What Medicare Costs in 2026
Before diving into the savings programs, it helps to know the standard costs that Florida beneficiaries face:
| Cost Item | 2026 Amount |
|---|
| Part A premium (if fully insured) | $0 per month |
| Part A premium (20-29 work credits) | $285 per month |
| Part A premium (fewer than 20 credits) | $518 per month |
| Part A hospital deductible | $1,676 per benefit period |
| Part B standard premium | $202.90 per month |
| Part B annual deductible | $283 |
| Part B coinsurance | 20% after deductible |
Higher-income enrollees pay more for Part B under IRMAA (Income-Related Monthly Adjustment Amount). The surcharge applies if your 2024 modified adjusted gross income exceeded $106,000 for an individual or $212,000 for a couple.
Florida Medicare Savings Programs 2026
Medicare Savings Programs (MSPs) are administered through Florida Medicaid and funded jointly by the state and federal government. They pay your Medicare premiums and, depending on the program, your deductibles and copays as well. There are four programs, each with its own income limit.
2026 MSP Income and Resource Limits
| Program | Individual Monthly Income | Couple Monthly Income | Individual Resources | Couple Resources |
|---|
| QMB | up to $1,350 | up to $1,824 | up to $9,950 | up to $14,910 |
| SLMB | $1,351 to $1,616 | $1,825 to $2,184 | up to $9,950 | up to $14,910 |
| QI | $1,617 to $1,816 | $2,185 to $2,455 | up to $9,950 | up to $14,910 |
| QDWI | up to $5,405 | up to $7,299 | up to $4,000 | up to $6,000 |
Income limits shown are gross monthly income. Resources (assets) generally exclude your primary home, one vehicle, personal belongings, and burial funds up to $1,500.
Qualified Medicare Beneficiary (QMB)
QMB is the most comprehensive savings program. If you qualify, Florida Medicaid pays your Part A and Part B premiums, your Part A hospital deductible, and your Part B deductible, copays, and coinsurance. Providers who accept Medicare are prohibited by federal law from billing QMB enrollees for cost sharing, so you should owe nothing out of pocket for Medicare-covered services.
Income limit for 2026: up to $1,350 per month for an individual (100% of the Federal Poverty Level), $1,824 for a couple.
Specified Low-Income Medicare Beneficiary (SLMB)
SLMB pays your monthly Part B premium of $202.90 in 2026. That works out to $2,434.80 in annual savings. SLMB does not pay deductibles or copays, but eliminating the premium alone is meaningful for seniors on fixed incomes.
Income limit for 2026: $1,351 to $1,616 per month for an individual (100% to 120% FPL), $1,825 to $2,184 for a couple.
Qualifying Individual (QI)
QI also pays the Part B premium in full, same as SLMB, but covers a slightly higher income range. Funding for QI slots is limited and allocated on a first-come, first-served basis each year, so applying early matters.
Income limit for 2026: $1,617 to $1,816 per month for an individual (120% to 135% FPL), $2,185 to $2,455 for a couple.
Qualified Disabled and Working Individuals (QDWI)
QDWI is for people under 65 who lost Medicare due to returning to work. It pays the Part A premium only (up to $518 per month in 2026). The income limit is much higher because it targets working-age adults who have returned to the workforce.
Income limit for 2026: up to $5,405 per month for an individual (200% FPL), $7,299 for a couple. Resource limits are lower: $4,000 for an individual, $6,000 for a couple.
Medicare Extra Help (Low-Income Subsidy) 2026
Extra Help, also called the Low-Income Subsidy (LIS), is a separate federal program that helps pay for Medicare Part D prescription drug costs. It is not the same as a Medicare Savings Program, but many Floridians qualify for both.
Extra Help Income and Resource Limits for 2026
| Household Size | Annual Income Limit | Monthly Income Limit |
|---|
| Individual | $23,475 | $1,956 |
| Couple | $31,725 | $2,644 |
Resource limits: $18,090 for an individual, $36,100 for a couple.
Extra Help covers up to 150% of the Federal Poverty Level, which is a wider net than most MSPs.
What Extra Help Pays For
If you qualify at the full subsidy level, Extra Help will:
- Pay your Part D plan premium (up to the benchmark amount)
- Eliminate the Part D annual deductible
- Cap each prescription copay at $5.10 for generics and $12.65 for brand-name drugs in 2026
- Eliminate copays entirely after you reach $2,000 in out-of-pocket drug costs for the year
Automatic enrollment in Extra Help applies if you receive Medicaid, SSI, or are already enrolled in a Medicare Savings Program. Otherwise you need to apply through Social Security.
Florida Medicaid Dual Eligibility
Some Florida residents qualify for both Medicare and full Medicaid. These "dual eligibles" receive the most complete coverage because Medicaid fills in the gaps Medicare leaves open. Florida Medicaid covers long-term care, dental, vision, and hearing services not covered by Medicare.
To qualify for full Florida Medicaid in 2026, your income must generally be at or below 100% FPL ($1,255 per month for an individual as a rough guide, though Medicaid rules include various disregards). Florida has not expanded Medicaid to working-age adults without disabilities, but the state does cover low-income seniors and people with disabilities.
