North Dakota Medicare Savings Programs 2026: QMB, SLMB & QI

In North Dakota, three Medicare Savings Programs help people on Medicare with limited income pay their Medicare Part B premium, which is $202.90 a month in 2026. The highest tier, the Qualified Medicare Beneficiary (QMB) program, goes further and also covers Medicare deductibles and copays. North Dakota Health and Human Services runs all three on the standard federal income limits, so a single applicant with monthly income at or below about $1,816 can usually qualify for one of them.1,2

What Are Medicare Savings Programs?

Medicare Savings Programs are Medicaid-administered benefits that pay some or all of a low-income Medicare beneficiary's Medicare premiums and cost-sharing. Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualifying Individual (QI) are mandatory eligibility groups under Title XIX of the Social Security Act, so every state, including North Dakota, must cover them.

North Dakota Health and Human Services (ND HHS) administers all three programs, with eligibility processed through county Human Service Zones across the state. North Dakota is a Section 209(b) state, meaning it can apply some financial methodologies independently from Supplemental Security Income (SSI) rules. For Medicare Savings Programs, though, federal law requires the standard Federal Poverty Level (FPL) income thresholds, so the 209(b) election does not tighten MSP eligibility here.3

Medicare Savings Programs use the SSI income-counting rules, which subtract a $20 general income disregard from most monthly income before it is measured against the limit. The income bands in this guide already reflect that $20 disregard.2

QMB: Qualified Medicare Beneficiary

QMB is the most comprehensive tier. It covers:

• The Medicare Part A premium, if you owe one (most people get premium-free Part A after 40 or more work quarters)
• The Medicare Part B premium, $202.90 a month in 20261
• The Part A inpatient hospital deductible, $1,736 per benefit period in 20261
• The Part B annual deductible, $283 in 20261
• All Medicare coinsurance and copays on Medicare-covered services

2026 North Dakota QMB income limits: at or below $1,350 a month for a single person, or $1,824 a month for a couple. These reflect 100% of the Federal Poverty Level with the $20 general income disregard applied.2

Resource limit: $9,950 for one person, $14,910 for a couple. Your primary home and one vehicle are excluded entirely.2

For a single North Dakota senior, QMB eliminates the $202.90 monthly Part B premium and, on top of that, erases the $283 Part B deductible, the $1,736 Part A hospital deductible, and every Medicare copay on a covered service. Every QMB enrollee is also automatically enrolled in full Part D Extra Help.1

SLMB: Specified Low-Income Medicare Beneficiary

SLMB covers one thing: the Medicare Part B premium, which is $202.90 a month in 2026.1

2026 North Dakota SLMB income limits: over $1,350 up to $1,616 a month for a single person, and over $1,824 up to $2,184 a month for a couple. The resource limit is the same as QMB: $9,950 single, $14,910 couple.2

Unlike QMB, SLMB does not pay deductibles or copays. But for a beneficiary with few medical claims, the Part B premium is usually the largest fixed Medicare cost, and SLMB removes it cleanly.

SLMB also confers automatic Part D Extra Help, which caps covered drugs at $5.10 per generic and $12.65 per brand-name prescription in 2026, with a $0 deductible and a $0 premium on a benchmark Part D plan.4

QI: Qualifying Individual

QI covers the Part B premium only, the same as SLMB, but at a higher income band: over $1,616 up to $1,816 a month for a single person, and over $2,184 up to $2,455 a month for a couple (2026 North Dakota figures).2

Two things set QI apart from QMB and SLMB:

1. First-come, first-served. QI is funded through a capped federal allotment. North Dakota enrolls applicants on a first-come, first-served basis, with a preference for prior-year QI enrollees. Unlike QMB and SLMB, which are entitlements, QI enrollment is not guaranteed once the annual allotment runs out.
2. Mutually exclusive with full Medicaid. If you qualify for any full-benefit Medicaid category, you cannot be on QI. You would instead qualify for QMB-Plus or SLMB-Plus, which pair MSP cost-sharing protection with full Medicaid coverage.

