Maryland Medicare Savings Programs 2026: QMB, SLMB & QI

Maryland Medicare Savings Programs can pay your Medicare Part B premium and cover Medicare cost-sharing for income-eligible seniors and people with disabilities. Many Maryland families save more than $2,000 a year once enrolled.

What Are Maryland Medicare Savings Programs?

A Medicare Savings Program (MSP) is a Medicaid benefit that pays some or all of a low-income Medicare beneficiary's Medicare premiums and cost-sharing. The Maryland Department of Health (MDH) administers all three MSPs, with eligibility processed by local departments of social services and health departments.

There are three programs, covering income tiers from the lowest through 135% of the Federal Poverty Level. Every Marylander on Medicare with limited income should check whether they qualify: the combined value of premiums, deductibles, and copays covered can exceed $4,000 per year.

The MSPs use the SSI-related ABD income methodology, not the MAGI methodology used for ACA Marketplace coverage. SSI income counting rules apply, including a $20 per month general income disregard that is already built into the published income ceilings below.

Note: Maryland's Medicaid program is notable for a relatively high Personal Needs Allowance ($106/month for nursing-home residents) and an effective asset limit of $2,500 for individuals (higher than the $2,000 default used by most states). Those LTSS parameters do not affect MSP, which follows the federal resource standards.

Qualified Medicare Beneficiary (QMB)

QMB is the most comprehensive Maryland Medicare Savings Program. It pays:

• The Part A premium (if any)
• The 2026 Part B standard premium of $202.90 per month
• The Part A inpatient hospital deductible ($1,736 per benefit period in 2026)
• The Part B annual deductible ($283 in 2026)
• All Medicare Part A and Part B coinsurance and copays

2026 Maryland QMB income limits (with $20 general income disregard):

These reflect 100% of the Federal Poverty Level plus the $20 general income disregard. MDH uses the SSI ABD counting methodology: $20 per household per month is excluded from unearned income before the FPL test. The $20 is one disregard per household, not per person.

QMB coverage begins the month after MDH determines eligibility. There is no retroactive QMB under federal law (42 USC § 1396a(e)(8)). Apply as early as you suspect you may qualify.

Specified Low-Income Medicare Beneficiary (SLMB)

SLMB pays the Part B premium only: $202.90 per month in 2026, or $2,434.80 per year.

2026 Maryland SLMB income limits (with $20 general income disregard):

SLMB covers income between 100% and 120% FPL. Up to three months of retroactive coverage is available under 42 CFR § 435.915 if the applicant met all eligibility criteria during those months. File as early as possible to protect the retroactive window.

Qualifying Individual (QI)

QI also pays the Part B premium only, for income between 120% and 135% FPL.

2026 Maryland QI income limits (with $20 general income disregard):

QI is funded through a federal capped allotment at 100% FMAP, allocated first-come, first-served with preference for prior-year enrollees. Maryland has not exhausted its QI allotment in recent years.

Important: QI is mutually exclusive with full Medicaid by statute (42 USC § 1396u-3(c)(1)). A Marylander enrolled in Community Options Waiver, Waiver for Older Adults, or any other full-Medicaid program cannot receive QI. They would instead qualify as QMB-Plus or SLMB-Plus.

QI also allows up to three months of retroactive coverage under 42 CFR § 435.915.

Full Maryland MSP Comparison

Resource limit (all three programs): $9,950 individual / $14,910 couple in 2026. The primary residence of any value, one vehicle, household goods, and burial funds up to $1,500 are excluded from countable resources. (Maryland's $2,500 LTSS asset limit applies only to nursing-home and HCBS-waiver Medicaid, not to MSP.)

The QMB Billing Prohibition

Federal law (42 USC § 1396a(n)(3)(B)) prohibits any Medicare provider from billing a QMB-enrolled beneficiary for Medicare cost-sharing. This applies to:

• Original Medicare and Medicare Advantage providers
• Providers who do not participate with Maryland Medicaid
• Hospitals, physicians, ambulance services, durable medical equipment suppliers, and skilled nursing facilities

If you are a QMB and receive a bill for a Medicare deductible, coinsurance, or copay, do not pay it. Tell the provider you are a QMB and that federal law prohibits the charge. If the provider refuses to drop the bill, call 1-800-MEDICARE (1-800-633-4227) or contact Maryland's SHIP program (Maryland SHIP) at 1-800-243-3425.

