New York Medicare Savings Programs 2026: QMB & QI, No Asset Test

New York's Medicare Savings Programs pay the Medicare Part B premium of $202.90 a month in 2026.1 The broadest tier also covers every Medicare deductible, coinsurance, and copay. New York runs these programs through its Medicaid program with two features that make them more generous than most states: no asset test and income limits set well above the federal poverty floor.2

What Are New York Medicare Savings Programs?

Medicare Savings Programs are Medicaid-administered benefits that pay some or all of a low-income Medicare beneficiary's Medicare premiums and cost-sharing. QMB and QI are mandatory eligibility groups under Title XIX of the Social Security Act, so New York, like every state, must offer them.

New York State Medicaid administers these programs through the Department of Health (DOH). Applications in New York City go through the Human Resources Administration (HRA); applications outside the five boroughs go through the Local Department of Social Services (LDSS) in each county. You can also apply through NY State of Health, the state's official health plan marketplace. The statewide Medicaid Helpline is 1-800-541-2831.2

Medicare Savings Programs exist because Medicare itself leaves real 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 accruing on most covered services after the deductible is met.1 For a New York resident who qualifies, a Medicare Savings Program pays those costs directly.

New York counts income under the aged, blind, and disabled (ABD) methodology tied to Supplemental Security Income (SSI), not the Modified Adjusted Gross Income (MAGI) rules that govern marketplace coverage. A $20 general income disregard is subtracted first, so New York publishes both a gross monthly figure and an effective figure that already includes the $20. The effective figures in this guide are the operative limits.2

QMB: Qualified Medicare Beneficiary

QMB is the most comprehensive New York Medicare Savings Program. It pays both the Medicare Part A and Part B premiums and covers all Medicare cost-sharing, including deductibles, coinsurance, and copays.

The income limits above are New York's 2026 QMB effective figures, which include the $20 general income disregard. The gross figures are $1,836 for an individual and $2,489 for a couple. New York applies no asset test to QMB.2 Most seniors already have premium-free Part A based on at least 40 quarters of work; QMB pays the Part A premium only for the minority who do not (up to $311 per month with 30 to 39 quarters, or $565 per month with fewer than 30).1

Every QMB enrollee is also automatically deemed eligible for full Part D Extra Help.

The QMB Billing Prohibition

Federal law bars any Medicare provider or supplier, including pharmacies, from billing a QMB enrollee for Medicare Part A or Part B cost-sharing, even when Medicaid pays nothing toward it. The prohibition covers Original Medicare and Medicare Advantage providers alike, whether or not they participate with New York Medicaid, under Social Security Act sections 1902(n)(3)(B) and 1866(a)(1)(A).4

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 Medicaid eligibility notice or your Medicare card.
3. Call 1-800-MEDICARE (1-800-633-4227) to report the billing violation.
4. Contact New York's Health Insurance Information, Counseling and Assistance Program (HIICAP) at 1-800-701-0501 for free help disputing the bill.

The provider must recall the bill from collections and refund any amount already collected.

QI: Qualifying Individual

QI pays the Part B premium only, for a New York resident with income above the QMB limit but below 186% FPL.2

The QI limits above are New York's 2026 effective figures including the $20 disregard; the gross figures are $2,474 for an individual and $3,355 for a couple. As with QMB, there is no asset test.2 At the 2026 Part B rate of $202.90 per month, QI returns $2,434.80 over a year to a beneficiary's Social Security deposit.1

Two QI-specific rules matter. First, QI is funded through a capped federal allotment and filled first-come, first-served, with priority for prior-year enrollees; unlike QMB, it is not a statutory entitlement. Second, QI is mutually exclusive with full Medicaid: anyone eligible for a full-benefit Medicaid category cannot be on QI. They would instead receive QMB with full Medicaid layered on top.2

Like QMB, QI enrollment triggers automatic Part D Extra Help.

What Happened to SLMB in New York?

