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 automatically qualifies 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). QMB, SLMB, and QI are mandatory Medicaid eligibility groups under federal law, and DPHHS, as the state Medicaid agency, decides who qualifies for each. Montana publishes its own income standards in the DPHHS Medicaid manual, and its resource limits match the federal figures.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 on most outpatient services after that deductible is met. For a Montana resident who qualifies, a Medicare Savings Program pays those costs directly.1

Every income limit in this guide is a limit on countable income, not on your gross Social Security check. DPHHS states the tiers as shares of the Federal Poverty Level: QMB at or below 100%, SLMB above 100% and up to 120%, and QI above 120% and up to 135%. Montana's own dollar standards, effective April 1, 2026, sit exactly $20 below the federal figures Social Security publishes, because the federal table adds the $20 Supplemental Security Income (SSI) general income exclusion and DPHHS's table doesn't. Montana takes that $20 off when it counts your income instead: its Combined Medicaid manual applies a $20 general income disregard to unearned income first, then disregards the first $65 and half of the rest of any earnings. So if at least $20 of your income is unearned, such as a Social Security check, the two tables set the same ceiling ($1,330 countable is $1,350 before the $20 comes off). If your income still looks just above a limit, apply anyway: Social Security tells its own staff to encourage anyone whose income looks somewhat high to apply.2

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 Montana figures are DPHHS's monthly countable-income standards. The federal figures come from Social Security's POMS table for every state except Alaska and Hawaii, and they equal 100% FPL plus the $20 SSI general income exclusion.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 bars Medicare providers and suppliers, pharmacies included, from billing a QMB enrollee for Medicare cost-sharing. You have no legal obligation to pay Part A or Part B deductibles, coinsurance, or copays for Medicare-covered services. In some cases you may owe a small Medicaid copayment, and CMS reports that people in QMB still get wrongly billed despite the law.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.3
4. Contact the Montana State Health Insurance Assistance Program (SHIP) at 1-800-551-3191 for free help disputing the bill.

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 of no more than $5.10 for a generic and $12.65 for a brand-name drug.4

In Montana, SLMB starts the first of the month you apply, and DPHHS may approve it retroactively for up to three months before your application.2 That back-dating is Montana's own rule: the federal start-date provision for Medicare Savings Programs names only QMB and sets nothing for SLMB or QI.5 Federal law shortens Medicaid's general retroactive window to two months for most applications made on or after January 1, 2027, so if you apply after that date, ask DPHHS how far back your SLMB coverage can reach.6

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, unlike QMB and SLMB, QI is not an entitlement: it runs on a capped annual federal allotment, and states select enrollees in the order they apply, with preference for people who had the help at the end of the previous year. Everyone who qualifies may still apply during the year, and once you're selected, you keep QI for the rest of that year as long as you still qualify.7 You must apply again every year to stay in QI.2 Second, QI is closed to anyone eligible for another Medicaid group: DPHHS won't issue other medical coverage, such as medically needy, alongside QI for more than one month.2 There is no QI-Plus category.7 If you have full Montana Healthcare Programs coverage and also meet the QMB or SLMB rules, you're classed as QMB Plus or SLMB Plus instead. QMB Plus carries QMB's protection from Medicare cost-sharing; SLMB Plus does not automatically, and whether it covers Medicare cost-sharing varies by state, though every Medicare provider must still accept the Medicare-approved amount as payment in full for your Part B services.8

Full Comparison: Montana Medicare Savings Programs

The income bands use Montana's DPHHS standards effective April 1, 2026; the federal POMS figures run $20 higher at every tier. All three Montana Medicare Savings Programs share the same resource limit of $9,950 (individual) and $14,910 (couple).2 That resource figure is the federal standard, not an absolute cutoff: states can effectively raise the income and resource limits by disregarding certain income and resources, so someone somewhat over should apply rather than rule themselves out.1 All three programs also make you automatically eligible for Part D Extra Help.4

What Counts as a Resource in Montana?

The $9,950 and $14,910 limits apply to countable resources, not to everything a household owns. DPHHS counts the equity value of everything you own unless a rule excludes it, and its Aged, Blind, and Disabled (ABD) Medicaid rules, the manual that also houses the MSPs, exclude your principal home and the land around it (one home only, kept excluded as long as you, a spouse, or someone acting for you states your intent to return), household goods and personal effects you need day to day, and one vehicle, regardless of value, used to transport you or someone in your household.2

Two other published lists point the same way:

• Federal SSI rules: Social Security doesn't count the home you live in and the land it's on, one vehicle of any value if someone in your household uses it for transportation, or household goods and personal effects.9
• DPHHS's general Medicaid brochure (current only as of 2017): lists a house and one car as exempt "under certain circumstances," along with most personal effects and household goods, low-face-value life insurance, burial plots, and a limited burial fund or irrevocable burial contract.10

Don't rule yourself out over home equity or a car; apply and let DPHHS do the count. The MSP resource limit is also far more generous than the federal SSI default of $2,000 (individual) and $3,000 (couple).9 Montana's separate nursing-home Medicaid program uses a much lower $2,000 single-applicant resource limit10 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 CFR 423.773(c), QMB, SLMB, and QI enrollees are treated as meeting the full-subsidy requirements, and the Centers for Medicare & Medicaid Services (CMS) notifies you that you don't need to apply.4

In 2026, full Part D Extra Help provides a $0 premium on a benchmark Part D plan (pick a pricier plan and you pay the difference), a $0 deductible, copays of no more than $5.10 per generic and $12.65 per brand-name prescription (lower for people who also have full Medicaid and income at or below 100% FPL, and $0 for full-Medicaid enrollees in a nursing home or getting home and community-based services), and $0 copays for the rest of the year once your out-of-pocket drug costs reach $2,100.4 Someone filling six generic prescriptions a month would pay at most about $367 in copays over the year (6 × $5.10 × 12) instead of full retail price, on top of the Part B premium savings.4

If your income is above the MSP limits, you may still qualify for Extra Help on its own: the 2026 limit is below 150% FPL, about $1,995 a month for one person or $2,705 for a married couple, and it rises if you support relatives who live with you. Apply online at ssa.gov/medicare/part-d-extra-help or call Social Security at 1-800-772-1213.4 DPHHS treats an Extra Help application to Social Security as an application for the Medicare Savings Programs too, so one filing starts both.2

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.10 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.