Medicare Savings Programs: Help Paying Your Premiums (2026)

Medicare Savings Programs can wipe out your Part B premium, which is $202.90 a month in 2026, 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 in three of the four also unlocks Extra Help for prescription drugs.1,2

What the four Medicare Savings 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 $1,350 a month for an individual and $1,824 for a married couple in the 48 contiguous states and the District of Columbia. QMB pays your Part A and Part B premiums and all of your Medicare cost-sharing: deductibles, coinsurance, and copays.2

Specified Low-Income Medicare Beneficiary (SLMB) covers income between 100% and 120% of the FPL, $1,616 a month for an individual and $2,184 for a couple in 2026. SLMB pays the Part B premium (in 2026, $202.90 a month) and nothing else.2,1

Qualifying Individual (QI) covers income between 120% and 135% of the FPL, $1,816 a month for an individual and $2,455 for a couple in 2026. 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, with preference going to people who received QI in the last month of the previous year, so applying early in the year matters most if you're new to the program, and you cannot have QI at the same time as full Medicaid. You must also apply for QI every year: being selected one year does not entitle you to help in the next.2

Qualified Disabled and Working Individual (QDWI) is the outlier, and not a rung on the same ladder as the other three. 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. Its limits are its own: for 2026, monthly income of $5,405 for an individual and $7,299 for a couple in the 48 contiguous states and DC, against resources of $4,000 and $6,000. Those income figures sit far above the other three tiers and do not reconcile to them, because SSA's published QDWI limits fold in earned-income disregards on top of the $20 general income exclusion built into the QMB, SLMB, and QI figures. The resource limits run the other way, well below the $9,950 and $14,910 that apply to the other three.2

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 the 2026 federal limits for the 48 contiguous states and the District of Columbia, described in more detail in the next section. Alaska and Hawaii have their own, higher income limits, listed further down.2

If you live in Alaska or Hawaii, those income figures are not yours: both states have higher limits, and the Alaska and Hawaii numbers are in the state section below. The resource limits in the next section are a different matter: those are not raised for Alaska or Hawaii.2

Do you qualify for a Medicare Savings Program?

Two tests decide eligibility: your income and your countable resources.

On income, the figures above are the exact federal standards, 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 both states' figures are listed below. And states can effectively raise them by disregarding amounts or certain types of income and resources before they test you, which lifts the income you can have and still qualify. For those reasons, treat the dollar amounts here as the federal floor and a guide to whether it's worth applying, not as a cutoff to disqualify yourself, and confirm the current income and resource limits with your state Medicaid agency.2

On resources, the 2026 federal standard for QMB, SLMB, and QI is $9,950 for an individual and $14,910 for a married couple. Unlike the income limits, that standard is not raised for Alaska or Hawaii: the Social Security Administration prints the same resource row in its Alaska and Hawaii tables as in its table for the other 48 states. (QDWI runs on its own, lower resource limits, $4,000 and $6,000, and those are not raised in Alaska or Hawaii either.) It is a federal standard, not an absolute cutoff: states can effectively raise it by disregarding certain resources, and some have used that authority to eliminate the resources test altogether, so apply rather than rule yourself out. Which of your assets even count is decided by the Supplemental Security Income counting rules, which the federal QMB definition incorporates by statute, and those rules exclude some things outright. Burial spaces for you, your spouse, or an immediate family member, including a plot, gravesite, crypt, mausoleum, urn, or niche, are excluded from resources entirely, as are up to $1,500 each for you and your spouse in funds kept separate from everything else and clearly designated for burial expenses. Because several states apply more generous resource rules than this federal floor, being over the federal limit is not the same as being over your state's: ask your state Medicaid agency what it counts before you conclude that a particular asset puts you over.2,4

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.2

Second, federal law prohibits providers from billing a QMB enrollee for any Medicare cost-sharing. This is the balance-billing protection. It covers Original Medicare and Medicare Advantage providers alike, it reaches suppliers and pharmacies too, and it holds whether or not the provider takes Medicaid and even when the state pays nothing toward the cost-sharing. You have no legal liability to pay it. A provider who bills a QMB patient for a Medicare deductible or coinsurance is violating its Medicare provider agreement and may face sanctions. 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.2,3,5

How Medicare Savings Programs work with Extra Help

Enrolling in QMB, SLMB, or QI automatically qualifies you for Extra Help, the Part D Low-Income Subsidy that lowers prescription drug costs. For those three programs you don't file a second application; the MSP enrollment triggers it.2

