Oregon Medicare Savings Programs 2026: QMB, SLMB & QI

If Medicare's monthly premium is straining your budget, Oregon's Medicare Savings Programs can wipe it out, and for the lowest incomes cover every deductible and copay too. Better still, Oregon is one of the rare states that counts none of your savings or property when it decides whether you qualify.1

What Are Medicare Savings Programs?

Medicare Savings Programs are Medicaid-administered benefits that pay some or all of a low-income Medicare beneficiary's premiums and cost-sharing. Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualifying Individual (QI) are federal eligibility groups every state Medicaid plan must cover, including Oregon's.1

Oregon runs these programs through the Oregon Health Plan, the state's Medicaid program. The Oregon Health Authority (OHA) sets policy, and the Oregon Department of Human Services (ODHS) determines eligibility and processes applications.1

The single most important thing to know before you rule yourself out: Oregon does not count your assets. Most states cap Medicare Savings Program eligibility at $9,950 in resources for one person and $14,910 for a couple. Oregon applies no such limit, so a paid-off home, a full savings account, or a retirement fund does not disqualify you here. Only your monthly income is measured against the limits below.1

QMB: Qualified Medicare Beneficiary

QMB is Oregon's most complete Medicare Savings Program. For a person whose income fits, it can bring nearly every Medicare cost to zero. QMB pays:

• The Medicare Part B premium, which is $202.90 per month in 2026 ($2,434.80 for the year)3
• The Medicare Part A premium, which most people already pay nothing for after 40 quarters of work
• The Part A hospital deductible, $1,736 per benefit period in 2026
• The Part B annual deductible, $283 in 2026
• All Medicare coinsurance and copays, including the 20% Part B coinsurance on most outpatient services3

2026 Oregon QMB income limit: at or below $1,330 per month for one person (100% of the federal poverty level) or $1,804 for a couple. Those are the figures ODHS publishes, and they are the poverty level itself, measured before the $20 general income exclusion Oregon sets aside first. Counting that $20, the effective cutoff is $1,350 for one person and $1,824 for a couple. Oregon applies no asset limit.1

For an Oregon senior living on Social Security, QMB covers the full $202.90 monthly Part B premium ($2,434.80 a year) plus every deductible and copay, and the Part A hospital deductible alone is another $1,736 in any year with an inpatient stay. Every QMB enrollee is also automatically deemed eligible for full Part D Extra Help.3

SLMB: Specified Low-Income Medicare Beneficiary

Oregon SLMB pays your Medicare Part B premium and nothing else. At the 2026 rate, that is worth $202.90 a month, or $2,434.80 over the year, back in your Social Security check.3

2026 Oregon SLMB income limit: at or below $1,596 per month for one person (120% of the federal poverty level) or $2,164 for a couple. As with QMB, those are ODHS's bare poverty-level figures; the $20 general income exclusion puts the effective cutoff at $1,616 and $2,184. Oregon counts no assets.1

SLMB does not pay deductibles or copays, but for a healthy beneficiary who rarely sees a doctor, the Part B premium is usually the largest Medicare cost of the year, and SLMB erases it. SLMB enrollment also triggers automatic Part D Extra Help, which can lower prescription costs to $5.10 per generic and $12.65 per brand-name drug with a $0 deductible on a benchmark Part D plan.2

QI: Qualifying Individual

QI also pays the Part B premium only. Its income limit sits above SLMB: at or below $1,796 per month for one person or $2,435 for a couple in Oregon, with no asset test. Again, those are the figures ODHS publishes; with the $20 general income exclusion applied, the effective cutoff is $1,816 and $2,455.1

Two features set QI apart from QMB and SLMB:

1. First-come, first-served. QI is funded through a capped federal allotment each year, so enrollment is limited and prior-year QI enrollees get priority. Apply early in the year.1
2. You cannot also have full Medicaid. Federal law bars QI for anyone eligible for full-benefit Medicaid. If you qualify for full Oregon Health Plan coverage, you would receive QMB-Plus or SLMB-Plus instead, which combine the Medicare cost help with full Medicaid.1

Like SLMB, QI enrollment automatically qualifies you for Part D Extra Help.

Does Oregon Count Your Home or Savings?

