Nebraska Medicare Savings Programs 2026: QMB, SLMB & QI

Nebraska's Medicare Savings Programs pay the Medicare Part B premium, and for the lowest-income tier every Part A and Part B deductible and copay, for beneficiaries with limited income and resources. Nebraska uses the standard federal income limits and a resource test, so both your monthly income and your countable assets decide whether you qualify.1

What Are Medicare Savings Programs?

Medicare Savings Programs are state-run, Medicaid-administered programs that help people with limited income and resources pay their Medicare premiums and, for QMB, their Medicare cost-sharing.1

In Nebraska, all three programs are administered by Nebraska Medicaid, the Division of Medicaid and Long-Term Care within the Nebraska Department of Health and Human Services (DHHS). Applicants apply online through iServe Nebraska, over the phone, or on a paper application mailed to a DHHS office, and DHHS makes the eligibility determination.3

Nebraska's published income limits are the federal tiers, not higher ones, and Nebraska applies a resource test. Two sets of numbers circulate for the same limits. Nebraska DHHS's own eligibility table prints plain poverty-level figures, such as $1,330 a month for QMB for one person. Social Security publishes the same limits with the $20 monthly Supplemental Security Income (SSI) general income exclusion already added, which gives $1,350. They are the same limit counted before and after that $20, not a discrepancy, and this guide uses the figures with the $20 added.1

QMB: Qualified Medicare Beneficiary

QMB is the most comprehensive Nebraska Medicare Savings Program tier. It covers:

• The Medicare Part A premium (most people pay no Part A premium because they or a spouse paid Medicare taxes long enough while working, generally at least 10 years)
• The Medicare Part B premium, which is $202.90 per month in 2026
• The Part A inpatient hospital deductible, which is $1,736 per benefit period in 2026
• The Part B annual deductible, which is $283 in 2026
• All Part A and Part B coinsurance and copays for Medicare-covered services4

2026 Nebraska QMB income limits: at or below $1,350/month for a single person, or at or below $1,824/month for a couple. These are 100% of the Federal Poverty Level plus the $20 SSI general income exclusion; Nebraska's own table prints them as $1,330 and $1,804.1

Resource limit: $9,950 for one person, $14,910 for a couple.1 The home you live in and one vehicle used for transportation are not counted (more on this below).2

For a single Nebraska senior on Social Security, QMB wipes out the Part B premium ($202.90 a month, or $2,434.80 a year), the $283 Part B deductible, and the $1,736 Part A hospital deductible, plus every Part A and Part B copay and coinsurance charge for Medicare-covered services.4 Every QMB enrollee also automatically qualifies for Part D Extra Help.1

QMB does not pay your Medicare drug-plan copays. Those fall to Extra Help, under which a QMB enrollee pays no more than $12.65 per covered drug in 2026. You may also get a bill for a small Medicaid copayment, if one applies.1

SLMB: Specified Low-Income Medicare Beneficiary

SLMB covers one benefit: the Medicare Part B premium. At the 2026 standard rate of $202.90 a month, that is worth $2,434.80 for the year.4

2026 Nebraska SLMB income limits: more than the QMB limit and up to $1,616/month for a single person, or up to $2,184/month for a couple. The resource limit is the same as QMB, $9,950 single and $14,910 couple. You must have both Part A and Part B to qualify.1

SLMB does not cover deductibles or copays. But for a beneficiary with relatively few medical claims, eliminating the Part B premium is the dominant cost saving. SLMB enrollment also triggers automatic Part D Extra Help, which caps covered drug copays at $5.10 for generics and $12.65 for brand-name drugs in 2026.5

QI: Qualifying Individual

QI pays the Part B premium only, the same as SLMB, but applies at a higher income band: more than the SLMB limit and up to $1,816/month for a single person, or up to $2,455/month for a couple. The resource limit is again $9,950 single and $14,910 couple, and as with SLMB you must have both Part A and Part B.1

Three structural differences set QI apart from QMB and SLMB:

1. First-come, first-served. QI is paid for out of a capped annual federal allocation to each state, and states approve applications first-come, first-served, with priority for people who got QI the previous year.1 Being eligible is not a guarantee of payment: an otherwise-eligible applicant can be turned away when the state has no slot left, and that denial says nothing about their Medicaid eligibility.6
2. Only for people with no other Medicaid. QI is only for people who don't qualify for any other Medicaid coverage, though they may qualify for help from another Medicare Savings Program.1 Someone who qualifies for both a Medicare Savings Program and full Medicaid is a QMB Plus or SLMB Plus enrollee, never a QI, so being shut out of QI because you already have Medicaid is not a loss of coverage.6 Nebraska spells out the same line in its own terms: a QI enrollee cannot be otherwise eligible for any other Nebraska Medicaid category, so if you would also qualify for medically needy (share-of-cost) coverage, you have to choose that coverage or QI, not both.1
3. You have to apply every year. Being selected for QI in one year does not entitle you to continued assistance in any later year, so file again each year to stay in it.1

Like SLMB, QI enrollment triggers automatic Part D Extra Help.1

The QMB Billing Prohibition

Federal law prohibits providers from billing a QMB enrollee for Medicare cost-sharing.1 The bar covers every Medicare provider and supplier, pharmacies included, and every Part A and Part B deductible, coinsurance and copay, even when Nebraska Medicaid pays nothing toward the bill. A provider that breaks it is violating its Medicare provider agreement or its Medicare Advantage (Part C) obligations (Social Security Act section 1902(n)(3)(B) and related sections).7

