The Qualifying Individual (QI) program is one of four Medicare Savings Programs that helps people with limited income pay Medicare costs. In 2026, it covers the Medicare Part B premium of $202.90 per month, saving eligible beneficiaries over $2,400 per year. To qualify, your monthly income must fall between 121% and 135% of the Federal Poverty Level (FPL), which puts you above the income limits for other Medicare Savings Programs but still within reach of meaningful help.
If your income is too high for the Specified Low-Income Medicare Beneficiary (SLMB) program but you still struggle to afford Part B premiums, the QI program may be exactly what you need.
What the QI Program Covers
The QI program pays your Medicare Part B premium directly. In 2026, that premium is $202.90 per month for most beneficiaries. The program does not require you to pay it yourself and then get reimbursed. The state pays it on your behalf.
That is the extent of the QI benefit. Unlike the Qualified Medicare Beneficiary (QMB) program, QI does not cover Part A premiums, deductibles, or copayments. If you need broader cost-sharing coverage, QMB may be a better fit if you qualify.
Key coverage summary:
- Part B premium: Covered in full ($202.90/month in 2026)
- Part A premium: Not covered
- Deductibles and copays: Not covered
- Part D premiums: Not covered directly, but qualifying for a Medicare Savings Program automatically qualifies you for Extra Help with Part D drug costs
2026 QI Program Income Limits
QI income limits are set at 121% to 135% of the Federal Poverty Level. The limits include a standard $20 income disregard applied to most income sources.
Monthly Income Limits (2026)
| Household Size | Most States and DC | Alaska | Hawaii |
|---|
| Individual | $1,816 | $2,265 | $2,086 |
| Couple | $2,455 | $3,064 | $2,821 |
These limits apply to gross monthly income before most deductions. The $20 general income disregard is already factored into the figures above.
How Income Is Counted
Not all income counts toward the QI limit. The following are excluded from the calculation:
- The first $20 of most monthly income
- SNAP benefits
- Home energy assistance (LIHEAP payments)
- Most home and community-based service waiver payments
- Income of other household members who are not your spouse
Social Security benefits, pensions, wages, and net self-employment income all count. If you receive Social Security, your gross benefit before any Medicare premium deductions is used.
2026 QI Program Asset Limits
In addition to income, the QI program uses asset limits (also called resource limits). Most liquid assets count, with some exceptions.
| Household Size | Asset Limit (2026) |
|---|
| Individual | $9,950 |
| Married couple | $14,910 |
Assets that count include:
- Bank accounts (checking, savings, money market)
- Stocks, bonds, and mutual funds
- Cash at home
- IRAs and most retirement accounts
Assets that do NOT count include:
- Your primary home (regardless of value)
- One vehicle
- Household goods and personal effects
- Life insurance with face value of $1,500 or less
- Burial plots and up to $1,500 in designated burial funds
QI vs. Other Medicare Savings Programs
There are four Medicare Savings Programs in total. Understanding where QI fits helps you determine which one to apply for.
| Program | Income Limit (Individual) | What It Covers |
|---|
| QMB (Qualified Medicare Beneficiary) | Up to $1,350/month (100% FPL + $20) | Part A and B premiums, deductibles, copays |
| SLMB (Specified Low-Income Medicare Beneficiary) | Up to $1,616/month (120% FPL + $20) | Part B premium only |
| QI (Qualifying Individual) | Up to $1,816/month (135% FPL + $20) | Part B premium only |
| QDWI (Qualified Disabled Working Individual) | Up to $5,272/month (200% FPL + $20) | Part A premium only (for working disabled individuals) |
If your income falls in the range for QMB or SLMB, you should apply for those programs instead, since they offer the same or greater benefits at lower income thresholds. The QI program is specifically for people whose income is too high for SLMB but still below 135% of FPL.
One important difference between SLMB and QI: SLMB can reimburse Part B premiums paid in the prior calendar year. QI does not offer retroactive reimbursement for prior-year premiums.
QI Program Eligibility Requirements
To qualify for the QI program in 2026, you must meet all of the following:
- Enrolled in Medicare Part A and currently enrolled in (or applying for) Medicare Part B
- Monthly income at or below the QI limit for your state (see table above)
- Assets at or below the limit ($9,950 individual / $14,910 couple)
- Not already eligible for Medicaid in your state. If you qualify for full Medicaid, you cannot receive QI benefits. Medicaid covers Part B premiums through a separate mechanism.
- U.S. residency in the state where you apply
Age is not a specific requirement. People under 65 who receive Medicare due to disability can also qualify for QI as long as they meet the other criteria.
How to Apply for the QI Program
The QI program is administered by each state's Medicaid agency. Applications are submitted through your state Medicaid office, not through Medicare directly.
Step-by-Step Application Process
Step 1: Check your eligibility. Use the income and asset tables above to see if you likely qualify. You can also run a quick check using the Benefits Navigator screener at benefitsusa.org/screener.
