Maryland Medicare Savings Programs 2026: QMB, SLMB & QI

A Maryland Medicare Savings Program can stop the $202.90 Part B premium from leaving your Social Security check and save you more than $2,400 a year. These three Medicaid-run programs (QMB, SLMB, and QI) pay the Part B premium for income-eligible Medicare beneficiaries, and the most generous of them, QMB, also covers your Medicare deductibles, coinsurance, and copays.

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.

There are three programs, covering income from the lowest tier up through 135% of the Federal Poverty Level (FPL).1

For a QMB enrollee, the premiums, deductibles, and copays Medicare would otherwise charge add up to more than $4,000 a year, money that stays in your pocket.2

The MSPs use the Supplemental Security Income (SSI)-related aged, blind, and disabled (ABD) income methodology, not the Modified Adjusted Gross Income (MAGI) rules used for Marketplace coverage. A $20-per-month general income disregard is already built into the income ceilings below.1

Note: Maryland's Medicaid program keeps a relatively high Personal Needs Allowance ($106/month for nursing-home residents) and a $2,500 asset limit for aged, blind, or disabled individuals, higher than the $2,000 federal SSI default most states use. Those long-term-care parameters do not change MSP, which follows the federal resource limits.3

Qualified Medicare Beneficiary (QMB)

QMB is the most comprehensive Maryland Medicare Savings Program, for people with income at or below 100% of the FPL.1

It pays:

• Your Part A premium, if you owe one
• The 2026 Part B standard premium of $202.90 a 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 copays2

2026 Maryland QMB monthly income limits (100% FPL plus the $20 disregard):1

These ceilings already include the $20 general income disregard, which is one exclusion per household, not per person.1

QMB coverage begins the month after MDH approves your application. Federal law provides no retroactive QMB (42 USC § 1396a(e)(8)), so apply as soon as you think you might qualify.

Specified Low-Income Medicare Beneficiary (SLMB)

SLMB pays the Part B premium only: $202.90 a month in 2026, or $2,434.80 over a full year.2 It covers income between 100% and 120% of the FPL.1

2026 Maryland SLMB monthly income limits (100 to 120% FPL plus the $20 disregard):1

SLMB allows up to three months of retroactive coverage under 42 CFR § 435.915 if you met the rules during those months, so file as early as you can to protect that window.

Qualifying Individual (QI)

QI also pays the Part B premium only, for income between 120% and 135% of the FPL.1

2026 Maryland QI monthly income limits (120 to 135% FPL plus the $20 disregard):1

QI runs on a capped pool of federal funding, awarded first-come, first-served with preference for people who received QI the year before. Maryland has not exhausted its QI funds in recent years.

Important: QI cannot be combined with full Medicaid (42 USC § 1396u-3(c)(1)). A Marylander in the Community Options Waiver, the Waiver for Older Adults, or any other full-Medicaid program qualifies instead 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 for one person, $14,910 for a couple in 2026.1 Your home, one vehicle, and household goods are not counted. Maryland's $2,500 long-term-care asset limit applies only to nursing-home and waiver Medicaid, not to MSP.3

The QMB Billing Prohibition

Federal law (42 USC § 1396a(n)(3)(B)) bars any Medicare provider from billing a QMB enrollee for Medicare cost-sharing.1 That protection covers:

• Original Medicare and Medicare Advantage providers
• Providers who do not participate in Maryland's Medicaid program
• Hospitals, physicians, ambulance services, equipment suppliers, and skilled nursing facilities

Getting a bill after you have been told you owe nothing is unsettling, and it is easy to assume you have to pay it. You do not. If you are a QMB and a bill arrives 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 will not drop it, call 1-800-MEDICARE (1-800-633-4227) or Maryland's State Health Insurance Assistance Program (SHIP) at 1-800-243-3425.

CMS guidance (MLN Matters SE1128) and a 2016 CMS final rule (81 Fed. Reg. 80170) 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 the full Part D Low-Income Subsidy (LIS), also called Extra Help. There is no separate application to the Social Security Administration.

In 2026, full Extra Help gives an enrollee:4

Auto-deeming flows from MDH's monthly data file to CMS. If you are not already in a Part D plan, CMS assigns you a benchmark plan, and you can switch to any other plan during open enrollment without losing Extra Help. For someone filling several prescriptions a month, this is often the largest single saving an MSP delivers, on top of the Part B premium.

The Income Disregards That Matter

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

The $20 general income disregard. Under SSI rules (20 CFR § 416.1124(c)(12)), $20 a month is excluded from unearned income before the FPL test, and it is one exclusion per household, not per person. The ceilings in the tables above already reflect it.1

The earned-income disregard. SSI methodology (20 CFR § 416.1112) also sets aside a fixed slice of monthly wages and then half of what remains before counting earned income. A retiree with part-time wages is often counted well below the ceiling even when gross pay looks disqualifying, so it is worth having MDH or a SHIP counselor run the real numbers rather than the gross figures.

How to Apply for Maryland Medicare Savings Programs

MDH takes MSP applications through the same channels as its other Medicaid programs. The steps below apply whether you file online, by mail, or in person.

Worked Example: A Maryland Couple Applying for SLMB

These figures are hypothetical, shown only to illustrate the arithmetic. They are not a real case or a prediction of your result.

Picture a married couple, both 74 and both on Medicare, in Anne Arundel County. Their combined Social Security is $2,200 a month, they have $11,500 in savings, and they own their home and one car. Their result turns on the 2026 SLMB couple ceiling of $2,184.1

Income test:

• Gross unearned income: $2,200
• Less the $20 general income disregard (one per household): $2,180 counted
• 2026 QMB couple limit is $1,824, so they are over the QMB line
• 2026 SLMB couple limit is $2,184, so they fall under SLMB
• Result: they qualify for SLMB1

Resource test:

• Savings counted: $11,500
• Home and car: excluded
• 2026 couple resource limit: $14,910
• Result: under the limit1

Outcome: SLMB pays the $202.90 Part B premium for each spouse, putting $4,869.60 a year back in their budget, and both are automatically deemed for full Part D Extra Help.2

Where to Get Help in Maryland

Learn More

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.