Medicare Savings Programs pay your Part B premium — and sometimes your deductibles and copays — if your income falls below the 2026 limits. Here is what QMB, SLMB, and QI each cover, where the cutoffs sit, and how enrolling automatically unlocks Extra Help for prescriptions.
Plain-English guide to Medicare, Medigap, Advantage, and Part D — 2026 rates included.
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Medicare Savings Programs (MSPs) are state-run programs that pay some or all of your Medicare costs if your income (learn more about medicaid and assisted living: eligibility and coverage by state) (learn more about medicare advantage vs medicare supplement) (learn more about retirement income strategies for 2025) (learn more about medicare and assisted living: what's covered and what's not) (learn more about prudential annuity review: all products rated & compared (2026)) (learn more about questions to ask when touring memory care facilities) and savings fall below certain limits. In 2026, a single person with monthly income at or below $1,350 and countable resources under $9,950 may qualify for the most generous program, QMB, which pays your Part B premium of $202.90 a month plus your deductibles, copays, and coinsurance. Higher income limits apply to two smaller programs, SLMB and QI, which pay the Part B premium only.
There is a second benefit that most people miss: enrolling in any of the three programs automatically qualifies you for Extra Help, the Part D low-income subsidy, which the Social Security Administration values at roughly $5,700 a year in prescription savings.
Here is what each program pays, where the 2026 cutoffs sit, and how to apply.
| Program | 2026 monthly income limit (single) | 2026 monthly income limit (couple) | What it pays | Resource limit |
|---|---|---|---|---|
| QMB — Qualified Medicare Beneficiary | $1,350 | $1,824 | Part A and Part B premiums, deductibles, coinsurance, and copays | $9,950 single / $14,910 couple |
| SLMB — Specified Low-Income Medicare Beneficiary | $1,616 | $2,184 | Part B premium only ($202.90/mo in 2026) | $9,950 single / $14,910 couple |
| QI — Qualifying Individual | $1,816 | $2,455 | Part B premium only; first-come, first-served each year | $9,950 single / $14,910 couple |
| QDWI — Qualified Disabled and Working Individual | Higher limits; varies by state | Varies | Part A premium only, for working people under 65 who lost premium-free Part A | Varies by state |
A few things worth understanding about that table.
QMB is the one to aim for. It is the only program that protects you from cost-sharing. QMB enrollees cannot legally be billed by providers for Medicare deductibles, copays, or coinsurance — a protection called balance billing prohibition. If a provider bills you anyway, that is improper billing and you can push back.
SLMB and QI pay the same thing. The difference is the income band. QI sits at a higher income level, but it comes with a catch: it is funded by an annual block grant, so it is awarded first-come, first-served, and you must reapply every year. Apply in January if you can.
You cannot have QI and Medicaid at the same time. QMB and SLMB can be paired with full Medicaid; QI cannot.
The published limits are lower than they look in practice, because states apply a standard $20 monthly income disregard before comparing your income to the cutoff. In plain terms: if the QMB limit reads $1,350, someone with $1,365 in Social Security may still land under it once the disregard is applied.
Generally counted: Social Security retirement or disability benefits, pension payments, wages, IRA and 401(k) withdrawals, annuity payments, rental income.
Generally not counted toward resources: your home, one vehicle, household goods and personal belongings, burial plots, and a modest burial fund. Countable resources are things like checking and savings balances, CDs, stocks, and bonds.
Where it gets more generous than the table suggests. Several states run more liberal rules than the federal minimums — a handful have eliminated the asset test for MSPs entirely, and others use higher income thresholds. Alabama, Arizona, Connecticut, Delaware, Louisiana, Mississippi, New York, Oregon, and Vermont have all loosened one or both tests at various points. If you are near the line, apply anyway. The worst outcome is a denial letter.
This is the part that changes the math for most households.
Enrolling in QMB, SLMB, or QI makes you automatically eligible for Extra Help — the Part D Low-Income Subsidy — with no separate application. Extra Help in 2026 means:
You can also qualify for Extra Help on its own, without an MSP. The 2026 limits are broader: annual income at or below $23,475 for an individual or $31,725 for a married couple, with countable resources up to $18,090 single and $36,100 married (including a $1,500-per-person burial allowance).
Notice how much wider that resource limit is than the MSP one. Someone with $15,000 in savings will be turned down for QMB but can still qualify for Extra Help. If your savings put an MSP out of reach, apply for Extra Help separately — it is a different application and a different answer.
The old partial-subsidy tier is gone. Before 2024, people between 135% and 150% of the federal poverty level received a reduced benefit with higher copays. The Inflation Reduction Act eliminated that middle tier and moved everyone who qualifies up to the full subsidy.