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

The QMB Billing Prohibition

Federal law, specifically 42 U.S.C. § 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 alike, whether or not they participate with North Dakota Medicaid.5

In plain terms: if you are a QMB enrollee and you receive a bill for a deductible, coinsurance, or copay on a Medicare-covered service, do not pay it. The provider is legally barred from collecting it.

If you receive such a bill:

• Tell the provider you are a QMB enrollee and cite the federal balance-billing prohibition.
• Show your ND HHS eligibility notice or your Medicare card with the QMB indicator.
• Call 1-800-MEDICARE (1-800-633-4227) to file a complaint.
• Contact the North Dakota State Health Insurance Counseling (SHIC) program at 1-888-575-6611 for free help.

A provider who has billed a QMB must recall the bill from any collections process and refund any payments already collected.

Part D Extra Help / Low-Income Subsidy

Every QMB, SLMB, and QI enrollee in North Dakota is automatically deemed eligible for full Part D Extra Help, also called the Low-Income Subsidy (LIS). No separate application is required.

Under the 2026 Part D Extra Help rules, a full-subsidy enrollee gets:

• A $0 Part D premium on a benchmark plan
• A $0 annual deductible
• $5.10 for each generic prescription and $12.65 for each brand-name prescription
• $0 for covered drugs once your out-of-pocket drug costs reach $2,100 for the year4

For a senior who fills several prescriptions a month, Part D Extra Help can save hundreds to thousands of dollars a year in drug costs, on top of the Part B premium that SLMB or QI already covers.

The deeming flows automatically from ND HHS to CMS each month after MSP enrollment. If you are not already in a Part D plan, CMS will auto-assign you to a zero-premium benchmark plan. You can switch to another Part D plan during the annual open enrollment period without losing LIS status.

North Dakota Medicare Savings Programs: 2026 Income Limits at a Glance

These bands reflect 100% FPL (QMB), 100 to 120% FPL (SLMB), and 120 to 135% FPL (QI), with the $20 general income disregard applied. The resource limit for all three is $9,950 (single) / $14,910 (couple).2

What Counts as a Resource, and What Doesn't

The $9,950 (single) / $14,910 (couple) resource test excludes several major asset categories.2

Excluded (do not count):

• Your primary residence, regardless of value or equity
• One vehicle, regardless of make, model, or value
• Household goods and personal effects
• Prepaid burial arrangements and a designated burial fund

Counted:

• Checking and savings account balances
• Stocks, bonds, certificates of deposit, and mutual funds
• A second vehicle or a second home
• The countable cash value of certain life insurance policies

Many North Dakota seniors count themselves out of MSP because they assume their home works against the limit. It does not. A QMB applicant who owns a mortgage-free home can still qualify, as long as countable assets such as bank balances stay within the $9,950 single limit.2

How to Apply for North Dakota Medicare Savings Programs

Effective Dates and Retroactive Coverage

• QMB: coverage begins the first day of the month after approval. Federal law (42 U.S.C. § 1396a(e)(8)) prohibits retroactive QMB coverage, so apply as early as you can.
• SLMB and QI: up to three months of retroactive coverage is available under 42 CFR § 435.915 if you were eligible during those months. Because your filing date is protected, apply early even if you cannot gather every document right away.

North Dakota as a 209(b) State

North Dakota is one of roughly a dozen states that operate under Section 209(b), which lets a state apply some Medicaid eligibility standards more restrictive than SSI. For Medicare Savings Programs, though, federal law requires FPL-based income thresholds, so the 209(b) election does not change MSP eligibility: North Dakota applicants face the same QMB, SLMB, and QI income bands used in other states.2

For long-term care Medicaid, by contrast, North Dakota's 209(b) status matters: the state applies its own asset limits ($3,000 for a single applicant, $6,000 for a couple) and a medically needy spend-down rather than a simple income cap. If you are also looking at long-term care Medicaid in North Dakota, those rules are covered in North Dakota Medicaid eligibility and income limits.3

Where to Get Help in North Dakota

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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.