Montana Medicare Savings Programs 2026: QMB, SLMB & QI

Montana's three Medicare Savings Programs can pay your Medicare Part B premium of $202.90 a month in 2026, more than $2,400 a year off your Social Security check.1 For the lowest incomes, they also cover every deductible, coinsurance, and copay Original Medicare leaves behind. The Montana Department of Public Health and Human Services (DPHHS) runs them through Montana Healthcare Programs, the state's Medicaid program, and every enrollee is automatically signed up for Part D Extra Help.

What Are Montana Medicare Savings Programs?

Montana's Medicare Savings Programs are part of Montana Healthcare Programs, the state's Medicaid program administered by the Montana Department of Public Health and Human Services (DPHHS). Federal law (42 USC 1396a(a)(10)(E)) requires every state to run QMB, SLMB, and QI, and Montana administers all three using the federal income and resource standards. DPHHS determines financial eligibility and manages enrollment for each 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 20% coinsurance accruing on top of that on most Medicare-covered services. For a Montana 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. The standard SSI income disregards are applied before the test runs, and the published income ceilings already build them in. A Montana resident whose gross Social Security benefit sits just above a ceiling should still apply and let DPHHS run the calculation.

QMB: Qualified Medicare Beneficiary

QMB is the most comprehensive Montana Medicare Savings Program. It pays both the Medicare Part A and Part B premiums (most beneficiaries already have premium-free Part A after 40 or more work quarters) and covers all Medicare cost-sharing, including deductibles, coinsurance, and copays.

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

For a single Montana senior on Social Security, the savings add up quickly. QMB stops the $202.90 monthly Part B premium ($2,434.80 over a year) and the $283 Part B deductible, which is more than $2,700 kept even in a year with no hospital stay. Add the $1,736 Part A hospital deductible and the coinsurance on any inpatient admission, and a single hospitalization pushes total savings well past $4,000.1

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 Montana Healthcare Programs and to those who do not.2

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 DPHHS QMB eligibility notice or Medicare card.
3. Call 1-800-MEDICARE (1-800-633-4227) to report the billing violation.
4. Contact the Montana State Health Insurance Assistance Program (SHIP) at 1-800-551-3191 for free 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 does not pay deductibles or copays, so for a beneficiary with limited medical utilization, eliminating the Part B premium is the dominant savings. 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, DPHHS can back-date coverage and SSA will refund premiums deducted during those months.

QI: Qualifying Individual

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

Two QI-specific rules matter. First, Montana receives a fixed federal QI allotment each year and fills enrollment on a first-come, first-served basis, with priority for prior-year enrollees; unlike QMB and SLMB, which are entitlements, QI enrollment is not guaranteed once the allotment is exhausted. Second, QI is mutually exclusive with full Medicaid: federal law (42 USC 1396u-3(c)(1)) bars QI for anyone eligible for full Medicaid, so if you already receive full Montana Healthcare Programs benefits you would instead qualify for QMB-Plus or SLMB-Plus, combining cost-sharing protection with full coverage.2

Full Comparison: Montana Medicare Savings Programs

All three Montana 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 Montana?

The SSI-related resource rules apply. Counted resources include cash, checking and savings balances, stocks, bonds, mutual funds, CDs, a second home, and a second vehicle.

Excluded resources include:

• The primary home of any value.
• One vehicle of any value.
• Household goods and personal effects.
• Prepaid burial arrangements and a limited burial fund.

Many Montana applicants assume their home equity disqualifies them; it does not, because the primary residence is fully excluded from the MSP resource count regardless of value. The MSP resource limit is also far more generous than the federal SSI default of $2,000 (individual) and $3,000 (couple).4 Montana's separate nursing-home Medicaid program uses a much lower $2,000 single-applicant resource limit5 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 Montana Medicare Savings Program automatically qualifies you for full Part D Extra Help, the Low-Income Subsidy (LIS), under 42 USC 1395w-114. DPHHS 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 Someone filling six generic prescriptions a month would pay about $367 in copays over the year (6 × $5.10 × 12) instead of full retail price, so for a Montana senior on several medications, Extra Help can save hundreds to over a thousand 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 DPHHS as an automatic MSP referral.3

How to Apply for Montana Medicare Savings Programs

DPHHS accepts Medicare Savings Program applications online at apply.mt.gov, by phone, and in person at a local Office of Public Assistance.5 Work through these steps.

Where to Get Help in Montana

Learn More

Find personalized help applying for Montana 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.