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

New Mexico's Medicare Savings Programs can wipe out or sharply cut your Medicare premiums and cost-sharing if your income is low. New Mexico is unusual in one important way: it applies no asset (resource) test to these programs, so what you have in the bank does not disqualify you. The broadest tier, QMB, pays your Part B premium and every Medicare deductible, copay, and coinsurance, and it is run through the New Mexico Health Care Authority.

What Are Medicare Savings Programs?

Medicare Savings Programs are Medicaid-administered benefits that pay a low-income Medicare beneficiary's premiums and cost-sharing. Under Title XIX of the Social Security Act, QMB, SLMB, and QI are mandatory eligibility groups that every state must cover.

In New Mexico, the programs are administered by the New Mexico Health Care Authority (HCA), the state's Medicaid agency (formerly the Human Services Department). The HCA's Income Support Division (ISD) processes applications and determines financial eligibility for all three tiers.1,2

New Mexico publishes its income limits as gross Federal Poverty Level (FPL) figures: QMB at or below 100% FPL, SLMB between 100% and 120% FPL, and QI between 120% and 135% FPL. That is why New Mexico's QMB limit of $1,305 a month for one person sits below the roughly $1,350 figure you may see quoted at the federal level: the federal number already folds in the $20 monthly general income disregard, while New Mexico lists the underlying FPL amount. The $20 general income disregard is still applied to your countable income before it is measured against the limit, so anyone slightly over the published figure should run the actual calculation before assuming they do not qualify.1

New Mexico Has No Asset Test

For most states, a Medicare Savings Program application turns on two tests: income and resources. New Mexico dropped the second one. Effective January 1, 2021, the state eliminated the resource (asset) limit for QMB, SLMB, and QI, and it is no longer applied.1

In practice, this means:

• Your checking, savings, CDs, stocks, and other assets are not counted for MSP eligibility in New Mexico.
• You do not have to "spend down" savings or reshuffle accounts to qualify.
• Only your income determines which tier you fall into.

If you were told years ago that too much in the bank ruled you out, that guidance is out of date in New Mexico. Only your monthly income matters now.

QMB: Qualified Medicare Beneficiary

QMB is the most comprehensive tier. It covers:

• The Medicare Part A premium (most beneficiaries already have premium-free Part A after 40 or more work quarters)
• The Medicare Part B standard premium, which is $202.90 a month in 20263
• The Part A inpatient hospital deductible, $1,736 per benefit period in 2026
• The Part B annual deductible, $283 in 2026
• All Medicare coinsurance and copays across every Medicare-covered service

2026 New Mexico QMB income limits: at or below $1,305 a month for a single person and $1,763 a month for a married couple. These are the state's published 100% FPL figures.1

There is no resource limit. For a single New Mexico senior on Social Security, QMB can be worth well over $4,000 a year once you add the $1,736 Part A hospital deductible and the $283 Part B deductible on top of roughly $2,435 in annual Part B premiums. Every QMB enrollee is automatically deemed eligible for full Part D Extra Help.3

SLMB: Specified Low-Income Medicare Beneficiary

SLMB pays one benefit: the Medicare Part B premium. At the 2026 standard rate of $202.90 a month, that is about $2,435 a year returned to the beneficiary.3

2026 New Mexico SLMB income limits: $1,305 to $1,565 a month for a single person and $1,763 to $2,115 a month for a couple. There is no resource limit.1

SLMB does not pay deductibles or copays, and New Mexico does not issue a Medicaid card for SLMB. For beneficiaries with limited medical utilization, the Part B premium is the dominant out-of-pocket cost, and SLMB eliminates it. SLMB enrollment also triggers automatic Part D Extra Help, which cuts generic copays to $5.10 and brand-name copays to $12.65 with a $0 deductible and $0 premium on a benchmark Part D plan.4

QI: Qualifying Individual

QI covers the Part B premium only, the same as SLMB, at a higher income band: $1,565 to $1,761 a month for a single person and $2,115 to $2,380 a month for a couple in 2026. There is no resource limit.1

Two structural differences set QI apart from QMB and SLMB:

1. First-come, first-served. QI is funded through a capped federal allotment. New Mexico allocates enrollment on a first-come, first-served basis, with preference for prior-year enrollees. Unlike QMB and SLMB, which are entitlements, QI enrollment is not guaranteed once the allotment is spent.
2. Mutually exclusive with full Medicaid. Anyone eligible for full-benefit Centennial Care cannot be on QI. They would instead receive the "Plus" version of QMB or SLMB, which layers full Medicaid benefits on top of the MSP cost-sharing protection.

QI enrollment also triggers automatic Part D Extra Help.

Full Program Comparison

Income limits reflect 100% FPL (QMB), 100 to 120% FPL (SLMB), and 120 to 135% FPL (QI). New Mexico applies no resource test to any tier.1

The QMB Billing Prohibition

Federal law (42 USC 1396a(n)(3)(B)) prohibits any Medicare provider from billing a QMB enrollee for Medicare cost-sharing. This applies to Original Medicare and Medicare Advantage providers, whether or not they contract with New Mexico Medicaid.1

If you receive a bill for a deductible, copay, or coinsurance as a QMB enrollee:

• Tell the provider you are enrolled in QMB and cite the federal prohibition on balance-billing.
• Show your HCA eligibility notice or your Medicare card with the QMB indicator.
• Call 1-800-MEDICARE (1-800-633-4227) to file a complaint.
• Contact New Mexico's State Health Insurance Assistance Program (SHIP) for free help disputing the bill.

Providers who have billed QMB enrollees in error must recall the bills from collections and refund any amounts already collected.

Part D Extra Help / Low-Income Subsidy

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

Under the 2026 Part D benefit structure, full Extra Help means:

• $0 premium on a benchmark Part D plan4
• $0 annual deductible
• No more than $5.10 per generic prescription
• No more than $12.65 per brand-name or preferred multi-source drug
• $0 in drug copays once your out-of-pocket costs reach the $2,100 annual cap

For a beneficiary filling several prescriptions a month, Extra Help can cut drug costs substantially over the course of a year. The deeming flows from HCA to CMS on a monthly cycle. If you are not already in a Part D plan, CMS will auto-assign you to a zero-premium benchmark plan.4

How to Apply for New Mexico Medicare Savings Programs

The Health Care Authority accepts applications online, by phone, in person, and through the Social Security Administration. Because there is no asset test, the application is largely about verifying your income and Medicare enrollment.

Filing Through Social Security

Applying for Part D Extra Help at the SSA using Form SSA-1020 generates a mandatory referral to New Mexico Medicaid under 42 USC 1320b-14. Your SSA filing date becomes the protected MSP filing date, which can matter for retroactive coverage.

Processing Timelines and Effective Dates

HCA must process non-disability MSP applications within 45 days under 42 CFR 435.912.

• QMB: coverage begins the first day of the month after HCA approves the application. Federal law prohibits retroactive QMB coverage, so apply as early as you can.
• SLMB and QI: up to three months of retroactive coverage is available if you were eligible during those months. File as early as possible to protect your filing date.

Where to Get Help

Learn More

Find personalized help applying for New Mexico 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.