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 is automatically signed up for Part D Extra Help.

What Are Missouri Medicare Savings Programs?

Missouri's Medicare Savings Programs are part of MO HealthNet, the state's Medicaid program administered by the Missouri Department of Social Services (DSS), Family Support Division. Federal law (42 USC 1396a(a)(10)(E)) requires every state to run QMB, SLMB, and QI. 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).2

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, with coinsurance accruing on top of that on every Medicare-covered service. For a Missouri resident who qualifies, a Medicare Savings Program pays those costs directly.1

Income is counted under the aged, blind, and disabled (ABD) methodology used for Supplemental Security Income (SSI) in 42 CFR Part 435, not the Modified Adjusted Gross Income (MAGI) rules that apply to marketplace coverage. 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.2
• A further earned-income exclusion for applicants who work, which lowers the income that counts toward the limit.

The published income ceilings already build in the $20 disregard. A Missouri resident whose gross Social Security benefit sits within about $20 of a ceiling should still apply and let DSS run the calculation.2

QMB: Qualified Medicare Beneficiary

QMB is the most comprehensive Missouri Medicare Savings Program. It pays both the Medicare Part A and Part B premiums and covers all Medicare cost-sharing, including deductibles, coinsurance, and copays.

The figures above are the federal QMB ceilings (100% FPL plus the $20 disregard) per SSA POMS HI 00815.023; Missouri does not set QMB income limits above that federal floor.2

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.

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.
4. Contact the Missouri State Health Insurance Assistance Program (SHIP) at 1-800-390-3330 for help disputing the bill.

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

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.3

SLMB also allows up to three months of retroactive coverage under 42 CFR 435.915. If you were eligible in the three months before filing, DSS can back-date coverage and SSA will issue a lump-sum refund of premiums deducted during those months.

QI: Qualifying Individual

QI pays the Part B premium only, for a Missouri resident with income between roughly 120% and 135% FPL.2

Two QI-specific rules matter. First, Missouri receives a fixed federal QI allotment each year and fills enrollment on a first-come, first-served basis, with priority for prior-year enrollees; Missouri has not exhausted its allotment in recent years, but QI is not a statutory entitlement. Second, QI is mutually exclusive with full MO HealthNet: federal law (42 USC 1396u-3(c)(1)) bars QI for anyone eligible for full Medicaid, so if you already receive full MO HealthNet benefits you would instead qualify for QMB-Plus or SLMB-Plus, combining cost-sharing protection with full coverage.2

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 trigger automatic Part D Extra Help enrollment.2

What Counts as a Resource in Missouri?

The SSI-related resource rules apply. Counted resources include cash, bank accounts, stocks, bonds, non-retirement investment accounts, a second home, and a second vehicle.

Excluded resources include:

• The primary home of any value. Missouri's $752,000 home-equity cap applies to nursing-home Medicaid, not to Medicare Savings Programs.4
• One vehicle of any value.
• Household goods and personal effects.
• Burial spaces and a limited burial fund.
• Life insurance with a low combined face value.

The MSP resource limit is far more generous than the federal SSI default of $2,000 (individual) and $3,000 (couple).5 Missouri's separate MO HealthNet nursing-home program uses a single-applicant resource limit of $6,068.80 (effective July 1, 2025)4 that does not apply to Medicare Savings Programs, which keep the federal $9,950 / $14,910 standard.2

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 USC 1395w-114. DSS transmits enrollment data to the Centers for Medicare & Medicaid Services (CMS) monthly, and CMS updates your Part D record, so no separate application is required.

In 2026, full Part D Extra Help provides a $0 premium on any benchmark Part D plan, a $0 deductible, a $5.10 copay per generic prescription, a $12.65 copay per brand-name prescription, and $0 copays for the rest of the year once your out-of-pocket drug costs reach $2,100.3 For a Missouri senior on several medications, that can save hundreds to thousands of dollars a year, on top of the Part B premium savings.

If your income is above the MSP limits but at or below 150% FPL, you can still apply directly for Extra Help using Form SSA-1020 at any Social Security office or online at SSA.gov, and SSA forwards it to DSS as an automatic MSP referral.3

How to Apply for Missouri Medicare Savings Programs

DSS accepts Medicare Savings Program applications online at mydss.mo.gov, by phone, and in person at a local Family Support Division office.2 Work through these steps.

For retroactive coverage, SLMB and QI allow up to three months of back-dated coverage if you met the criteria during those months. QMB coverage begins the month after the eligibility determination, with no retroactive period.

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.