2026 Medicare Savings Program Income Limits in North Carolina
North Carolina offers three Medicare Savings Programs. Each has its own income ceiling and covers different costs. The income limits below include the standard $20 monthly income disregard that federal rules allow.
QMB, SLMB, and QI Income Limits at a Glance
| Program | Individual Monthly Income Limit | Couple Monthly Income Limit | What It Pays |
|---|
| QMB (Qualified Medicare Beneficiary) | $1,350 | $1,824 | Part A and Part B premiums, deductibles, copays, coinsurance |
| SLMB (Specified Low-Income Medicare Beneficiary) | $1,616 | $2,184 | Part B premium only |
| QI (Qualifying Individual) | $1,820 | $2,459 | Part B premium only (limited slots) |
Resource Limits (Assets)
In addition to income, all three programs check countable resources. For 2026, the limits are the same across all three tiers:
| Household Type | Resource Limit |
|---|
| Individual | $9,950 |
| Couple | $14,910 |
Countable resources include bank accounts, stocks, and bonds. They exclude your home, one vehicle, personal belongings, and burial funds up to $1,500 per person.
QMB: The Most Comprehensive Program
The Qualified Medicare Beneficiary program is the most valuable of the three. If your income is at or below $1,350 per month as a single person (or $1,824 as a couple), QMB will cover:
- Your Part A premium (if applicable)
- Your Part B premium of $202.90 per month
- The Part A hospital deductible of $1,736 per benefit period
- The Part B annual deductible of $283
- Part A and Part B copays and coinsurance
An important protection: if you are a QMB member, Medicare providers are not allowed to bill you for cost-sharing. This is a federal rule. If a provider attempts to charge you a copay or deductible, you can report them to 1-800-MEDICARE.
SLMB: Part B Premium Relief
The Specified Low-Income Medicare Beneficiary program is for people whose income falls between the QMB ceiling and $1,616 per month (individual) or $2,184 per month (couple). SLMB pays your Part B premium of $202.90 per month. That is $2,434.80 in annual savings.
QI: First-Come, First-Served Help
The Qualifying Individual program covers the same benefit as SLMB: your Part B premium. Income limits are slightly higher, up to $1,820 per month for individuals and $2,459 for couples. The key difference: QI funding is capped. Applications are approved on a first-come, first-served basis each year. Apply as early as possible, preferably in January, to secure a spot.
2026 Medicare Extra Help (Low-Income Subsidy) Income Limits
Extra Help is a separate federal program that cuts Part D prescription drug costs. It is not run through NC Medicaid. You apply through the Social Security Administration.
| Household Type | Annual Income Limit | Monthly Equivalent |
|---|
| Individual | $23,475 | $1,956 |
| Married couple | $31,725 | $2,644 |
Resource limits for Extra Help in 2026:
| Household Type | Resource Limit |
|---|
| Individual | $18,090 |
| Married couple | $36,180 |
These thresholds are set at approximately 150% of the federal poverty level. If your income is below these limits, Extra Help can reduce your Part D premium, deductible, and copays significantly. Many people with Extra Help pay $0 or a few dollars per prescription.
If you are enrolled in a Medicare Savings Program (QMB, SLMB, or QI), you are automatically eligible for Extra Help. You do not need to file a separate application.
What Extra Help Covers
| Benefit | Without Extra Help | With Full Extra Help (2026) |
|---|
| Part D monthly premium | Varies by plan (avg. $40-$60) | $0 or greatly reduced |
| Annual deductible | Up to $590 | $0 |
| Generic drug copay | $5-$20+ | $1.55 to $4.90 |
| Brand-name drug copay | $20-$50+ | $4.90 to $12.15 |
| Coverage gap costs | 25% cost sharing | No coverage gap |
IRMAA: How Higher Incomes Affect Medicare Costs in 2026
Residents with income above certain thresholds pay higher Part B and Part D premiums. These are called Income-Related Monthly Adjustment Amounts. The income Medicare uses is your Modified Adjusted Gross Income (MAGI) from two years prior, meaning 2024 income determines your 2026 premiums.
2026 Part B IRMAA Thresholds
| 2024 Individual MAGI | 2024 Joint MAGI | 2026 Monthly Part B Premium |
|---|
| Up to $106,000 | Up to $212,000 | $202.90 |
| $106,001 to $133,000 | $212,001 to $266,000 | $284.10 |
| $133,001 to $167,000 | $266,001 to $334,000 | $365.60 |
| $167,001 to $200,000 | $334,001 to $400,000 | $447.10 |
| $200,001 to $500,000 | $400,001 to $750,000 | $578.60 |
| Above $500,000 | Above $750,000 | $689.90 |
If your income dropped significantly after 2024 (due to retirement, job loss, or another life event), you can request that Social Security use more recent income information. File Form SSA-44 to request an IRMAA reduction.
