Missouri Medicare Savings Programs 2026: QMB, SLMB & QI

Missouri's three Medicare Savings Programs can pay your Medicare Part B premium of $202.90 a month in 2026.1 For the lowest incomes, they also cover every deductible, coinsurance, and copay Original Medicare leaves behind. The Missouri Department of Social Services runs them through MO HealthNet, the state's Medicaid program, and every enrollee automatically qualifies for Part D Extra Help.2

What Are Missouri Medicare Savings Programs?

Missouri's Medicare Savings Programs are part of MO HealthNet, the state's Medicaid program.3 MO HealthNet applications go to the Missouri Department of Social Services (DSS).4 Federal law (42 USC 1396a(a)(10)(E)) requires every state Medicaid plan in the 50 states and the District of Columbia to cover QMB, SLMB, and QI.5 Missouri administers all three using the federal income and resource standards, labeling them QMB, SLMB1 (the federal SLMB tier), and SLMB2, also called QI-1 (the federal QI tier).3

The programs exist because Medicare itself leaves substantial cost exposure. In 2026, the Part B standard premium is $202.90 per month, the Part A inpatient hospital deductible is $1,736 per benefit period, and the Part B annual deductible is $283, after which Part B coinsurance is 20% of the Medicare-approved amount for most outpatient services.1 How much of that a Medicare Savings Program covers depends on the tier: QMB pays the Part B premium, in some cases the Part A premium, and Medicare's deductibles and co-payments, while SLMB1 and SLMB2 (QI-1) pay the Part B premium only.3

Income and resources are counted under the rules of the Supplemental Security Income (SSI) program, not the Modified Adjusted Gross Income (MAGI) rules that apply to marketplace coverage.6 Two disregards apply before the income test:

• A $20 general income exclusion each month, taken first from unearned income such as Social Security, pensions, or VA compensation.6
• A further earned-income exclusion for applicants who work: the first $65 of monthly earnings and half of the rest don't count toward the limit.6

The income limits in this guide are SSA's 2026 figures, which already build in the $20 exclusion. Missouri's own MO HealthNet chart lists the bare poverty-level figures instead, $20 lower (for QMB, $1,330 for one person and $1,804 for a couple). Either way, if your income or resources look somewhat higher than the limits, apply anyway and let DSS run the calculation; SSA tells its own staff to encourage people in that position to apply.3

QMB: Qualified Medicare Beneficiary

QMB is the most comprehensive Missouri Medicare Savings Program. It pays the Part B premium, in some cases the Medicare Part A premium too, and the deductibles and copays for Medicare services.3

The income figures above are SSA's 2026 federal QMB limits (100% FPL plus the $20 exclusion). Missouri's income limits track the Federal Poverty Level, and its own chart prints the same limits $20 lower, before that exclusion.3

The QMB Billing Prohibition

Federal law (42 USC 1396a(n)(3)(B)) bars any Medicare provider, whether Original Medicare or Medicare Advantage, from billing a QMB enrollee for Medicare cost-sharing. The ban applies to providers who participate in MO HealthNet and to those who do not, and it holds even when Medicaid pays nothing toward the bill.7

If a provider bills you for a Medicare deductible, coinsurance, or copay while you are enrolled in QMB:

1. Do not pay it. Tell the provider you are a QMB enrollee.
2. Show your MO HealthNet QMB eligibility letter or Medicaid card.
3. Call 1-800-MEDICARE (1-800-633-4227) to report the billing violation.8
4. Contact the Missouri State Health Insurance Assistance Program (SHIP; official site) at 1-800-390-3330 for help disputing the bill.9

The provider must recall the bill from collections and refund any amount already collected.7

SLMB: Specified Low-Income Medicare Beneficiary

SLMB pays the Part B premium only. At the 2026 rate of $202.90 per month, twelve monthly premiums come to $2,434.80 returned to the enrollee's Social Security deposit over the year.1

SLMB enrollees are automatically deemed eligible for full Part D Extra Help, so no separate application to the Social Security Administration (SSA) is needed. In 2026, that means a $0 Part D premium on a benchmark plan, a $0 deductible, and copays capped at $5.10 for a generic and $12.65 for a brand-name drug.2