Step 2: Gather your documents. You will typically need:
- Medicare card (showing Parts A and B)
- Proof of income (Social Security award letter, recent pay stubs, pension statements)
- Recent bank statements and investment account statements for asset verification
- Proof of state residency (utility bill, lease, or similar)
- Photo ID
Step 3: Contact your state Medicaid office. You can find your state's contact information at medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227). Many states allow online, phone, mail, or in-person applications.
Step 4: Submit your application. Apply as early as possible in the year. QI funding is limited and applications are approved on a first-come, first-served basis. People who received QI in the previous year get priority, but new applicants are accepted until funds run out.
Step 5: Wait for a determination. States have up to 45 days to process most applications (90 days for disability-related cases). If approved, your Part B premium will be covered going forward from your approval date.
Step 6: Reapply each year. QI enrollment does not carry over automatically. You must reapply annually to maintain coverage.
Where to Apply
- Online: Many states have online Medicaid portals. Search for your state name plus "Medicare Savings Program application."
- By phone: Call your state Medicaid office or 1-800-MEDICARE for referral.
- In person: Visit your local Medicaid or Department of Social Services office.
- Through SHIP: Your State Health Insurance Assistance Program (SHIP) offers free, unbiased help applying. Call 1-877-839-2675 or visit shiphelp.org.
The First-Come, First-Served Rule
The QI program has a finite annual budget set by Congress. When funding runs out for the year, new applicants may be placed on a waiting list or denied until the next calendar year. This is different from QMB and SLMB, which have no funding cap.
In practice, most states have enough funding to serve eligible applicants, but applying early in the calendar year reduces risk. If you were enrolled in QI last year, your renewal application gets priority over new applicants.
Extra Help with Part D Drug Costs
One of the most valuable side effects of qualifying for any Medicare Savings Program, including QI, is automatic eligibility for Extra Help (also called the Low Income Subsidy or LIS) with Medicare Part D prescription drug costs.
Extra Help in 2026 can reduce your drug plan premiums, deductibles, and copayments significantly. The Social Security Administration automatically enrolls most MSP recipients in Extra Help. If you are not automatically enrolled, you can apply directly through SSA at ssa.gov or by calling 1-800-772-1213.
Common Reasons Applications Are Denied
Understanding why applications get denied can help you prepare a stronger application.
- Income over the limit: Even being slightly over the QI income limit disqualifies you. Review every income source carefully. Some income types may be excluded.
- Assets over the limit: Bank accounts are counted. If you have more than $9,950 in liquid assets (individual), you will not qualify. Spending down assets on exempt items before applying is permitted.
- Already Medicaid-eligible: If your income qualifies you for full Medicaid, you cannot get QI. Check whether you qualify for Medicaid first.
- Not enrolled in Medicare Part B: You must be enrolled in Part B to receive the benefit that covers Part B premiums.
- Missing documentation: Incomplete applications or missing income proof are common delays and denials.
If you are denied, you have the right to appeal. The denial notice will include instructions for requesting a fair hearing.
Frequently Asked Questions
What is the income limit for the QI Medicare Savings Program in 2026?
In most states, the 2026 QI income limit is $1,816 per month for an individual and $2,455 per month for a married couple. Alaska and Hawaii have higher limits. These figures already include the standard $20 income disregard.
What does the QI program pay for?
The QI program pays your Medicare Part B premium, which is $202.90 per month in 2026 for most people. It does not cover deductibles, copays, or Part A premiums.
Do I have to reapply for QI every year?
Yes. QI enrollment is not automatic year to year. You must submit a new application each year. Previous QI recipients get priority in the funding queue, but you still need to reapply.
Can I get QI if I have Medicaid?
No. If you are eligible for full Medicaid benefits, you cannot receive QI. Medicaid covers Part B premiums through a separate mechanism for dual-eligible beneficiaries.
How does QI affect my Part D drug coverage?
Qualifying for QI automatically qualifies you for Extra Help with Medicare Part D costs, which can significantly reduce your prescription drug premiums and out-of-pocket expenses.
Can I get QI if I am under 65?
Yes. If you are under 65 and receive Medicare due to a disability, you can still qualify for QI as long as you meet the income, asset, and enrollment requirements.
What assets are not counted for QI eligibility?
Your primary home, one vehicle, household goods, personal effects, and certain burial funds are not counted. Life insurance policies with a face value of $1,500 or less are also excluded.
Is the QI program the same in every state?
The federal income and asset limits are the same in most states (with adjustments for Alaska and Hawaii). However, each state administers the program through its Medicaid agency and sets its own application process.
What happens if QI funding runs out?
If your state's QI funding for the year is exhausted, new applicants may be waitlisted or denied until the following year. This is why applying early in the calendar year matters.
How is QI different from SLMB?
Both QI and SLMB cover only the Medicare Part B premium. The key differences are: QI has a higher income limit (135% FPL vs. 120% FPL for SLMB), QI has limited annual funding, and SLMB can reimburse premiums from the prior calendar year while QI cannot.
To find out if you qualify for the QI program or other Medicare Savings Programs, use the free eligibility screener at benefitsusa.org/screener. The screener checks multiple programs at once and takes about three minutes to complete.
