Oklahoma Medicare Savings Programs 2026: QMB, SLMB & QI

Oklahoma's Medicare Savings Programs help Medicare beneficiaries with limited income cover premiums and cost-sharing they would otherwise pay out of pocket. Oklahoma runs them as SoonerCare Supplemental, a program of the Oklahoma Health Care Authority (OHCA), which administers SoonerCare, Oklahoma's Medicaid program. Oklahoma Human Services (OKDHS) decides who qualifies and takes the applications. The three programs are QMB, SLMB, and QI.1

What Are Oklahoma Medicare Savings Programs?

Oklahoma's Medicare Savings Programs are a component of SoonerCare, the state's Medicaid program. OKDHS checks applicants against the dollar standards it publishes in OKDHS Appendix C-1, and those 2026 amounts equal the federal MSP figures SSA lists for every state except Alaska and Hawaii. Money is only part of the test, though. Oklahoma's rules first require you to be categorically related to aged, blind or disabled, SLMB and QI require you to be enrolled in Medicare Part A, and QMB requires you to meet all other SoonerCare eligibility conditions.1

The programs exist to fill gaps Medicare does not cover. 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 deductible is $283 per year. These costs fall entirely on the beneficiary unless an MSP or supplemental coverage is in place.4 For an Oklahoma resident who qualifies, SoonerCare Supplemental may help pay them: premiums, deductibles and coinsurance under QMB, and the Part B premium under SLMB and QI.1

Income is counted under the Supplemental Security Income (SSI)-related rules for aged, blind and disabled applicants, not the MAGI rules used for marketplace coverage. Every limit is a test of countable income and resources, and three adjustments matter before the comparison:

• A $20 general income disregard, applied to either earned or unearned income (Social Security benefits, pensions) but not both. A couple gets only one $20 disregard.1
• An earned-income disregard: if you still have wages, more than half of your pay, before taxes, doesn't count toward the limit.1
• A Part B premium withheld from your Social Security check is added back before your income is compared with the limit, so start from your gross benefit, not the deposit.1

The published income ceilings already build in the $20 disregard.1 A resident whose gross Social Security benefit is close to the limit should apply and let OKDHS run the calculation. SSA tells its own staff to encourage people whose income or resources look somewhat higher than the state limits to apply anyway.1

Oklahoma's MSP income standards are set as percentages of the federal poverty guidelines, which the U.S. Department of Health and Human Services (HHS) published for 2026 on January 15, 2026. Each program decides when a new year's guidelines take effect for it, so the dates can differ from program to program.5 The monthly figures in the tables below are the 2026 standards in OKDHS Appendix C-1, so a figure checked against an older or newer FPL table may differ slightly.1

QMB: Qualified Medicare Beneficiary

QMB is Oklahoma's most protective Medicare Savings Program. Oklahoma's rule calls it Qualified Medicare Beneficiary Plus (QMBP), so expect that name on OKDHS paperwork. SoonerCare Supplemental may help pay Medicare Part A and Part B premiums, deductibles and coinsurance.1 Medicare providers also can't bill a QMB enrollee for Part A or Part B cost-sharing on Medicare-covered services.6

The Appendix C-1 figures above equal the 2026 federal figures in SSA POMS HI 00815.023, and the Part A deductible ($1,736 per benefit period) and Part B deductible ($283 per year) QMB pays on the enrollee's behalf are the 2026 CMS amounts.1,4

The QMB Billing Prohibition

Federal law (section 1902(n)(3)(B) of the Social Security Act) says a QMB enrollee has no legal liability to pay a provider for Medicare Part A or Part B cost-sharing, and every Medicare provider and supplier, pharmacies included, is barred from billing it. The protection holds even when SoonerCare pays nothing toward the bill, and you can't waive it by choosing to pay.6

If you receive a bill for a Medicare deductible, coinsurance, or copay while enrolled in QMB:

1. Do not pay it. Tell the provider you're in the QMB program.
2. Show your Medicare and SoonerCare cards, or a Medicare Summary Notice that says you're in QMB and shouldn't be billed.6
3. If the billing continues, call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048). Medicare can confirm your QMB status and ask the provider to stop billing you and refund what you've paid.7,6
4. Contact Oklahoma SHIP at 1-800-763-2828 for free counseling and advocacy.8

CMS tells providers to recall any QMB cost-sharing bills, including ones sent to collections, and to refund any QMB cost-sharing money they collected.6

SLMB: Specified Low-Income Medicare Beneficiary

SLMB helps with the Part B premium only, which is $202.90 per month in 2026.4 It's for people enrolled in Medicare Part A whose countable income is above the QMB level and up to 120% FPL plus $20.1 SLMB doesn't pay Medicare deductibles or coinsurance, and it doesn't carry QMB's protection against being billed for them.9