Ask DSS directly how far back your SLMB coverage can start. The federal rule that starts QMB only after the approval month names QMB alone, and the federal sources we rely on set no back-dating window for SLMB or QI.10 If you also qualify for full MO HealthNet, federal law makes that Medicaid coverage available for covered services you received as far back as the third month before the month you applied, if you were eligible then; the state plan sets the exact start date, and a Section 1115 demonstration can make a state's window shorter. For applications made on or after January 1, 2027, federal law cuts that window to two months for most people.5 If DSS does make your Part B premium coverage effective for past months, SSA refunds the premiums that were deducted from your benefit for those months.11

QI: Qualifying Individual

QI pays the Part B premium only, for a Missouri resident with income between roughly 120% and 135% FPL.3

Two QI-specific rules matter. First, QI is not a federal entitlement: each state gets a capped federal QI allotment each year and selects applicants in the order they apply, with preference for people who had the help at the end of the previous year. Once you are selected, you keep QI for the rest of that year as long as you still qualify.12 Second, QI is mutually exclusive with MO HealthNet: Missouri's SLMB2 (QI-1) enrollees cannot receive MO HealthNet under any other type of assistance.3 Federal law (42 USC 1396a(a)(10)(E)(iv)) limits QI to people not otherwise eligible for Medicaid, so someone who qualifies for both a Medicare Savings Program and full Medicaid is a QMB-Plus or SLMB-Plus enrollee instead, which is fuller coverage, not less.5

Full Comparison: Missouri Medicare Savings Programs

All three Missouri Medicare Savings Programs share the same resource limit of $9,950 (individual) and $14,910 (couple), and all three make you automatically eligible for Part D Extra Help. Those figures are the federal standard rather than an absolute cutoff: states can disregard certain income and resources, so apply rather than rule yourself out if you land somewhat over.3

What Counts as a Resource in Missouri?

The SSI resource rules apply,6 and they measure only counted resources against the limit, not everything you own.13

Excluded resources include:

• The primary home you live in, and the land it sits on.13 Missouri's $752,000 home-equity cap applies to MO HealthNet nursing-home, home-and-community-based and PACE eligibility, not to Medicare Savings Programs.14
• One vehicle of any value, if you or someone in your household uses it for transportation.13
• Household goods and personal effects.13
• Burial spaces, plus up to $1,500 each for you and your spouse kept separately and set aside for burial; that $1,500 shrinks by the face value of certain life insurance and by irrevocable burial arrangements.6

The MSP resource limit is far more generous than the federal SSI default of $2,000 (individual) and $3,000 (couple).13 Missouri's MO HealthNet for the Aged, Blind and Disabled uses a lower resource limit of $6,220.50 for one person and $12,441 for a couple (effective July 1, 2026)14 that does not apply to Medicare Savings Programs, which keep the federal $9,950 / $14,910 standard.3

Part D Extra Help

Enrollment in any Missouri Medicare Savings Program automatically qualifies you for full Part D Extra Help, the Low-Income Subsidy (LIS). Under 42 CFR 423.773(c), anyone eligible for Medicaid as a QMB, SLMB, or QI is treated as meeting the Extra Help eligibility rules, and the Centers for Medicare & Medicaid Services (CMS) notifies you that you do not need to apply.2

In 2026, full Part D Extra Help provides a $0 premium on a benchmark Part D plan (choose a pricier plan and you pay the difference), a $0 deductible, copays of no more than $5.10 per generic prescription and $12.65 per brand-name prescription (less for some people who also have full MO HealthNet), and $0 copays for the rest of the year once your out-of-pocket drug costs reach $2,100.2

If your income is above the MSP limits but below 150% FPL (about $1,995 a month for one person or $2,705 for a couple in 2026), you may still qualify for Extra Help on its own. Those figures are for one- and two-person households: the limit is higher if relatives you support live with you, and SSA doesn't count all income, so apply and let SSA do the math rather than ruling yourself out. Apply online on SSA's Extra Help page or call Social Security at 1-800-772-1213.2

How to Apply for Missouri Medicare Savings Programs

The Family Support Division (FSD) of DSS takes MO HealthNet applications for aged, blind, and disabled Missourians.4 Work through these steps.

QMB coverage applies to services you get after the end of the month in which you are found eligible, so it starts the month after approval. The federal sources we rely on set no back-dating rule for SLMB or QI, so ask DSS how far back your coverage can be made effective.10

Where to Get Help in Missouri

Learn More

Find personalized help applying for Missouri 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.