No. This is where Oregon breaks from the federal default. In most states, a Medicare Savings Program applies a resource limit of $9,950 for one person and $14,910 for a couple, and countable assets above that line disqualify you. Oregon imposes no asset or resource limit on QMB, SLMB, or QI.1

That means the following do not affect your eligibility in Oregon at all:

• Your home, whatever it is worth
• Money in checking, savings, or certificates of deposit
• Stocks, bonds, mutual funds, and retirement accounts
• A second vehicle or other property

Only your monthly income is measured against the QMB, SLMB, and QI limits. Many Oregon seniors assume a paid-off home or a modest nest egg rules them out. In Oregon, it does not.1

The QMB Billing Protection

Once you are a QMB enrollee, federal law prohibits any Medicare provider from billing you for Medicare cost-sharing. This protection applies to Original Medicare and Medicare Advantage providers alike, whether or not they take Oregon Health Plan.1

If you have QMB and receive a bill for a deductible, coinsurance, or copay, do not pay it. Instead:

• Tell the provider you are a QMB enrollee and that federal law bars the charge.
• Show your ODHS eligibility notice.
• Call 1-800-MEDICARE (1-800-633-4227) to file a complaint.
• Contact Oregon SHIBA (Senior Health Insurance Benefits Assistance) at 1-800-722-4134 for free counseling.

The provider must recall the bill from collections and refund anything you already paid.

Part D Extra Help for Prescription Drugs

Every Oregon QMB, SLMB, and QI enrollee is automatically deemed eligible for full Part D Extra Help, the Low-Income Subsidy that lowers prescription costs. No separate application is required.2

Under the 2026 Extra Help benefit, a full-subsidy enrollee pays:

• $0 for the Part D premium on a benchmark plan
• $0 Part D deductible
• No more than $5.10 for each generic prescription
• No more than $12.65 for each brand-name drug
• $0 for covered drugs once out-of-pocket costs reach the $2,100 annual cap2

For someone filling several prescriptions a month, Extra Help can save hundreds to thousands of dollars a year in drug costs on top of the premium help from SLMB or QI. ODHS transmits your deemed status to Medicare each month after your Medicare Savings Program is approved, and if you are not already in a Part D plan, Medicare auto-assigns you to a zero-premium benchmark plan.2

Oregon Medicare Savings Programs: 2026 Income Limits at a Glance

The first figure in each cell is what Oregon ODHS publishes for March 2026 through February 2027, the poverty-level percentage itself. The second is the effective cutoff, $20 higher, once the federal $20/month SSI general income exclusion is set aside. Both are correct; they measure different things, and the one that decides your case is the second. Oregon applies no asset or resource test to any of the three programs. Confirm current figures with Oregon SHIBA or ODHS.1

How Oregon Counts Your Income

The most common reason eligible Oregon seniors skip these programs is that they compare their gross Social Security check to the limit and stop. Oregon uses the Supplemental Security Income (SSI) counting rules, which set aside part of your income before the comparison.

The clearest example is the $20 general income exclusion: Oregon disregards the first $20 of your monthly income, so your countable income starts $20 below your gross check. This is exactly why the published limit is not the cutoff. A single applicant with a gross Social Security check of $1,340 is over ODHS's published QMB figure of $1,330 and qualifies anyway, because the $20 set-aside brings the countable income to $1,320. Anywhere in the $1,331–$1,350 band, the published number says no and the actual rule says yes. Oregon also applies the standard SSI earned-income exclusion, so wages count for less than dollar-for-dollar.1

If your income is anywhere near a limit, apply and let ODHS run the actual calculation rather than assuming you earn too much.

How to Apply for Oregon Medicare Savings Programs

Oregon offers three ways to apply.

1. Online. Apply through the state benefits portal at one.oregon.gov. You can complete the application and upload your documents there.

2. By phone. Call ODHS at 1-800-699-9075. Staff can take your application over the phone.

3. In person. Visit a local ODHS office with your Medicare card, Social Security award letter, recent bank statements, and proof of Oregon residency, and staff will help you apply.

You can also start through the Social Security Administration (SSA). Applying for Part D Extra Help at a Social Security office automatically sends a referral to Oregon Medicaid, and federal law requires SSA to forward it to the state with your SSA filing date as your protected application date.

Documents to Gather Before You Apply

• Medicare card (showing your Medicare Beneficiary Identifier, or MBI)
• Social Security card or proof of your Social Security number
• Your most recent Social Security benefit or cost-of-living notice
• Recent bank and investment statements
• Pension or annuity statements, if you have them
• Proof of Oregon residency, such as a utility bill, lease, or mortgage statement

How Long a Decision Takes

ODHS must process a standard Medicare Savings Program application within 45 days, or 90 days if eligibility is based on a disability.4

When Coverage Starts

• QMB starts the first day of the month after ODHS approves your application. Federal law does not allow retroactive QMB coverage (42 USC 1396a(e)(8)), so apply as early as you can.
• SLMB and QI can reach back up to three months before your application if you were eligible then, under standard Medicaid retroactive-coverage rules (42 CFR 435.915).

After approval, ODHS notifies Medicare so it stops withholding the Part B premium from your Social Security check, and any premiums withheld during the changeover are credited back to you.5

Learn More

Find personalized help applying for Oregon 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.