If you are a Nebraska QMB enrollee and receive a bill for a deductible, coinsurance, or copay from any Medicare provider, do not pay it. The provider cannot legally collect it. Instead:

• Tell the provider you are enrolled in QMB and cite the federal prohibition.
• Show both your Medicare and Medicaid cards (or a QMB Program card), or a Medicare Summary Notice that says you're in the QMB Program.7
• If the billing continues, call 1-800-MEDICARE (1-800-633-4227). Medicare can confirm your QMB status and ask the provider to stop billing you and refund what you've paid.7
• Contact Nebraska SHIP, the State Health Insurance Assistance Program, for free one-on-one help with the problem.8

CMS tells providers to recall any QMB cost-sharing bill, including one turned over to collections, and to refund any cost-sharing money already collected.7

Part D Extra Help / Low-Income Subsidy

Every Nebraska QMB, SLMB, and QI enrollee is automatically deemed eligible for full Part D Extra Help (the Low-Income Subsidy). No separate application is required.1

Under the 2026 Part D benefit rules, full Extra Help caps your out-of-pocket cost at $5.10 per generic prescription and $12.65 per brand-name drug, and once your out-of-pocket drug spending reaches $2,100 for the year, you pay $0 for covered drugs the rest of the year.5

Because the deeming is automatic, the Centers for Medicare & Medicaid Services (CMS) notifies deemed enrollees that they do not need to apply for Extra Help.5

Nebraska Medicare Savings Programs: 2026 Income Limits at a Glance

The "what it pays" column covers Medicare Part A and Part B costs only. Each of these three programs also automatically qualifies you for full Part D Extra Help, so no row below is the whole benefit.1

These income limits reflect 100% of the Federal Poverty Level for QMB, 100 to 120% for SLMB, and 120 to 135% for QI, each with the $20 SSI general income exclusion added. The resource limit for all three is $9,950 single and $14,910 couple.1 Both sets of figures are 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

What Counts as a Resource and What Doesn't

Nebraska applies a resource test of $9,950 (single) / $14,910 (couple).1 Under federal law, Medicare Savings Program resources are measured with the Supplemental Security Income (SSI) rules, and those rules leave several major assets out.9

Not counted:

• The home you live in, and the land it sits on
• One vehicle, whatever its value, if you or someone in your household uses it for transportation
• Household goods and personal effects2
• Burial spaces such as a plot, crypt, headstone or vault, plus up to $1,500 each for you and your spouse in funds set aside for burial and kept separate from your other money9

Usually counted:

• Checking and savings account balances
• Stocks, bonds, certificates of deposit, and mutual funds10
• A second vehicle, or land and buildings other than your home10
• The cash value of life insurance, when the policies on one person have a combined face value over $1,5002

Owning a home does not rule you out, because the home you live in is not a countable resource.2 A QMB applicant who owns a paid-off home can still qualify as long as their countable resources fall within $9,950.1

How the Income Disregards Work

Looking only at gross income can lead an eligible Nebraska senior to skip these programs. The SSI rules these programs use do not count all income, so a gross figure above the threshold does not settle the question.9

The $20 SSI general income exclusion is already built into the limits above: Social Security's figures add $20 on top of the poverty-level amount Nebraska prints, so $1,350 and $1,330 are the same QMB limit for one person.1 Beyond that, states can effectively raise these limits by disregarding certain amounts or types of income and resources, so someone whose income looks somewhat over should apply and let DHHS decide.1

Run the actual disregard math, or ask a counselor to run it, before concluding you do not qualify.

Where to Get Help in Nebraska

How to Apply for Nebraska Medicare Savings Programs

Determination Timeline and Effective Dates

Federal rules give Nebraska DHHS no more than 45 days to decide a Medicaid application, or 90 days if you apply on the basis of disability (42 CFR § 435.912), except in unusual circumstances such as an applicant delaying a required step or an emergency beyond the agency's control.13

• QMB: coverage is prospective only under federal law, applying to services furnished after the end of the month in which the determination is made.14 In Nebraska, payment starts the first of the month after the month DHHS processes your eligibility determination. Nebraska's own example: meet every QMB requirement on August 15, and premiums, deductibles and coinsurance are paid from September 1, with nothing for earlier months. Apply as early as possible.1
• QI: Nebraska allows up to three months of retroactive QI coverage before the month you apply, but only for months in which you met every QI requirement, and never earlier than January 1 of the same calendar year, so a February application reaches January but not the previous November or December.1
• SLMB: ask Nebraska DHHS how far back your SLMB coverage can start. For Medicaid in general, federal law makes eligibility effective as early as the third month before the month you apply, if you received covered services then and would have qualified, and the state plan sets the exact start date.6 File early either way.

Three months is the federal default for Medicaid, and a state's actual window can be shorter, because Section 1115 of the Social Security Act lets HHS approve demonstration projects that change what a state provides. The default itself shrinks for applications made on or after January 1, 2027, to two months before the application month for most enrollees. Confirm the window for your program with Nebraska DHHS before you count on it.6

DHHS then notifies you of its decision.13

Learn More

Find personalized help applying for Nebraska 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.