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 goes further than the federal rules in one important way: it applies no asset (resource) test to QMB, SLMB, or QI, so what you have in the bank does not disqualify you from them. The broadest tier, QMB, pays your Part B premium and your Part A and Part B deductibles, copays, and coinsurance, and it is run through the New Mexico Health Care Authority.

What Are Medicare Savings Programs?

Medicare Savings Programs are state-run, Medicaid-administered programs that pay a low-income Medicare beneficiary's premiums and cost-sharing. There are four federally defined programs; the fourth, QDWI, pays the Part A premium for certain working people with disabilities, so this guide covers the other three: QMB, SLMB, and QI.1

In New Mexico, the programs are administered by the New Mexico Health Care Authority (HCA), the state's Medicaid agency. The HCA's Income Support Division (ISD) offices make the eligibility determinations for all three tiers.1,2

You need Medicare Part A to qualify for any of them. For QMB, you must already have Part A or be conditionally eligible for it; for SLMB and QI, you must already have Part A.1 Federal rules also require Part B for SLMB and QI.1

New Mexico publishes its limits as Federal Poverty Level (FPL) amounts: QMB below 100% FPL, SLMB below 120% FPL, and QI between 120% and 135% FPL. Its SLMB and QI figures are stated in countable monthly income, not gross income. That is why New Mexico's QMB limit of $1,330 a month for one person sits exactly $20 below the $1,350 figure you may see quoted at the federal level: Social Security's federal tables add the $20 monthly SSI general income exclusion on top of the FPL percentage, while New Mexico lists the FPL amount without it. New Mexico's pamphlet doesn't spell out which income it excludes, so if your income is a little above a New Mexico limit, apply anyway; Social Security tells its own staff to encourage people whose income looks somewhat higher than the state limits to apply.1

New Mexico Has No Asset Test for QMB, SLMB, or QI

The federal Medicare Savings Program rules set two tests: income and resources.1 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. That change does not reach New Mexico's separate QD (QDWI) category, which pays the Part A premium for certain working people under 65 with disabilities and still has a $4,000 resource limit for an individual.1

In practice, this means:

• Your checking, savings, CDs, stocks, and other assets are not counted for QMB, SLMB, or QI 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, if you owe one (most people get Part A premium-free because they or a spouse paid Medicare taxes long enough while working, generally at least 10 years)3
• 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 20263
• The Part B annual deductible, $283 in 20263
• All Part A and Part B coinsurance and copays for Medicare-covered services. It does not cover Part D drug copays; through Extra Help, a QMB enrollee pays no more than $12.65 per covered drug in 2026.1

2026 New Mexico QMB income limits: at or below $1,330 a month for a single person and $1,804 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 in a year with a hospital stay, 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.3 Every QMB enrollee is automatically deemed eligible for full Part D Extra Help.4

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: countable income of $1,330 to $1,596 a month for a single person, and $1,804 to $2,164 a month for a married applicant whose spouse isn't eligible and whose spouse's income is deemed to them. 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 caps generic copays at $5.10 and brand-name copays at $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: countable income of $1,596 to $1,796 a month for a single person and $2,164 to $2,435 a month for a married applicant whose spouse's income is deemed, 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 paid from a capped annual federal allocation to each state and granted first-come, first-served, with preference for people who received QI in the last month of the previous year. You must reapply every year, and being selected one year doesn't guarantee help the next.1
2. Not for people with full Medicaid. QI is only for people who don't qualify for any other Medicaid coverage. Anyone eligible for full New Mexico Medicaid, which has run as Turquoise Care since July 1, 2024, cannot be on QI, though they may qualify for help from another Medicare Savings Program.1,2

QI enrollment also triggers automatic Part D Extra Help.4

Full Program Comparison

Income limits reflect below 100% FPL (QMB), below 120% FPL (SLMB), and 120 to 135% FPL (QI); the SLMB and QI figures are countable income, and their married figures apply when a spouse who isn't eligible has income deemed to the applicant. New Mexico applies no resource test to any of these three tiers.1 All three tiers carry automatic Part D Extra Help, because federal rules deem QMB, SLMB, and QI full-subsidy eligible; QDWI, the fourth federal Medicare Savings Program, does not confer it.1

The QMB Billing Prohibition

Federal law prohibits Medicare providers and suppliers, including pharmacies, from billing a QMB enrollee for Medicare Part A and Part B cost-sharing. This applies to Original Medicare and Medicare Advantage providers, not only those that accept Medicaid.5

If you receive a bill for a Part A or Part B 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 both your Medicare card and your Medicaid or QMB card each time you get care.5
• Call 1-800-MEDICARE (1-800-633-4227), Medicare's official line, for help with the bill.6
• Contact New Mexico's State Health Insurance Assistance Program (SHIP) at 1-800-432-2080 for one-on-one help disputing the bill.7

CMS tells providers who have billed QMB enrollees for Medicare cost-sharing to recall those bills, including bills sent to collections, and to refund any amounts already collected.5

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 plan (choose a pricier plan and you pay the difference)4
• $0 annual deductible
• No more than $5.10 per generic prescription
• No more than $12.65 per brand-name 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. CMS notifies deemed enrollees that they do not need to apply for the subsidy.4

How to Apply for New Mexico Medicare Savings Programs

The Health Care Authority accepts applications online and by phone, at any time. Because QMB, SLMB, and QI have no asset test, the application is largely about verifying your income and Medicare enrollment.2

Processing Timelines and Effective Dates

Federal rules give a state Medicaid agency up to 45 days to decide an application that isn't based on disability, except in unusual circumstances.8

• QMB: coverage applies to services furnished after the end of the month in which HCA determines you eligible, so it starts the month after approval and does not reach back before it. Apply as early as you can.9
• SLMB and QI: the federal provisions we rely on don't set a retroactive window for these two programs, so ask HCA how far back your coverage can start, and file as early as possible.

General Medicaid coverage can reach back up to three months before the month you apply, if you received covered services then and would have been eligible. Three months is the federal default, and a state's window can be shorter under an approved Section 1115 demonstration. It is also shrinking nationally: for applications made on or after January 1, 2027, federal law cuts it to two months before the application month for most enrollees. Ask HCA how the rule applies to the group you are applying under.10

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.