Quick answer
Medicare Savings Programs are run by your state and pay your Part B premium, and with QMB your Medicare deductibles and coinsurance too, if your income and savings are low. For 2026, the federal income limits for one person run from $1,350 a month for QMB to $1,816 for QI, with resources of no more than $9,950. Extra Help lowers Part D drug costs for people with 2026 income up to $23,940 a year and resources up to $18,090, and you get it automatically if you’re in a Medicare Savings Program.
Key takeaways
- QMB pays your Part B premium, deductibles, coinsurance and copays, plus the Part A premium if you owe one, and Medicare providers can’t bill QMB members for those costs.
- SLMB and QI pay only the Part B premium, which is $202.90 a month in 2026, or about $2,435 a year.
- Limits are slightly higher in Alaska and Hawaii, and some states, including New York and Massachusetts, have no asset test.
- In 2027, Extra Help means a $0 deductible and copays of no more than $5.80 for generics and $14.40 for brand-name drugs.
- You apply for a Medicare Savings Program through your state Medicaid office and for Extra Help through Social Security, which can pass your information to your state.
On this page
The programs at a glance
| Program | What it pays | 2026 income limit (single / couple) | 2026 resource limit (single / couple) |
|---|---|---|---|
| QMB | Part B premium, Part A premium if you owe one, deductibles, coinsurance and copays | $1,350 / $1,824 a month | $9,950 / $14,910 |
| SLMB | Part B premium | $1,616 / $2,184 a month | $9,950 / $14,910 |
| QI | Part B premium | $1,816 / $2,455 a month | $9,950 / $14,910 |
| Extra Help | Part D deductible, most drug cost sharing and some or all of the premium | $23,940 / $32,460 a year | $18,090 / $36,100 |
What each Medicare Savings Program pays
QMB (Qualified Medicare Beneficiary) is the most generous. It pays your Part B premium ($202.90 a month in 2026), your Part A premium if you don’t get Part A free ($311 or $565 a month in 2026), and the deductibles, coinsurance and copays for services Medicare covers. You might still get a bill for a small Medicaid copay.
SLMB (Specified Low-Income Medicare Beneficiary) pays only your Part B premium. You need both Part A and Part B.
QI (Qualifying Individual) also pays the Part B premium, for people with somewhat higher income. You have to apply every year, approvals are first-come, first-served (people who had QI the year before get priority), and you can’t get QI if you qualify for any other Medicaid coverage.
A fourth program, QDWI, pays the Part A premium for certain people under 65 with disabilities who lost premium-free Part A when they went back to work.
Getting into QMB, SLMB or QI also erases a Part B late enrollment penalty, if you have one, and can let you sign up for Part B outside the usual enrollment periods. See Medicare late enrollment penalties.
Income and resource rules
The table shows the federal limits for 2026. Countable resources include money in checking and savings accounts, stocks and bonds. Your home, one car, a burial plot, up to $1,500 set aside for burial costs, furniture and other household and personal items don’t count.
Limits can be higher where you live:
- Alaska and Hawaii use higher income limits. NCOA lists the 2026 QMB limit for one person at $1,683 a month in Alaska and $1,550 in Hawaii.
- Some states don’t count assets at all. NCOA counted 13 states plus DC with no asset test for these programs as of March 2026. New York has no asset limit and covers QMB up to $1,856 a month for one person in 2026. Massachusetts dropped its asset test on March 1, 2024.
Medicare.gov’s advice is to apply even if you don’t think you qualify. For a broader look at coverage after 65, see health insurance for the elderly.
QMB billing protections
If you’re in QMB, federal law bars Medicare providers and suppliers, including pharmacies, from billing you for Medicare deductibles, coinsurance and copays. You have no legal obligation to pay them. That applies to providers who don’t take Medicaid, too, and in Medicare Advantage it applies to in-network providers when you follow the plan’s rules.
To head off bills:
- Show your Medicare card and your Medicaid or QMB card every time you get care.
- Keep your Medicare Summary Notice, which says you’re in QMB and shouldn’t be billed.
- If you get a bill, tell the provider you’re in QMB. If bills keep coming, call 1-800-MEDICARE or your Medicare Advantage plan.