SLMB enrollees are automatically deemed eligible for full Part D Extra Help. No separate SSA application is required. Benefits in 2026: $0 Part D premium on a plan at or below the regional benchmark, $0 deductible, and drug copays of no more than $5.10 per generic and $12.65 per brand-name prescription.3

QMB's start date is fixed by federal law, but no such rule sets how far back SLMB coverage can reach before the month you apply. Ask OKDHS when you apply whether your SLMB coverage can be back-dated.10

QI: Qualifying Individual

QI helps with the Part B premium only, for Oklahoma residents enrolled in Medicare Part A with countable income greater than 120% but less than 135% FPL.1

Key points specific to QI:

• Capped federal allotment. Unlike QMB and SLMB, QI is not an entitlement. It's paid from a capped annual federal allotment, and the state selects qualifying people in the order they apply, with preference for people who had it in the last month of the previous year. The state must still let everyone apply during the year, and once you're selected, you keep QI for the rest of that year as long as you still qualify. Because selection is first-come, first-served, it's worth applying early in the year.2
• Not combined with any other Medicaid. Oklahoma's rule says a QI recipient cannot be receiving or eligible for any other type of Medicaid benefit.1 If you qualify for full SoonerCare, you'd be classed instead as QMB Plus or SLMB Plus, or as Other Full-Benefit Dually Eligible if you meet neither QMB nor SLMB rules. That's a fuller category, not a loss of coverage.11

Full Comparison: Oklahoma Medicare Savings Programs

All three programs share the same countable-resource limit.1 All three also make you automatically eligible for Part D Extra Help.3

What Counts as a Resource in Oklahoma?

OKDHS describes resources as things you own, such as checking and savings accounts, certificates of deposit, the cash value of life insurance, stocks, bonds and real estate.

Some things you own don't count toward the limit. OKDHS's examples:

• Your home and its furnishings. Oklahoma's $752,000 home-equity cap is a long-term-care rule for people approved for long-term-care services.12
• Your car.
• Pre-paid funeral trusts up to $10,000.

These are examples, not a complete list, and an OKDHS worker will go over all your resources with you to decide what counts.1

Part D Extra Help

Enrollment in any Oklahoma Medicare Savings Program means you're automatically treated as eligible for full Part D Extra Help (the Low-Income Subsidy) under 42 CFR 423.773(c). CMS notifies you that you don't need to apply, and you shouldn't fill out an Extra Help application.3

In 2026, full Part D Extra Help includes:

• $0 premium on a plan at or below the regional benchmark; a pricier plan costs you the difference.
• $0 Part D deductible.
• Copays of no more than $5.10 per generic and $12.65 per brand-name prescription. People who also have full SoonerCare pay less: $1.60 and $4.90 with income at or below 100% FPL, and $0 in a nursing facility or while receiving home and community-based services.
• $0 for covered drugs for the rest of the year once out-of-pocket drug costs reach $2,100.3

If your income is above the MSP ceilings, you may still qualify for Extra Help on its own. Its 2026 limits are about $1,995 a month for an individual and $2,705 for a married couple (150% FPL), with resources up to $18,090 or $36,100. Apply with Social Security online at ssa.gov/medicare/part-d-extra-help or by calling 1-800-772-1213.3

How to Apply for Oklahoma Medicare Savings Programs

Because you have Medicare, you apply with OKDHS, not on OHCA's website. OHCA's own routing sends people with Medicare who need help paying premiums, coinsurance or deductibles to OKDHS.13

Primary application channels:

1. Online: OKDHS Live!, the OKDHS online benefits site, through its SoonerCare (65+ or disabled) page.13
2. In person or by phone: visit or call your local OKDHS Human Services Center.
3. By mail: download the Request for Benefits form from the OKDHS forms website (search PS-1 or 08MP001E) and send it to your local OKDHS office. An application form and an interview are required.1

Documents to have ready:

• Medicare card or Medicare Beneficiary Identifier (MBI)
• Social Security number and date of birth (applicant and spouse)
• Most recent SSA COLA letter showing current monthly benefit
• Pension or annuity statements (if applicable)
• Recent bank statements (all accounts)
• Proof of Oklahoma residency (utility bill, lease, or mortgage statement)

Processing time: within 30 to 60 days, you'll get a notice in the mail telling you whether your application was approved.1

When coverage starts: QMB doesn't reach back. A QMB determination covers services furnished after the end of the month in which it's made, so QMB runs from the following month forward. No federal source sets a retroactive window for SLMB or QI, so ask OKDHS how far back yours can start.10 Full SoonerCare Medicaid works differently: federal law generally reaches back up to three months before the month you apply, a window a Section 1115 demonstration can shorten, and one that federal law cuts to two months for most applications made on or after January 1, 2027.11

Renewal: coverage doesn't last forever without a check. Open and return any renewal paperwork from OKDHS promptly so your help with Medicare costs doesn't lapse.

Learn More

Find personalized help applying for Oklahoma 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.