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. Three of Maryland's Medicaid-run savings 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 Part A and Part B 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. Maryland administers the MSPs, which the Maryland Department of Health (MDH) also calls Medicare Buy-In Programs, and you apply through your local department of social services.1

There are four MSPs in all. This guide covers the three that pay the Part B premium for income-eligible beneficiaries, QMB, SLMB, and QI, which together cover income up through 135% of the Federal Poverty Level (FPL).1 The fourth, the Qualified Disabled and Working Individual (QDWI) program, pays the Part A premium for certain working people with disabilities who lost premium-free Part A, and it does not bring Extra Help with it.1

For a QMB enrollee with one hospital stay in a year, the Part B premium ($2,434.80 over 12 months), the $283 Part B deductible, and the $1,736 Part A hospital deductible alone come to $4,453.80, before any 20% coinsurance, and QMB covers all of it.3

The MSPs count income and resources under Supplemental Security Income (SSI) rules, not the Modified Adjusted Gross Income (MAGI) rules Medicaid uses for groups such as expansion adults, children, and parents.4,5 A $20-per-month general income disregard is already built into the income ceilings below.1

Note: Maryland's other Medicaid rules for older adults are separate. A nursing-home resident keeps a Personal Needs Allowance of $106 a month (the federal floor is $30), and the medically needy (non-MAGI) asset limit for people who are aged, blind, or disabled is $2,500 for one person, while Maryland's separate categorically needy standard is $2,000. Neither changes MSP, which uses the standard federal resource limits.6

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 copays3

QMB does not cover your Part D drug-plan copays. Through Extra Help, a QMB enrollee pays no more than $12.65 per covered drug in 2026.1

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

These ceilings already include the $20 general income disregard, so don't subtract it again when you compare your income.1

Under federal law (Social Security Act § 1902(e)(8)), QMB applies to services furnished after the end of the month in which MDH determines you qualify, so it does not reach back before that decision. Apply as soon as you think you might qualify.7

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.3 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

The federal provision that fixes QMB's start date (§ 1902(e)(8)) names only QMB, not SLMB, so ask MDH how far back SLMB coverage can begin before you count on any month before you applied.7 For Medicaid in general, federal law reaches back to the third month before the month of application if you were eligible then. That three-month window is the federal default, a Section 1115 demonstration can change what a state provides, and for applications made on or after January 1, 2027 it shrinks to two months for most enrollees. Either way, file as early as you can.8

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 is paid from a capped annual federal allocation to each state and granted first-come, first-served, with preference for people who received QI in the last month of the previous year. You must reapply every year, so file early each year.1 An eligible applicant can still be turned away if Maryland has no QI slot open, and that denial says nothing about your Medicaid eligibility.8

Important: QI is only for people who are not otherwise eligible for Medicaid (Social Security Act § 1902(a)(10)(E)(iv)). A Marylander in the Community Options Waiver or any other full-Medicaid program cannot be a QI. If they also meet the QMB or SLMB rules they are a QMB Plus or SLMB Plus, and if not they are still a full-benefit dual eligible, which is fuller coverage, not a loss.8

As with SLMB, that QMB start-date provision does not name QI, so confirm with MDH how far back QI coverage can start.7

Full Maryland MSP Comparison

Resource limit (all three programs): $9,950 for one person, $14,910 for a couple in 2026.1 Under the SSI rules MSP uses, the home you live in, one vehicle used for transportation, and household goods are not counted.9 Maryland's $2,500 medically needy (non-MAGI) asset limit for aged, blind, or disabled Medicaid does not apply to MSP.6

These limits are not a simple bank-balance test. Medicare.gov says you may still qualify even if your income or resources are higher, because some states don't count certain types or amounts, and MDH says the best way to know if you're eligible is to apply. If you're close to the line, apply rather than rule yourself out.1

The QMB Billing Prohibition

Federal law prohibits Medicare providers and suppliers, including pharmacies, from billing people in the QMB group for Medicare Part A and Part B 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 Part A or Part B 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)10 or Maryland's State Health Insurance Assistance Program (SHIP) at 1-800-243-3425.11

The prohibition binds Original Medicare and Medicare Advantage providers alike, holds even if Medicaid doesn't pay the provider in full, and a provider that bills you anyway must recall the bill and refund anything collected. The one bill that can still come is a small Medicaid copayment, if one applies.12

Part D Extra Help (Automatic for QMB, SLMB, and QI Enrollees)

Under federal rules (42 CFR § 423.773(c)), every QMB, SLMB, and QI enrollee is automatically treated as eligible for the full Part D Low-Income Subsidy (LIS), also called Extra Help. There is no separate application to the Social Security Administration.2

In 2026, full Extra Help gives an enrollee:2

The premium subsidy is pegged to your region's benchmark, so if you choose a plan that costs more than the benchmark, you pay the difference.2 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

If your gross Social Security benefit sits above the QMB limit, don't stop there. Two SSI rules matter when you compare your income to the ceilings.

The $20 general income disregard. SSI rules don't count the first $20 of most income in a month, applying it to unearned income first.13 The ceilings in the tables above already include it, so don't subtract it again when you compare your income to them.1

The earned-income disregard. SSI methodology (20 CFR § 416.1112) also excludes the first $65 of monthly earnings (after any unused part of the $20 disregard) and then counts only half of what remains, so countable wages are always less than half the gross amount.4 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

MSP applications go to your local department of social services. Here is what to gather and what to expect.

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 $2,150 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: $2,150
• The published ceilings already include the $20 general income disregard, so compare the gross figure directly
• 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: excluded9
• 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.3,2

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.