CMS guidance (MLN Matters Article SE1128) and CMS final rule 81 Fed. Reg. 80170 (Nov. 15, 2016) extended these protections explicitly to Medicare Advantage providers.

Part D Extra Help (Automatic for All MSP Enrollees)

Under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (42 USC § 1395w-114), every QMB, SLMB, and QI enrollee is automatically deemed eligible for full Part D Low-Income Subsidy. No separate application to the Social Security Administration is required.

In 2026, full Part D Extra Help provides:

Auto-deeming flows from MDH's monthly data file to CMS. If an enrollee is not already in a Part D plan, CMS will auto-assign a benchmark plan. The enrollee can switch to any other Part D plan during open enrollment without losing Extra Help status.

For a senior on several prescriptions per month, the drug-cost reduction is often $1,500 to $2,500 per year on top of the Part B savings.

The Income Disregards That Matter

Many Marylanders look at their gross Social Security benefit, see it is above the QMB limit, and never apply. Two disregards regularly pull people back under the ceiling:

The $20 general income disregard. Under SSI methodology (20 CFR § 416.1124(c)(12)), $20 per month per household is excluded from unearned income before the FPL test. The ceiling figures in the tables above already reflect this $20. It is one disregard per household, not per person.

The $65 + ½ earned-income disregard. Under 20 CFR § 416.1112(c)(4)-(5), the first $65 of earned income is excluded, then half the remaining earned income is excluded. A part-time worker earning $900 per month has countable earned income of ($900 - $65) ÷ 2 = $417.50, not $900.

For applicants with both Social Security and part-time wages, running the actual numbers rather than the gross amounts can mean the difference between qualifying and not.

How to Apply for Maryland Medicare Savings Programs

MDH processes MSP eligibility through the same channels as other Medicaid programs.

Maryland Health Connection (online): Apply at marylandhealthconnection.gov. The state's primary benefits enrollment portal accepts MSP applications, document uploads, and status tracking.

Local department of social services or health department: Marylanders applying for long-term-care Medicaid or other ABD benefits typically apply at the local DSS or county health department. MSP applications can be filed there as well.

Social Security Administration: Applying for Part D Extra Help at SSA on Form SSA-1020 automatically generates an MSP application referral to MDH under 42 USC § 1320b-14. The SSA filing date is protected for retroactive coverage purposes.

Documents to bring:

• Medicare card or Medicare claim number (MBI)
• Social Security card and proof of age
• Proof of Maryland residency (utility bill, lease, or bank statement)
• Most recent SSA award or COLA letter
• Recent bank and investment statements
• Pension or annuity statements

Processing timeline: Non-disability ABD applications carry a 45-day clock under 42 CFR § 435.912(c)(3). MDH must send a written decision explaining the determination and the right to appeal.

Maryland SHIP: The Maryland State Health Insurance Assistance Program (SHIP) offers free, unbiased MSP application help. Call 1-800-243-3425 or visit a local Senior Center or Area Agency on Aging.

Worked Example: Couple Applying for QI in Maryland

The figures below are hypothetical and shown only to illustrate how the income calculation works. They are not a real case and not a prediction of your own result.

A married couple, both age 74, both on Medicare, living in Anne Arundel County. Combined Social Security: $2,200 per month. Savings: $11,500. They own their home and one car.

Income test:

• Gross unearned income: $2,200
• Less $20 general income disregard (one per household): $2,180 countable
• 2026 QMB couple limit: $1,824 -- above QMB.
• 2026 SLMB couple limit: $2,184 -- below SLMB.
• Result: they qualify for SLMB.

Resource test:

• Savings: $11,500 (counted)
• Home and vehicle: excluded
• Total counted resources: $11,500
• 2026 couple resource limit: $14,910
• Result: below the limit.

Outcome: SLMB pays the Part B premium of $202.90 per month for each spouse, total annual savings of $4,869.60. Both are auto-deemed for full Part D Extra Help.

Learn More

• Maryland Medicaid Eligibility and Income Limits
• How to Apply for Maryland Medicaid
• Medicaid Personal Needs Allowance Explained

Find personalized help applying for Maryland 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.