New Jersey Medicare Savings Programs 2026: QMB, SLMB & QI

If you have Medicare and a limited income, New Jersey's Medicare Savings Programs can erase the $202.90 monthly Part B premium.1

The broadest tier, QMB, also wipes out your Medicare deductibles and copays. All three are Medicaid programs, part of NJ FamilyCare, and enrolling in any one of them automatically opens the door to Part D drug-cost help.2

What Are Medicare Savings Programs?

Medicare Savings Programs are Medicaid-administered benefits that pay some or all of a low-income Medicare beneficiary's premiums and cost-sharing. QMB, SLMB, and QI are mandatory eligibility groups under federal law, so New Jersey is required to offer all three.2,5

The programs count your income and resources under Supplemental Security Income (SSI) rules, not the MAGI rules used for most other NJ FamilyCare coverage.6 That puts them alongside New Jersey's Aged, Blind, and Disabled (ABD) Medicaid programs, the non-MAGI, SSI-related coverage for people 65 and older or blind or disabled, which looks at both income and countable resources.7

The state's Division of Aging Services publishes the Medicare Savings Program eligibility limits and takes applications for QMB, SLMB, and QI through NJSave, its online and paper application for older adults and people with disabilities.8

QMB: Who Qualifies and What It Pays

QMB is the broadest tier. To qualify in 2026, a single New Jersey resident's countable monthly income must be at or below $1,350 ($1,824 for a couple), with countable resources at or below $9,950 ($14,910 for a couple).2

QMB covers:

• The full Medicare Part B premium, $202.90 a month in 2026
• The Medicare Part B deductible, $283 in 2026
• The Medicare Part A hospital deductible, $1,736 per benefit period in 20261
• The Part A premium, which most people already receive at no cost after 40 quarters of work
• All Medicare coinsurance and copays on covered services

The Part B premium alone is worth about $2,435 a year ($202.90 a month over 12 months), before you count the deductibles and coinsurance QMB also erases.1 Every QMB enrollee is also automatically qualified for full Part D Extra Help.2

SLMB: Help With the Part B Premium

SLMB covers one thing: the Medicare Part B premium. A single New Jersey resident qualifies with monthly income above the QMB limit and at or below $1,616 ($2,184 for a couple), and the resource limit is the same $9,950 and $14,910.2

At the 2026 rate, that single benefit is worth about $2,435 a year ($202.90 a month). SLMB does not touch deductibles or copays, but for someone with few medical bills, wiping out the Part B premium is the savings that matters most.1 SLMB also confers automatic Part D Extra Help.2

QI: The Part B Premium at a Higher Income

QI pays the Part B premium too, but at a higher income band: above the SLMB limit and up to $1,816 a month for a single person ($2,455 for a couple), with the same $9,950 and $14,910 resource limits.2

Three things set QI apart from QMB and SLMB. First, you must apply every year: selection for QI in one year does not entitle you to continued assistance in any following year, though once you're selected you keep QI for the rest of that year as long as you still qualify. Second, it is funded by a capped federal allotment, so New Jersey enrolls applicants first-come, first-served, giving preference to people who had QI or other Medicare Savings Program help in the last month of the previous year, and cannot guarantee a spot the way it must for QMB and SLMB. Third, there is no QI-Plus: unlike QMB and SLMB, you can't get QI if you qualify for any other New Jersey Medicaid coverage, though you may still qualify for help from another Medicare Savings Program.9 Like SLMB, QI enrollment triggers automatic Part D Extra Help.2

New Jersey 2026 Income Limits at a Glance

These bands reflect 100% of the Federal Poverty Level for QMB, 100 to 120% for SLMB, and 120 to 135% for QI, with the standard monthly income disregard already built in. The resource limit for all three is $9,950 for a single person and $14,910 for a couple. Both sets of figures are the federal standard, not an absolute cutoff: states can effectively raise the income and the resource limits by disregarding certain income and resources, and SSA tells staff to encourage people to apply even when income or resources appear somewhat higher.2,1

New Jersey publishes its own limits as annual figures rather than monthly ones, and those are the numbers the state's own materials quote. The Division of Aging Services lists QMB at $15,960 a year for a single person and $21,640 for a married couple, SLMB at $19,152 and $25,968, and QI at $21,546 and $29,214, and applies the same $9,950 and $14,910 asset limits to all three. All three programs also pay any Medicare late enrollment penalty you owe.8

The state's annual figures do not line up exactly with the monthly limits above multiplied by twelve. If your income lands anywhere near a line, ask Aging Services or NJ SHIP to run your numbers before you rule yourself out.

What Counts as a Resource in New Jersey

New Jersey's $9,950 and $14,910 resource test counts less than many people expect, because the biggest assets are excluded.2 The programs use SSI's resource rules, and SSI doesn't count the following (the list is a sample, not the full set):6

Excluded (do not count):

• The home you live in, and the land it sits on
• One vehicle, regardless of value, if someone in your household uses it for transportation
• Household goods and personal effects3
• Burial spaces such as a plot, crypt, or headstone, plus up to $1,500 each for you and your spouse kept in a separate fund clearly set aside for burial6

Counted:

• Checking and savings account balances
• Stocks, bonds, certificates of deposit, and mutual funds10
• A second home or a second vehicle
• The cash value of life insurance, once the policies on one person have a combined face value above $1,5003

Many New Jersey seniors rule themselves out because they think of their house as an asset. It is not. Someone who owns a paid-off home can still qualify for QMB, as long as their bank balances and other countable assets stay under the limit.