Run the arithmetic for a single person on QMB in 2026:
| Cost | Without help | With QMB + Extra Help |
|---|---|---|
| Part B premium | $202.90/mo → $2,434.80/yr | $0 |
| Part B annual deductible | $283 | $0 |
| Part D premium and deductible | Varies; deductible up to $615 | $0 |
| Prescription copays | Up to the $2,100 annual out-of-pocket cap | $5.10 generic / $12.65 brand |
| 20% coinsurance on Part B services | Unlimited exposure without supplemental coverage | $0 |
For someone living on about $1,300 a month, the Part B premium alone is roughly 15% of income. QMB gives that back. That is the single largest guaranteed raise available to most low-income Medicare beneficiaries, and by most estimates millions of people who qualify have never applied.
If you are comparing this against buying supplemental coverage, our guide to Medicare Supplement insurance explains what Medigap covers — but if you qualify for QMB, you generally do not need a Medigap policy, because QMB already covers the cost-sharing Medigap is designed to fill.
Apply through your state Medicaid office, not Social Security. MSPs are administered by states even though they pay Medicare costs. Search for your state's Medicaid agency or call your local State Health Insurance Assistance Program (SHIP) for free, unbiased help with the paperwork.
What to have ready: proof of income (Social Security award letter, pension statements, recent pay stubs), bank statements for the last few months, your Medicare card, and proof of residence.
Timing matters. QMB coverage typically starts the month after approval. SLMB and QI can pay retroactively for up to three months before the application month if you qualified during that period, so do not skip the retroactive question on the form.
If you are denied, read why. Denials often come down to a counted resource that should have been excluded, or income that was calculated before the $20 disregard. You have appeal rights, and a SHIP counselor can help you file.
Once you know what you will pay, our Medicare cost calculator guide helps you build the rest of the year's budget, and our review of 2026 Part D drug plans is worth a look once Extra Help changes what you pay at the pharmacy.
Program structures and beneficiary protections reflect federal Medicare Savings Program and Part D Low-Income Subsidy rules. The 2026 Part B standard premium ($202.90) and annual deductible ($283), and the Part D standard deductible ($615) and $2,100 out-of-pocket cap, come from the CMS 2026 Parts A & B premiums and deductibles fact sheet released in November 2025. MSP income and resource limits track the federal poverty guidelines and are updated annually. States may apply more generous rules than the federal minimums, so confirm your own state's current figures with its Medicaid agency before assuming you do not qualify.
What is the income limit for Medicare Savings Programs in 2026?
For a single person: $1,350 a month for QMB, $1,616 for SLMB, and $1,816 for QI. For a married couple: $1,824, $2,184, and $2,455 respectively. A standard $20 monthly disregard is applied before your income is compared to the limit.
What is the asset limit?
$9,950 for an individual and $14,910 for a married couple in 2026. Your home, one vehicle, personal belongings, and a burial fund generally do not count. Some states have eliminated the asset test entirely.
Which program pays the most?
QMB. It covers Part A and Part B premiums plus all Medicare deductibles, copays, and coinsurance. SLMB and QI pay only the Part B premium.
Do I get Extra Help automatically?
Yes. Enrollment in QMB, SLMB, or QI automatically qualifies you for the Part D Low-Income Subsidy with no separate application.
Can I get Extra Help without a Medicare Savings Program?
Yes, and many people should apply separately. Extra Help's limits are wider: $23,475 annual income and $18,090 in resources for an individual in 2026.
What does Extra Help cost me at the pharmacy?
Copays are capped at $5.10 for generics and $12.65 for brand-name covered drugs in 2026, with a $0 deductible and typically a $0 plan premium.
Can a doctor bill me if I have QMB?
No. Providers are prohibited from billing QMB enrollees for Medicare deductibles, coinsurance, or copays. If you receive a bill, contact your provider and your state Medicaid office.
Where do I apply?
Through your state Medicaid agency, not Social Security. Your local SHIP office offers free help completing the application.
Do I have to reapply every year?
QI must be renewed annually and is awarded first-come, first-served. QMB and SLMB are typically subject to periodic redetermination rather than a yearly reapplication, but rules vary by state.
Does an MSP affect my Social Security check?
Yes, in your favor. If Medicare is paying your Part B premium through an MSP, the premium is no longer deducted from your Social Security payment, so your monthly deposit goes up.
Last updated: September 2026. We review this guide each year when CMS publishes new premium figures and when the federal poverty guidelines are updated.
This article is educational information, not financial, legal, or medical advice. Income and resource limits vary by state and change annually. Confirm your eligibility with your state Medicaid agency or a SHIP counselor before making decisions about your coverage.
About SeniorSimple — SeniorSimple publishes plain-language retirement and healthcare education for adults 55 and older. We work from the primary program rules and official CMS figures, and we date every guide so you can see how current it is.
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Plain-English guide to Medicare, Medigap, Advantage, and Part D — 2026 rates included.
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Plain-English guide to Medicare, Medigap, Advantage, and Part D — 2026 rates included.
