Medicare's standard Part B premium is $202.90 a month in 2026, and for most people it is taken out of their Social Security payment automatically, according to the Centers for Medicare & Medicaid Services (CMS) and Medicare.gov. Three Medicare Savings Programs, run by each state's Medicaid office, pay that premium for people with limited income and savings. When a state starts paying, Social Security stops the deduction and the monthly payment goes up, according to CMS's manual for the programs.
Many people who qualify are not enrolled. The National Council on Aging (NCOA) estimates that only 49% of eligible older adults were enrolled in the Medicare Savings Programs in 2023, which left 6.6 million people without the help.
What Medicare takes each month
The $202.90 standard premium adds up to $2,434.80 over 2026. Medicare.gov says most people have it deducted from their Social Security payment, and people who get neither Social Security nor Railroad Retirement benefits get a bill from Medicare instead.
Not everyone pays exactly $202.90. CMS says about 8% of people with Part B pay more because of higher income, starting with single tax filers whose income is above $109,000. A federal law also stops the yearly premium increase from shrinking a person's Social Security payment, so some people whose cost-of-living raise was smaller than the premium increase pay less.
The three programs and their 2026 limits
The table shows the federal limits Medicare.gov lists for 2026. The income limits include $20 a month that is not counted, according to NCOA, and run slightly higher in Alaska and Hawaii.
| Program | Income limit, one person | Income limit, married couple | What it pays |
|---|
| Qualified Medicare Beneficiary (QMB) | $1,350 a month | $1,824 a month | Part B premium, Part A premium if you owe one, and Medicare deductibles, coinsurance and copays |
| Specified Low-Income Medicare Beneficiary (SLMB) | $1,616 a month | $2,184 a month | Part B premium |
| Qualifying Individual (QI) | $1,816 a month | $2,455 a month | Part B premium |
The federal savings limit for all three programs is $9,950 for one person and $14,910 for a married couple. Medicare.gov says the limit counts money in checking, savings and retirement accounts, plus stocks and bonds. States do not count your home, one car, a burial plot, up to $1,500 set aside for burial, or furniture.
The income that counts is the full Social Security benefit before Medicare takes the premium out. Federal SSI rules count a withheld Medicare premium as income, and CMS says states cannot be stricter than SSI's rules. A single person with no other income whose deposit is $1,250 after only the $202.90 premium comes out has a full benefit of $1,452.90. The $1,452.90 is over the QMB limit and under the SLMB limit, so that person can qualify for SLMB if savings are under $9,950.
Medicare.gov says Medicare providers may not bill a QMB member for deductibles, coinsurance or copays on services Medicare covers, though a small Medicaid copay can still apply. The Part B deductible alone is $283 in 2026. SLMB and QI require both Part A and Part B. QI members must reapply every year, and states approve QI first come, first served, with priority for last year's members.
Any Medicare Savings Program that pays the Part B premium also qualifies a person for Extra Help with drug costs automatically, according to Medicare.gov. With Extra Help, a person pays no more than $12.65 in 2026 for each drug their Medicare drug plan covers. Our guide to the Medicare Savings Programs has more detail on each program.
Some states go further
The CMS manual says states can raise the income limits and drop the savings test. New York has done both. The New York State Department of Health says there is no resource test for its programs, and a single person with income under $2,494 a month, a limit that includes the $20 that is not counted, can qualify for help with the Part B premium.
Medicare.gov tells people to apply even if they think they are over the limits, because each state decides. Our state-by-state list of limits shows where the rules differ.
How to apply
- Check first. Check if your state can pay your premium.
- Contact your state Medicaid office. Medicaid.gov lists every state's office and phone number.
- Or apply for Extra Help through Social Security. Medicare.gov says Social Security sends the Extra Help application to your state to start a Medicare Savings Program application, unless you say no on the form. Call 1-800-772-1213.
- Expect a decision within 45 days. Federal Medicaid rules give a state up to 45 days to decide most applications.
- Watch your Social Security deposit. Once the state's payment starts, the deduction stops. The CMS manual says Social Security refunds any premium it took for a month the state covers.
- Apply now, not at Open Enrollment. States take Medicaid applications all year. Medicare's Open Enrollment, October 15 to December 7, 2026, is for changing health and drug plans, with changes starting January 1, 2027.
Frequently Asked Questions
Can the state take money from my estate later to pay back the premiums?
No. Federal law bars states from recovering Medicare cost-sharing, which includes the Part B premium, from the estates of Medicare Savings Program members. People who also have full Medicaid should ask their state about recovery for other Medicaid services.
Sources
- CMS, 2026 Medicare Parts A & B Premiums and Deductibles, November 14, 2025
- Medicare.gov, Medicare Savings Programs
- Medicare.gov, How to pay Part A and Part B premiums
- Medicare.gov, Help with drug costs
- CMS, Manual for State Payment of Medicare Premiums, Chapter 1, sections 1.5 and 1.6
- Federal Register, Medicare Part B premium rates for 2026, November 19, 2025
- NCOA, Older Adults Leave $58 Billion in Benefits Unclaimed Every Year, May 7, 2026
- NCOA, What Are the 4 Types of Medicare Savings Programs?
- New York State Department of Health, Medicare Savings Program and Medicare Savings Program 2026
- Medicaid.gov, Estate recovery and where to get help in your state
- eCFR, 20 CFR 416.1123, 42 CFR 435.906 and 42 CFR 435.912
- U.S. Code, 42 U.S.C. 1396p(b) (estate recovery) and 42 U.S.C. 1396d(p)(3) (what counts as Medicare cost-sharing)
- Social Security, Extra Help FAQ