New Jersey PAAD and Senior Gold: Beyond the MSP Limits

If your income runs above the Medicare Savings Program limits, two New Jersey state programs can still help with prescription costs. Both are run by the Division of Aging Services, both are applied for through NJSave, and both wrap around your Medicare Part D plan.4

PAAD (Pharmaceutical Assistance to the Aged and Disabled) is the lower-income tier. You must be a New Jersey resident age 65 or older, or 18 to 64 and receiving Social Security disability benefits, with 2026 income under $54,943 if single or $62,390 if married. PAAD charges $5 for each covered generic and $7 for each covered brand-name drug, and it pays the monthly premium for certain basic Part D plans priced at or below the regional benchmark. Someone receiving Medicaid isn't eligible for PAAD.4

Senior Gold is the higher-income tier, for 2026 income between $54,943 and $64,943 if single or between $62,390 and $72,390 if married. You pay $15 plus half of the remaining cost of each covered drug until your out-of-pocket spending passes $2,000 for the year ($3,000 for a couple), then a flat $15 per prescription. Senior Gold doesn't pay your Part D premium.4

Because the two income bands don't overlap, you'd qualify for one tier or the other. Call the PAAD and Senior Gold line at 1-800-792-9745 to ask how either program fits with a Medicare Savings Program before deciding you earn too much to get help.4

Billed for a Copay While on QMB? Don't Pay It

Federal law bars every Medicare provider and supplier, pharmacies included, from billing a QMB enrollee for Medicare Part A or Part B deductibles, coinsurance, or copays, even if Medicaid doesn't pay the provider in full. This holds whether you have Original Medicare or a Medicare Advantage plan, and whether or not the provider takes NJ FamilyCare. The one bill that can still come is a small Medicaid copayment, if one applies.2,8

If a hospital, doctor, or other provider sends you a cost-sharing bill:

• Tell them you are a QMB enrollee and that federal law prohibits the charge.
• Show your Medicare card and your Medicaid or QMB card; with Original Medicare, your Medicare Summary Notice also shows you're in QMB.8
• 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.11,12
• Contact New Jersey's State Health Insurance Assistance Program (SHIP) at 1-800-792-8820 for free help disputing the bill.13

New Jersey SHIP, run by the state Department of Human Services, gives free Medicare counseling through trained volunteers, with counseling sites in all 21 counties, and its counselors don't sell, recommend, or endorse any insurance plan, company, or agent.13 A provider who wrongly billed a QMB must recall the bill, including one sent to collections, and refund anything already collected.8

MSP Automatically Opens Part D Extra Help

Enrolling in QMB, SLMB, or QI automatically qualifies you for the full Part D Extra Help, also called the Low-Income Subsidy, with no separate application.2

In 2026, full Extra Help caps covered generic drugs at $5.10 and covered brand-name drugs at $12.65, and drops your cost to $0 once your out-of-pocket drug spending reaches $2,100 for the year. On a benchmark plan, the Part D premium and deductible are both $0.14

Federal rules call this being deemed eligible, and the status lasts at least through the end of the calendar year, and if you're deemed eligible between July 1 and December 31 it runs through the following year too. If you later lose your Medicare Savings Program, you keep Extra Help for the rest of that year but need to file an Extra Help application for the next one. A gain, loss, or change in your Extra Help or Medicaid status also opens a 3-month window to join or switch Part D plans.15

How New Jersey Counts Your Income

A common reason New Jersey seniors skip these programs: they look at their gross Social Security check, see it above the limit, and stop. The SSI-related methodology sets aside part of your income before comparing it to the ceiling.

New Jersey's 100% Federal Poverty Level figure for 2026 is $1,330 a month for a single person ($1,804 for a couple).7 The QMB ceiling lands slightly higher, at $1,350 ($1,824), because the SSI rules set aside the first $20 of monthly income before counting it. A single person with $1,370 in Social Security has $1,350 in countable income, right at the QMB line.2

If you work, the SSI rules leave out the first $65 of monthly earnings and half of the rest, so less than half of your gross wages actually counts.6 The practical lesson: run your real numbers, or ask NJ SHIP to run them, before deciding you earn too much to qualify.

How to Apply for a New Jersey Medicare Savings Program

Federal rules cap how long New Jersey's Medicaid agency may take on a Medicare Savings Program application: no more than 90 days for applicants who apply for Medicaid on the basis of disability, and no more than 45 days for all other applicants, including an MSP applicant who applies on the basis of age.17 Which cap applies turns on the basis you applied under, not on whether a disability determination happens to arise. The agency can run past it in unusual circumstances, such as a delay by the applicant or an examining physician, so treat it as a ceiling on the agency rather than a promised decision date.17 QMB coverage starts with services you get after the end of the month in which you're approved, so it can't reach back to earlier bills, and applying early matters.18 That QMB rule doesn't govern SLMB or QI, and each state's own Medicaid plan sets its effective dates, so ask the agency or NJ SHIP how far back SLMB or QI coverage can start for you.18

If you'd rather start with Part D Extra Help, you can apply for it directly through the Social Security Administration (SSA), online or at 1-800-772-1213.14

Learn More

Find personalized help applying for New Jersey 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.