Medicare Savings Programs can wipe out your Part B premium of $202.90 a month, and for the lowest-income enrollees, every deductible and copay Medicare charges. Four programs, run by state Medicaid agencies, pay these costs for people with limited income and savings. This guide covers the four programs, who qualifies under the 2026 income and resource limits, what each one pays, and how enrolling also unlocks Extra Help for prescription drugs.
What the four programs are
Medicare Savings Programs are administered by state Medicaid agencies, not by Medicare directly, and each is defined by where your income falls relative to the Federal Poverty Level (FPL). Three of the four (QMB, SLMB, and QI) work as a single income ladder: as income rises through the tiers, the help narrows from "premiums plus all cost-sharing" down to "the Part B premium only." The fourth, QDWI, sits apart and serves a specific group of working people with disabilities.
Qualified Medicare Beneficiary (QMB) is the broadest. It covers income at or below 100% of the FPL, which in 2026 is roughly $1,350 a month for an individual and $1,824 for a married couple. QMB pays your Part A and Part B premiums and all of your Medicare cost-sharing: deductibles, coinsurance, and copays.
Specified Low-Income Medicare Beneficiary (SLMB) covers income between 100% and 120% of the FPL, about $1,616 a month for an individual and $2,184 for a couple. SLMB pays the Part B premium and nothing else.
Qualifying Individual (QI) covers income between 120% and 135% of the FPL, about $1,816 a month for an individual and $2,455 for a couple. QI also pays the Part B premium, but with two conditions SLMB doesn't carry: it's funded from a limited annual federal block grant and granted first-come, first-served, so applying early in the year matters, and you cannot have QI at the same time as full Medicaid.
Qualified Disabled and Working Individual (QDWI) is the outlier. It pays the Part A premium for certain people with disabilities who returned to work, earned enough to lose their premium-free Part A, and now face a Part A premium most people never see.
The four programs side by side
The table below sorts the programs by income tier and shows what each one pays. The dollar figures are 2026 approximations and described in more detail in the next section.
| Program | Income limit (2026, approximate) | What it pays |
|---|---|---|
| QMB | At or below 100% FPL, about $1,350/mo individual or $1,824/mo couple | Part A and Part B premiums plus all cost-sharing; balance billing prohibited |
| SLMB | 100% to 120% FPL, about $1,616/mo individual or $2,184/mo couple | Part B premium only |
| QI | 120% to 135% FPL, about $1,816/mo individual or $2,455/mo couple | Part B premium only; limited funding, first-come, no full Medicaid |
| QDWI | For certain working people with disabilities who lost premium-free Part A | Part A premium |
Do you qualify?
Two tests decide eligibility: your income and your countable resources.
On income, the figures above are approximate, and they are the part of this guide most likely to differ from your own state's numbers. Three things shift them. They rise each year with the FPL. They run higher in Alaska and Hawaii, which have their own poverty guidelines. And many states apply income disregards, set amounts subtracted before they test your income, which effectively raise the limit you can have and still qualify. For those reasons, treat the dollar amounts here as a guide to whether it's worth applying, not as a cutoff to disqualify yourself, and confirm the current limit with your state Medicaid agency.
On resources, the 2026 limit for QMB, SLMB, and QI is $9,950 for an individual and $14,910 for a married couple. Countable resources are things like money in checking and savings accounts, stocks, and bonds. What you live in and drive generally doesn't count: your home, one car, household goods, and a burial plot are typically excluded.
A practical takeaway follows from how close these tiers sit. If your income is too high for QMB, you may still land in SLMB or QI, and the resource test is the same for all three. Don't assume that being over one limit shuts you out of the others.
What QMB protects, and the billing rule that matters
QMB is worth singling out because it does two things the other programs don't.
First, it covers all of your Medicare cost-sharing, not just premiums. After QMB, a covered doctor visit, hospital stay, or lab test carries no deductible or coinsurance for you. Combined with the premiums it also pays, that can be worth several thousand dollars a year.