Most states run three Medicare Savings Programs: QMB, SLMB (Specified Low-Income Medicare Beneficiary), and QI. New York runs only two. It eliminated the separate SLMB tier and raised the QMB income ceiling to 138% FPL, absorbing the income band SLMB used to cover.2

This is good news for New York seniors. In a state with a separate SLMB tier, a beneficiary in that middle income band gets only the Part B premium paid. In New York, the same beneficiary now qualifies for QMB, which pays the Part B premium and every Medicare deductible, coinsurance, and copay. If you have seen older guidance pointing you to "New York SLMB," apply for QMB instead. You are likely eligible for the broader benefit.

Full Comparison: New York 2026 Medicare Savings Programs

Both programs use income-only tests with no resource limit, and both trigger automatic Part D Extra Help. The dollar limits reset each year when the Federal Poverty Levels update, so confirm the current figures on New York's Medicare Savings Program page or with HIICAP before relying on a specific number.2

New York Has No MSP Asset Test

Unlike most states, New York imposes no resource (asset) limit on any Medicare Savings Program. Your savings and checking balances, stocks, bonds, certificates of deposit, mutual funds, a second vehicle, a second home, and cash-value life insurance do not count against eligibility. Only your monthly income is evaluated.2

To see how unusual this is, compare the federal defaults. Most states apply a Medicare Savings Program resource limit of $9,950 for an individual and $14,910 for a couple in 2026, and the federal SSI program itself caps countable resources far lower, at $2,000 for an individual and $3,000 for a couple.1,5 New York waives all of it. A New York applicant with a paid-off home and substantial retirement savings can still qualify, as long as monthly income falls within the program limits.

Part D Extra Help

Enrollment in any New York Medicare Savings Program automatically qualifies you for full Part D Extra Help, also called the Low-Income Subsidy (LIS). New York transmits your enrollment to the Centers for Medicare & Medicaid Services (CMS) each month, so no separate application is required.

In 2026, full Part D Extra Help provides a $0 premium on any benchmark Part D plan, a $0 deductible, a $5.10 copay per generic prescription, a $12.65 copay per brand-name prescription, and $0 copays for the rest of the year once your out-of-pocket drug costs reach $2,100.3 For a New York senior filling several prescriptions a month, that can mean hundreds to thousands of dollars in annual drug-cost savings, on top of the Part B premium savings.

If your income is above the QI limit but at or below 150% FPL (about $1,995 per month for an individual or $2,705 for a married couple in 2026), you can still apply for Extra Help directly using Form SSA-1020 at any Social Security Administration (SSA) office or online at SSA.gov. SSA forwards the application to New York Medicaid as an automatic Medicare Savings Program referral, using your SSA filing date as the protected date.3

How to Apply for New York Medicare Savings Programs

New York offers several application pathways. NY State of Health accepts Medicaid and Medicare Savings Program applications year-round and is generally the fastest route for anyone comfortable applying online.

Once you are approved, New York sets up a state buy-in with CMS that stops the Part B premium from being deducted from your Social Security check. There is usually a short processing lag, so you may see the premium withheld for a month or two after approval; any amounts withheld for months New York is now responsible for are credited back to you. Do not pay the Part B premium separately after a Medicare Savings Program approval.6

QMB coverage begins the first day of the month after New York approves the application, with no retroactive period. QI allows up to three months of retroactive coverage under 42 CFR 435.915 if you were eligible during those months, so file as early as possible to protect that window.

Where to Get Help in New York

New York-Specific Notes

New York coordinates its Medicare Savings Programs with a robust Medicaid long-term-care system. A QMB or QI enrollee who later develops long-term-care needs may qualify for a Managed Long Term Care (MLTC) plan, which provides home-based services through a managed care organization. MLTC and Medicare Savings Programs operate compatibly.

New York's Community Medicaid program is a separate benefit that provides home care and other services. For 2026, the Community Medicaid monthly income level is $1,836 for a single applicant and $2,489 for a couple, with a non-MAGI resource limit of $33,038 for a single applicant.7 A senior whose income falls within the Medicare Savings Program limits may qualify for both a Medicare Savings Program and Community Medicaid at the same time.

Applicants with income above the Community Medicaid level can still qualify for home care by depositing surplus income into a pooled income trust. That mechanism is distinct from the Medicare Savings Programs described here but is often relevant for seniors who qualify for both.

Learn More

Find personalized help applying for New York 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.