QDWI, the fourth Medicare Savings Program, does not carry Extra Help with it. Federal rules deem QMB, SLMB, and QI enrollees eligible for the full subsidy, and QDWI is not one of those deemed groups.2 So if QDWI is your program, don't assume your drug costs are handled: apply for Extra Help separately through the Social Security Administration, which decides it against its own income and resource limits.6

Extra Help is substantial on its own. It subsidizes the Part D premium, deductible, and copayments: under Extra Help the plan premium and the plan deductible are both $0. 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.6

The $0 premium comes with one condition worth knowing before you choose a drug plan. Medicare pays the premium subsidy to the plan, and the amount is based on your service area's regional benchmark premium. Someone with a full premium subsidy who picks a more expensive plan is responsible for the difference between the benchmark premium and that plan's premium.6

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. Those ceilings rise again, to $18,090 and $36,100, if you notify Social Security that you expect to use some of your resources for burial expenses. 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. Extra Help isn't available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa; residents there should contact their local Medicaid office instead.6

States that expand the Medicare Savings Programs

The standard federal income tiers and the $9,950 resource limit are the baseline, and states are allowed to disregard income and resources to loosen either one; several have, 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.2

• Connecticut: No asset limit, and much higher income limits. The Department of Social Services states that Connecticut does not have an asset limit for its Medicare Savings Programs, so owning a home or holding money in the bank does not by itself disqualify you. Effective March 1, 2026 its monthly QMB limit is $2,807 for an individual and $3,806 for a couple, roughly double the federal $1,350. Gross income sets the category, but DSS also states that not all earned income from wages is counted, so a Connecticut resident whose wages exceed a limit should still apply.2
• Oregon: No asset test. ODHS states there are no asset limits for these programs in Oregon, in the paragraph introducing all four of them, so no amount of savings or property puts an Oregon applicant over a resource limit. Its income tiers track the federal ladder, but ODHS prints the bare poverty-level amount, $1,330 a month for a QMB individual, where the federal figure of $1,350 already has the $20 general income disregard added. Same limit, measured at two different points, so a few dollars over the number Oregon prints is not a reason to skip applying.2
• Mississippi: No asset test on QMB, SLMB, or QI. The Division of Medicaid states for each of the three groups that "it does not matter what your resources are in this group. There is no resource test," so being over the federal $9,950 asset limit does not disqualify you there. On income it publishes a ceiling and nothing else, no dollar figures of its own and no lower bound: total monthly income cannot exceed 100% of the FPL for QMB, 120% for SLMB, and 135% for QI.2
• Rhode Island: Runs the MSPs as the Medicare Premium Payment program, and effective February 1, 2026 people who would have qualified for SLMB now qualify for QMB instead and are automatically enrolled in the QMB group, so they get full cost-sharing protection rather than premium help only. EOHHS publishes 2026 monthly limits of $1,683 individual and $2,275 couple for QMB and $2,255 and $3,050 for QI, above the federal QMB and SLMB floors; no Rhode Island source states the poverty-level percentage behind those figures. Rhode Island has not eliminated its asset test: it keeps the federal $9,950 and $14,910 resource limits for both tiers.2
• Vermont: No resource test for QMB or QI, and effective December 31, 2025, Vermont ended its SLMB program and moved most former members into QMB. For 2026, Vermont QMB covers income up to 150% FPL, $1,995 a month for an individual, well above the federal 100% cutoff.2
• Alaska and Hawaii: Both states have higher income limits than the contiguous 48 states because their Federal Poverty Levels are higher, and both get their own row in the Social Security Administration's 2026 limits tables. In Alaska the monthly limits are $1,683 individual and $2,275 couple for QMB, $2,015 and $2,725 for SLMB, $2,265 and $3,064 for QI, and $6,735 and $9,102 for QDWI. In Hawaii they are $1,550 and $2,095 for QMB, $1,856 and $2,509 for SLMB, $2,086 and $2,821 for QI, and $6,205 and $8,382 for QDWI. The resource limits are a different story: neither state's is raised, so an Alaskan or Hawaii resident is tested against the same federal $9,950 and $14,910 the contiguous 48 use, before any disregards the state chooses to apply.2

How to apply for a Medicare Savings Program

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.2

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. If you received QI in the last month of the previous year, your state must give you preference over new applicants, though you still have to reapply.2

Learn More

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.