paid-off home and a car are already outside the $9,950 limit.
Part D Extra Help
Every QMB, SLMB, and QI enrollee is automatically deemed eligible for the Part D Low-Income Subsidy (Extra Help), under 42 USC § 1395w-114. No separate application is required. The state sends a monthly data file to CMS, and CMS updates the LIS subsystem.
In 2026, full Part D Extra Help provides:
- $0 premium on any benchmark Part D plan.
- $0 Part D deductible.
- $5.10 copay per generic prescription.
- $12.65 copay per brand-name prescription.
- $0 copays after $2,100 in true out-of-pocket drug costs.
For a Kentucky senior on several regular prescriptions, this benefit alone can be worth $1,500 to $3,000 per year on top of the Part B premium savings.
If you don't automatically qualify through an MSP (income above 135% FPL but below 150% FPL), you can apply directly for Extra Help using Form SSA-1020 at any Social Security office or online at SSA.gov. SSA will forward the application to CHFS, which automatically creates an MSP application.
How to Apply for Kentucky Medicare Savings Programs
Kentucky processes MSP applications through the kynect benefits system and through local DCBS offices.
Primary application channels:
- kynect online portal at kynect.ky.gov. Create an account and submit the application with supporting documents online.
- Phone: call DCBS at 1-855-306-8959 (Mon–Fri during business hours). A caseworker can assist with the application.
- In person at any local Department for Community Based Services (DCBS) office. Kentucky has DCBS offices in every county.
- Through SSA: applying for Part D Extra Help on Form SSA-1020 automatically generates an MSP referral to CHFS. The SSA application date is protected as the filing date.
Documents to have ready:
- Medicare card or Medicare Beneficiary Identifier (MBI)
- Social Security number and date of birth (applicant and spouse, if applicable)
- Most recent SSA COLA letter showing current monthly benefit amount
- Pension or annuity statements
- Recent bank statements (all checking, savings, and money market accounts)
- Proof of Kentucky residency (utility bill, lease, or mortgage statement)
Processing time: CHFS is required to process non-disability ABD applications within 45 days (90 days if a disability determination is needed). If CHFS misses the deadline, the applicant is presumptively eligible pending a final decision.
Retroactive coverage: SLMB and QI allow up to three months of retroactive coverage if eligibility criteria were met during those months. QMB coverage begins the month after the eligibility determination, with no retroactive period.
Annual renewal: CHFS attempts to renew coverage each year using existing electronic data. If it cannot confirm eligibility through its data sources, it sends a renewal packet. Return it promptly to avoid a gap in coverage. If MSP ends, Medicare resumes withholding the Part B premium from your Social Security check the following month.
Frequently Asked Questions
Any Kentucky resident who has Medicare (Part A or Part B), has monthly income at or below approximately 100% of the Federal Poverty Level after the $20 general income disregard, and has countable resources under $9,950 (individual) or $14,910 (couple). The primary home and one vehicle are not counted.
Not necessarily. The SSI methodology excludes $20 per household per month of unearned income before the income test. If you also have earned income, an additional $65 plus half of remaining earnings is excluded. Your countable income may be lower than your gross benefit.
Yes. If you qualify for both, you are in QMB-Plus, which provides all QMB cost-sharing protections on top of your full Medicaid benefits. The only mutual exclusivity is QI with full Medicaid. QI enrollees cannot hold full Medicaid simultaneously.
No. Enrollment in any Kentucky MSP automatically triggers full Part D Extra Help (Low-Income Subsidy). CHFS sends your enrollment data to CMS each month, and CMS updates your Part D record.
Do not pay the bill. Federal law prohibits any Medicare provider from billing a QMB for cost-sharing. Report the violation to 1-800-MEDICARE and to Kentucky SHIP at 1-877-293-7447.
SLMB and QI allow up to three months of retroactive coverage if you met eligibility criteria during those months. QMB does not allow retroactive coverage under federal law; it takes effect the month after your determination date.
Apply for a Kentucky Medicare Savings Program through kynect at kynect.ky.gov or call DCBS at 1-855-306-8959. Free one-on-one help is available from Kentucky SHIP at 1-877-293-7447.
Learn More
- Kentucky Medicaid Eligibility and Income Limits
- How to Apply for Kentucky Medicaid
- Medicaid Personal Needs Allowance Explained
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.