Second, federal law prohibits providers from billing a QMB enrollee for any Medicare cost-sharing. This is the balance-billing protection, and it holds whether or not the provider takes Medicaid. A provider who bills a QMB patient for a Medicare deductible or coinsurance is breaking federal rules. If you're enrolled in QMB and get a bill for cost-sharing, that's an error to dispute, not a charge to pay. Keep your QMB enrollment notice, and show it when you get care.
The Extra Help bonus
Enrolling in any of the four Medicare Savings Programs automatically qualifies you for Extra Help, the Part D Low-Income Subsidy that lowers prescription drug costs. You don't file a second application; the MSP enrollment triggers it.
Extra Help is substantial on its own. In 2026, full Extra Help enrollees pay no more than $5.10 for a generic drug and $12.65 for a brand-name drug, and $0 once their out-of-pocket spending reaches the $2,100 catastrophic threshold.
It's also worth knowing that Extra Help has its own, higher resource limits, $16,590 for an individual and $33,100 for a couple in 2026, well above the MSP limits. So if your resources are too high for a Medicare Savings Program, you may still qualify for Extra Help directly through the Social Security Administration. The two programs share a purpose but not a cutoff.
States with distinctive MSP rules
Most states use the standard federal income tiers, but a handful have expanded their programs in ways that qualify more people. If you live in one of these states, check with your state agency before assuming you don't qualify based on the federal numbers.
- Connecticut: No asset test. Connecticut eliminated its resource-limit screen entirely, and its income thresholds are nearly double the federal standard (QMB up to about $2,197/month individual vs. the federal $1,350). Far more Connecticut residents qualify than the national figures suggest.
- Oregon: SLMB extended to 200% of the Federal Poverty Level (about $2,660/month individual), versus the federal SLMB ceiling of 120% FPL. Oregon's SLMB is effectively a near-universal Part B premium subsidy for modest-income residents.
- Mississippi: SLMB covers income up to 135% FPL, combining the federal SLMB and QI tiers into one program at the higher ceiling.
- Rhode Island and Vermont: Both states moved former SLMB enrollees into QMB in early 2026 (Rhode Island effective February 1, 2026; Vermont effective January 1, 2026), giving those residents the more comprehensive QMB benefit instead of Part B premium help only.
- Alaska and Hawaii: Both states have higher income limits than the contiguous 48 states because their Federal Poverty Levels are higher.
How to apply
Applications go through your state Medicaid agency, because the states run these programs even though they pay Medicare costs. You can apply online, by phone, or in person, depending on your state, and you'll provide proof of income and resources. Your local State Health Insurance Assistance Program (SHIP) offers free, unbiased help with the application and can confirm your state's current income limits.
Apply even if you think your income is slightly over the line. State income disregards and the gap between the QMB, SLMB, and QI tiers mean the only way to know for certain is to let the state run the numbers. And if you want QI specifically, apply early in the calendar year, while its limited funding lasts.
Frequently asked questions
For QMB and SLMB, yes. Many people have both full Medicaid and an MSP, and the programs coordinate. QI is the exception: you cannot receive QI while you have full Medicaid.
Not directly, but enrolling in any MSP automatically qualifies you for Extra Help, the Part D subsidy that lowers drug premiums, deductibles, and copays. The MSP handles your Medicare premiums and, for QMB, cost-sharing; Extra Help handles drug costs.
Yes. The published figures are approximate, they're higher in Alaska and Hawaii, and many states subtract income disregards before testing eligibility, which effectively raises the limit. The only reliable way to know is to apply through your state Medicaid agency.
No. Federal law bars providers from billing QMB enrollees for Medicare cost-sharing, whether or not the provider accepts Medicaid. Treat the bill as an error, contact the provider with your QMB enrollment notice, and dispute it rather than paying.
Both pay only the Part B premium, and both use the same resource limit. QI covers a slightly higher income range, but it's funded from a limited annual federal allotment granted first-come, first-served, and it can't be combined with full Medicaid. SLMB has neither restriction.
Learn More
- What Is Medicare? Parts A, B, C, and D explained
- Dual-eligible plans (FIDE-SNPs): Medicare and Medicaid together
- IRMAA: the income surcharge on Medicare premiums
Find personalized help checking whether you qualify for a Medicare Savings Program 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.