2026 Medicare Costs in North Carolina: Full Summary
| Cost Type | 2026 Amount |
|---|
| Part A premium (most people) | $0 |
| Part A premium (30-39 work quarters) | $311/month |
| Part A premium (under 30 work quarters) | $565/month |
| Part A hospital deductible | $1,736 per benefit period |
| Part B standard premium | $202.90/month |
| Part B annual deductible | $283 |
| Part B coinsurance | 20% after deductible |
How to Apply for Medicare Savings Programs in North Carolina
Applications for QMB, SLMB, and QI go through the North Carolina Department of Health and Human Services. Here are the three ways to apply:
Step 1: Confirm You Are Enrolled in Medicare
You must already be enrolled in Medicare Part A to apply for any Medicare Savings Program. If you are not yet enrolled, contact Social Security at 1-800-772-1213.
Step 2: Choose Your Application Method
Option A: Apply Online
Go to epass.nc.gov and create an account. Select "Apply for Benefits" and choose Medicaid, which includes the Medicare Savings Programs. The online application takes 30 to 45 minutes on average.
Option B: Apply at Your County Department of Social Services
Find your local DSS office at ncdhhs.gov. Bring documents including your Medicare card, proof of income (recent pay stubs, Social Security award letter), bank statements, and a photo ID. Staff can help you complete the form on-site.
Option C: Apply by Phone
Call NC Medicaid at 1-888-245-0179 to request a paper application or get help by phone.
Option D: Get Free Counseling from SHIIP
North Carolina's Seniors' Health Insurance Information Program (SHIIP) offers free, unbiased Medicare counseling. Call 855-408-1212 to speak with a trained counselor who can review your situation and help you apply. SHIIP has counselors in every county.
Step 3: Submit Your Documents
NC Medicaid will typically need:
- Proof of Medicare enrollment (Medicare card)
- Proof of income for all household members (Social Security letters, pay stubs, pension statements)
- Bank and asset statements for the past three months
- Government-issued photo ID
- Proof of residence (utility bill, lease)
Step 4: Wait for a Decision
NC Medicaid has up to 45 days to process your application. Most applicants hear back sooner. If approved, benefits are generally retroactive to the first day of the month in which you applied.
Step 5: Apply for Extra Help Separately
If you want Extra Help for Part D drug costs and were not automatically enrolled through MSP, apply at ssa.gov or call Social Security at 1-800-772-1213. You can also apply in person at any Social Security office.
Dual Eligibility: Medicare and Medicaid Together
North Carolina residents who qualify for both Medicare and full Medicaid benefits are called "dual eligibles" or "duals." These individuals typically pay nothing for Medicare-covered services and have very low or no Part D costs. North Carolina has approximately 390,000 dual-eligible residents.
If your income is at or below 100% of the federal poverty level ($1,255 per month for an individual in 2026) and you meet Medicaid asset rules, you may qualify for full NC Medicaid in addition to Medicare, giving you more complete coverage.
Check Your Eligibility in Minutes
If you are not sure whether you qualify for a Medicare Savings Program or Extra Help, use the Benefits Navigator screener. Enter your household size, income, and basic information, and the tool will flag every program you may be eligible for across Medicare, Medicaid, and other federal programs. There is no cost, and you are not required to enroll in anything.
You can also visit the North Carolina benefits guide for a full overview of assistance programs available in the state.
Frequently Asked Questions
Does Medicare have an income limit for enrollment?
No. Medicare eligibility is based on age (65 or older) or disability status, not income. Income only affects what you pay in premiums and whether you qualify for assistance programs like Medicare Savings Programs or Extra Help.
What is the income limit to get help paying my Medicare Part B premium in North Carolina?
If you are single, you may qualify for help with your Part B premium if your monthly income is at or below $1,820 (QI program). The SLMB threshold is $1,616 per month and the QMB threshold is $1,350 per month.
Can I apply for QMB if I also have Medicare Advantage?
Yes. If you have Medicare Advantage (Part C) instead of Original Medicare, you may still qualify for QMB. Your Medicare Advantage plan must accept QMB members, and most do. QMB limits the cost-sharing your plan can charge you.
How is Extra Help different from a Medicare Savings Program?
Medicare Savings Programs are administered by states through Medicaid and help with Parts A and B costs (premiums, deductibles, copays). Extra Help is a federal program that only covers Part D prescription drug costs. You can qualify for both at the same time, and MSP enrollment automatically qualifies you for Extra Help.
Will assets like my house affect my Medicare Savings Program eligibility?
Your primary home is excluded from the resource count. The main assets that count are bank account balances, stocks, bonds, and cash. For 2026, the resource limit is $9,950 for individuals and $14,910 for couples across all three MSP tiers.
How long does it take to get approved for QMB in North Carolina?
NC Medicaid has up to 45 days to process applications. Many are decided faster. If approved, benefits typically start on the first day of the month you applied. You should apply as soon as possible to avoid delays.
What if my income is just above the QI limit?
If your income is above $1,820 per month as an individual, you would not qualify for a Medicare Savings Program. However, you may still be able to save through a Medicare Advantage plan that has lower cost-sharing, or by shopping for a lower-cost Part D plan. SHIIP counselors at 855-408-1212 can help you compare options at no charge.
Do I need to reapply for the Medicare Savings Program each year?
Yes. North Carolina requires annual renewal. NC Medicaid will send you a renewal notice. If your income or household situation has not changed significantly, renewal is straightforward. Missing the renewal deadline can result in loss of benefits, so respond promptly.
