So you went back to work, your Social Security disability benefits stopped, and now you've got a letter saying your free Medicare Part A is ending and you'll owe a monthly premium. That's a real bill. But there's a program built for exactly this situation, and it's the one almost nobody has heard of: the Qualified Disabled and Working Individual program, or QDWI.

In This Guide

What Is the QDWI Program?

QDWI stands for Qualified Disabled and Working Individual, and it's one of the four Medicare Savings Programs run through Medicaid. Three of them (Qualified Medicare Beneficiary, or QMB; Specified Low-Income Medicare Beneficiary, or SLMB; and Qualifying Individual, or QI) help pay your Part B costs. QDWI is the odd one out. It's the only one aimed at Part A, and it exists for one specific group the other three leave behind.

Here's the situation it's built for. If you got Medicare before 65 because of a disability, you almost certainly got Part A for free. Then you went back to work, and at some point your earnings climbed above what Social Security calls the Substantial Gainful Activity (SGA) level. When that happens, Social Security can end your disability status, and your premium-free Part A goes with it. You can keep your Medicare, but now you have to pay the Part A premium out of pocket.

That's the whole reason QDWI is there. Losing free Part A because you started earning again isn't a disqualifier for QDWI. It's the exact trigger that makes you eligible for it.

Do You Qualify for QDWI?

There are five pieces, and you need all of them:

  • You're under 65.
  • You have a disability.
  • You're working.
  • You lost premium-free Part A because your earnings went over the SGA level.
  • Your income and resources fall under the program's limits.

Those last two limits are where people trip up, so let's be specific. On income, the federal rule sets the ceiling at 200 percent of the federal poverty level, but the number Medicaid actually uses is higher than a flat 200 percent because the program ignores a chunk of what you earn. For 2026, the published QDWI monthly income limit is $5,405 for one person and $7,299 for a couple in the 48 contiguous states and Washington, D.C. Alaska and Hawaii run higher.

On resources, your countable assets have to stay under $4,000 for an individual or $6,000 for a couple. That's twice the standard Supplemental Security Income (SSI) resource limit. Countable resources are things like money in the bank and investments, not your home or your car.

Because those income figures vary by state group, treat the numbers above as the starting point and check your own state's Medicaid office for the exact limit that applies to you.

What QDWI Pays For

This is short, and that's the point. QDWI pays your Medicare Part A premium, and nothing else. No other cost-sharing.

So it's worth knowing what that premium actually is. In 2026, if you have 30 to 39 quarters of Medicare-covered work, the Part A premium is $311 a month. With fewer than 30 quarters, it's $565 a month. Over a year, that's real money, and QDWI takes it off your plate.

What QDWI does not do is help with your Part B premium, your deductibles, or your coinsurance. Those are what the other three Savings Programs handle. Unlike QMB, SLMB, and QI, being on QDWI does not automatically enroll you in Part D Extra Help, the low-income subsidy for prescription drugs. If you want help with drug costs, that's a separate application.

How to Apply for QDWI

Because QDWI is a Medicaid eligibility group, you apply through your state's Medicaid agency, the same office that runs the other Medicare Savings Programs. You don't apply through Medicare or Social Security for this one.

Before you start, pull together the paperwork you'll be asked for: proof of your income, a record of your countable resources, your Medicare information, and the notice showing that your premium-free Part A is ending or has ended. Then contact your state Medicaid office to ask specifically about QDWI, since it's less familiar to caseworkers than the Part B programs and it helps to name it directly. If your income or resources are close to the limits, apply anyway and let the state make the call, because the exact numbers and the way earnings are counted vary by state.

Frequently Asked Questions

What does QDWI stand for?

QDWI stands for Qualified Disabled and Working Individual. Of the four Medicare Savings Programs, it's the only one that pays the Part A premium rather than Part B costs, which is why caseworkers who see the Part B programs far more often can overlook it. When you apply, name QDWI directly so it isn't confused with the others.

Why did I lose my free Medicare Part A?

Premium-free Part A under 65 comes with disability status. When your earnings climbed above the Substantial Gainful Activity level and Social Security ended that status, your premium-free Part A ended with it. The good news is you don't have to drop Medicare: you can keep Part A by paying the premium, and QDWI is the program built to cover that premium. Apply through your state Medicaid office before the monthly bills stack up.

Does QDWI help with Part B or my prescriptions?

No. QDWI pays the Part A premium only, with no other cost-sharing, and it doesn't automatically enroll you in Part D Extra Help the way the other Savings Programs do. So it's worth checking two other doors: Extra Help for drug costs, which is a separate application, and QMB, SLMB, or QI if you also need help with your Part B premium or deductibles.

What's the income limit for QDWI in 2026?

For 2026, the published monthly income limit is $5,405 for one person and $7,299 for a couple in most states, with higher limits in Alaska and Hawaii; countable resources have to stay under $4,000 for an individual or $6,000 for a couple. Because states count earned income differently and often disregard part of what you make, apply even if you look a little over the line and let the state make the call rather than ruling yourself out.

Learn More

MedicareMedicare Savings Programs: Help Paying Premiums and CostsMedicare Savings Programs help low-income enrollees pay Part B premiums and, with QMB, all cost-sharing. See the four MSPs, 2026 limits, and how to apply. MedicareDo You Have to Pay for Medicare Part A? Premiums and the Buy-InMost people pay $0 for Medicare Part A, but not everyone. See who qualifies premium-free, the 2026 buy-in costs of $311 or $565, and how to get help paying. MedicareHow to Get Medicare Under 65 Through DisabilityMedicare under 65 by disability: the 24-month SSDI wait, the ALS and ESRD exceptions that skip it, which disabilities qualify, and how Medigap differs at 65.

Find personalized help figuring out whether QDWI can cover your Medicare Part A premium 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.

BC

Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.