More than 8 million people, over 1 in 8 people with Medicare, were in QMB in 2023, according to CMS.
How to apply for a Medicare Savings Program
Apply through your state Medicaid office, by phone or with an application. Your state runs the program and makes the decision, and some states use more generous rules than the federal ones. If you apply for Extra Help through Social Security, it sends your information to your state unless you tell it not to, and that can start a Medicare Savings Program application too. Your State Health Insurance Assistance Program (SHIP) can help for free.
Extra Help with Part D costs
Extra Help, also called the Low-Income Subsidy, lowers what you pay for Medicare drug coverage. Social Security estimates it’s worth about $5,700 a year.
For 2026, you can qualify with income up to $23,940 for one person or $32,460 for a married couple living together, and resources up to $18,090 or $36,100. Your home, vehicles, life insurance policies and money set aside for burial don’t count as resources. Benefits such as food, housing and energy assistance don’t count as income. You may still qualify with higher income if you support family members who live with you, have earnings from work, or live in Alaska or Hawaii.
| Extra Help costs | 2026 | 2027 |
|---|---|---|
| Deductible | $0 | $0 |
| Generic drugs | Up to $5.10 | Up to $5.80 |
| Brand-name drugs | Up to $12.65 | Up to $14.40 |
| After the out-of-pocket cap | $0 after $2,100 | $0 after $2,400 |
Your premium is $0 if you pick a basic drug plan with a premium at or below your state’s Extra Help limit. A pricier plan costs you the difference. You also don’t owe a Part D late enrollment penalty while you get Extra Help, and you may be able to change drug plans once a month instead of waiting for open enrollment. Extra Help isn’t available in Puerto Rico or the other U.S. territories.
Who gets Extra Help automatically
You qualify automatically, without a separate application, if you have:
- Full Medicaid coverage
- A Medicare Savings Program (QMB, SLMB or QI)
- Supplemental Security Income (SSI)
If you get Extra Help and don’t choose a drug plan, Medicare chooses one for you. Check that it covers your drugs, and switch if another plan fits better. See Medicare Part D costs and 2027 changes.
How to apply for Extra Help
Apply through Social Security any time of year, before or after you join a Part D plan:
- Online at ssa.gov/medicare/part-d-extra-help
- By phone at 1-800-772-1213 (TTY 1-800-325-0778), Monday through Friday, 8 a.m. to 7 p.m.
- At your local Social Security office
Have bank statements, tax returns and statements for any IRAs, 401(k)s, pensions or annuities ready for you and your spouse. Social Security may contact you later to review your eligibility. Reviews usually happen at the end of August, and any change takes effect the next January. To see how Extra Help fits with the rest of your Medicare choices, see who is eligible for Medicare and Medicare open enrollment.
Have a spouse or family member who isn’t on Medicare yet? Compare health plans by ZIP code.
Frequently asked questions
Can I get a Medicare Savings Program and Extra Help at the same time?
Yes. If you qualify for QMB, SLMB or QI, you automatically get Extra Help too.
What’s the difference between QMB and SLMB?
QMB pays your Part B premium plus Medicare deductibles, coinsurance and copays, and the Part A premium if you owe one. SLMB pays only the Part B premium and has a higher income limit.
Can I qualify if my income is a little over the limit?
Possibly. Alaska and Hawaii have higher limits, some states don’t count certain income or assets, and Extra Help allows higher income in some cases. Medicare.gov suggests applying even if you think you’re over.
Does a Medicare Savings Program get rid of the Part B late penalty?
Yes. Enrolling in one eliminates a Part B late enrollment penalty if you have one.
Sources
- Medicare.gov: Medicare Savings Programs
- Medicare.gov: Help with drug costs (Extra Help)
- Social Security: Understanding the Extra Help with your Medicare prescription drug plan (PDF)
- CMS: Qualified Medicare Beneficiary program
- CMS: 2026 low-income subsidy resource and cost-sharing limits (PDF)
- NCOA: 2026 Medicare Savings Programs eligibility and coverage (PDF)
This article is general information, not insurance, tax or legal advice. Income and asset rules vary by state, so check with your state Medicaid office or Social Security about your situation. Last reviewed October 2026.