How to Apply for Florida Medicare Savings Programs
Applications for QMB, SLMB, QI, and QDWI all go through the Florida Department of Children and Families (DCF). There are several ways to apply:
Step 1: Gather Your Documents
You will need:
- Proof of Medicare enrollment (Medicare card or Medicare Summary Notice)
- Proof of identity (driver's license, passport, or state ID)
- Proof of Florida residency (utility bill, lease, or bank statement)
- Proof of income for the past month (Social Security award letter, pay stubs, pension statements)
- Bank statements or asset documentation for the past three months
- Social Security number
Step 2: Choose Your Application Method
Online: Apply through ACCESS Florida at myaccessflorida.com. Create or log into your account, start a new application, and select "Medicare Savings Program."
By Phone: Call the DCF Customer Call Center at 1-866-762-2237, Monday through Friday, 8 a.m. to 5 p.m.
In Person: Visit your local DCF service center. Florida has offices in all major counties, including Miami-Dade, Broward, Palm Beach, Orange, Hillsborough, and Duval.
By Mail: Download the Florida Medicaid application from the DCF website, complete it, and mail it to your regional office.
Step 3: Complete the Interview
DCF may schedule a phone interview to verify your information. Answer all questions and submit any requested documents promptly to avoid delays.
Step 4: Wait for a Decision
Florida is required to process MSP applications within 45 days. If approved, coverage can be retroactive to the first day of the month in which you applied. You will receive a letter with the decision. If denied, you have the right to appeal.
How to Apply for Extra Help
Extra Help applications go through the Social Security Administration, not DCF.
Online: Apply at ssa.gov/extrahelp. The application takes about 15 minutes.
By Phone: Call Social Security at 1-800-772-1213, Monday through Friday, 8 a.m. to 7 p.m.
In Person: Visit your local Social Security office. Find the nearest office at ssa.gov/locator.
There is no asset test for Extra Help if you are already enrolled in a Medicare Savings Program. In that case, you automatically qualify for Extra Help and do not need a separate application.
Do the Income Limits Apply to All Income?
Not all income counts the same way for MSP eligibility. Florida uses the federal rules for what counts as income.
Items that count as income include: Social Security benefits, SSDI, pension payments, wages, self-employment income, and rental income.
Items that generally do not count include: the first $20 of most income sources (called the "general income disregard"), the first $65 per month of earned income, and certain veterans benefits.
For Extra Help, the exclusions are different. Work-related expenses for people with disabilities, irregular or infrequent income, and housing assistance are generally excluded.
If your gross income is slightly above the listed limits, apply anyway. The disregards often bring countable income below the threshold.
Check Your Eligibility Now
The income limits above cover the main programs, but individual situations vary. Use the free screener at benefitsusa.org/screener to check your eligibility across all Florida benefit programs at once, including Medicare Savings Programs, Extra Help, SNAP, and other assistance.
You can also explore all programs available to Florida residents at benefitsusa.org/states/florida.
Frequently Asked Questions
What is the income limit for Medicare in Florida in 2026?
Medicare itself has no income limit for enrollment. However, the Medicare Savings Programs that help pay your costs do have income limits. For QMB, the most generous program, the limit is $1,350 per month for an individual. SLMB goes up to $1,616, and QI goes up to $1,816. Extra Help for Part D drug costs covers income up to $1,956 per month for an individual.
Does Florida have free Medicare for low-income residents?
Effectively, yes. If you qualify for QMB, your Part A and Part B premiums, deductibles, and copays are all covered. You would owe nothing out of pocket for Medicare-covered services. Combine that with Extra Help for Part D, and your total Medicare cost can be close to zero.
How do I apply for Medicare Savings Programs in Florida?
Apply through the Florida Department of Children and Families via ACCESS Florida online, by phone at 1-866-762-2237, or in person at a local DCF office. You will need proof of Medicare enrollment, proof of income, and proof of residency.
What assets does Florida count for Medicare Savings Program eligibility?
Florida counts bank accounts, stocks, bonds, and second homes. It generally excludes your primary home, one vehicle, personal belongings, and burial funds up to $1,500. The resource limit is $9,950 for an individual and $14,910 for a couple for QMB, SLMB, and QI.
What is the difference between QMB and SLMB in Florida?
QMB covers premiums, deductibles, and copays for both Part A and Part B. SLMB only pays the Part B premium of $202.90 per month. QMB has the lower income limit (up to $1,350 per month for an individual), while SLMB covers those with income up to $1,616 per month.
Can I get Medicare Extra Help in Florida if I already have a Medicare Savings Program?
Yes, and in fact you automatically qualify for Extra Help if you are enrolled in QMB, SLMB, or QI. You do not need a separate application. Social Security will enroll you automatically.
What happens if my income is just over the limit?
Apply anyway. The income disregards (such as the $20 general disregard and $65 earned income disregard) often reduce your countable income below the published limits. The only way to know for sure is to submit an application and let DCF calculate your eligibility.
When should I enroll in Medicare in Florida?
Your Initial Enrollment Period is the seven-month window that includes the three months before your 65th birthday month, your birthday month, and the three months after. Enrolling in the first three months of this window ensures your coverage starts on time. If you miss this window, you may face late enrollment penalties and gaps in coverage.
