Medicare Savings Programs: QMB, SLMB, QI Eligibility

What Are Medicare Savings Programs?

Medicare Savings Programs (MSPs) are federal programs that help people with limited incomes pay their Medicare costs. About 10 million Americans are enrolled in an MSP. The Centers for Medicare & Medicaid Services (CMS) sets the federal rules, and state Medicaid agencies run the programs locally.

There are three main MSP tiers: QMB, SLMB, and QI. Each tier covers different costs depending on your income. The most generous tier, QMB, pays for Part A premiums, Part B premiums, deductibles, coinsurance, and copays. The other two tiers, SLMB and QI, cover the Part B premium only. In 2026, the standard Part B premium is $202.90 per month, which adds up to $2,435 per year.

Everyone who qualifies for an MSP also gets Extra Help, a separate program that lowers prescription drug costs under Medicare Part D. With Extra Help, you pay no more than $12.65 per drug in 2026.

If you are already on Medicare and struggling with premiums or out-of-pocket costs, an MSP could save you thousands of dollars each year. Many people who qualify never apply because they do not know these programs exist. According to federal estimates, millions of eligible Medicare beneficiaries are not enrolled. Applying is free, and there is no penalty for being denied.

MSPs are sometimes called "Medicare buy-in" programs because Medicaid "buys in" to Medicare on your behalf by paying your premiums and, in some cases, your cost-sharing.

Who Qualifies for Medicare Savings Programs?

You must be enrolled in Medicare Part A to qualify for any MSP. Most applicants are 65 or older, but younger people on Medicare due to a disability also qualify. Your monthly income and countable resources must fall below the limits for your tier.

2026 Federal Income and Resource Limits

Source: Medicare.gov Medicare Savings Programs, 2026 limits.

These income limits include a $20 general income disregard that is already built into the numbers above. The limits are slightly higher in Alaska and Hawaii.

What Counts as Income?

Your countable monthly income includes Social Security benefits, pensions, wages, and interest from savings. It does not include food or housing assistance you receive from other programs like SNAP or LIHEAP.

What Counts as Resources?

Resources include bank accounts, stocks, bonds, and cash. Your home does not count. Your car does not count. Burial plots and up to $1,500 in burial funds per person are also excluded. Life insurance policies with a face value under $1,500 do not count.

Many states set their own resource rules that are more generous than the federal limits. Some states have removed resource limits for MSPs entirely. Contact your state Medicaid office to find out your state's specific rules.

State Variations

States can expand eligibility beyond the federal minimums. Some states use higher income thresholds or ignore certain types of income when determining eligibility. In California, New York, and Illinois, some applicants with income above the federal limits still qualify because of how those states count income.

You can use our free screener to check if you qualify in about five minutes.

What Each Program Covers

The three MSP tiers differ in what costs they pay for you. Here is a breakdown.

QMB (Qualified Medicare Beneficiary)

QMB is the most generous tier. It covers:

• Medicare Part A premiums (if you do not have premium-free Part A)
• Medicare Part B premiums ($202.90 per month in 2026)
• Part A and Part B deductibles
• Coinsurance and copays for Medicare-covered services

If you have QMB, Medicare providers cannot bill you for deductibles, coinsurance, or copays on covered services. If a provider sends you a bill, you do not have to pay it. Contact 1-800-MEDICARE (1-800-633-4227) to report billing issues.

The total value of QMB can exceed $5,000 per year when you add up premiums, deductibles, and cost-sharing savings. For people with frequent medical visits or hospital stays, the savings are even higher.

SLMB (Specified Low-Income Medicare Beneficiary)

SLMB covers your Part B premium only. In 2026, that saves you $202.90 per month, or $2,435 per year. You must have both Part A and Part B to qualify.

SLMB does not cover deductibles, coinsurance, or copays. But the Part B premium savings alone free up over $200 per month that you can put toward other expenses. For someone living on a fixed Social Security income, that $200 can make the difference between affording groceries and going without.

QI (Qualifying Individual)

QI also covers your Part B premium only, the same as SLMB. The difference is the income limit. QI has the highest income threshold of the three programs, reaching up to $1,816 per month for an individual.

One important difference: QI requires you to reapply every year. States approve QI applications on a first-come, first-served basis, with priority given to people who received QI benefits the previous year. Funding has never run out in practice, but applying early in the year is a good idea.

Comparison Table

All three tiers automatically include Extra Help with prescription drug costs.

How to Apply for Medicare Savings Programs

Your state Medicaid agency handles MSP applications. The process is free and straightforward.

Step 1: Check your eligibility

Use our free eligibility screener or review the income and resource limits above. The screener takes about five minutes and checks MSPs along with 20 other programs.

Step 2: Gather your documents

You will need:

• Proof of identity (driver's license, state ID, or passport)
• Proof of Medicare enrollment (your Medicare card)
• Proof of income (Social Security award letter, pension statements, pay stubs)
• Bank statements showing current balances
• Proof of resources (investment account statements if applicable)

Step 3: Submit your application

Online: Many states accept MSP applications through their Medicaid portals. In Texas, apply through YourTexasBenefits.com. In California, use BenefitsCal.com. In Florida, use MyACCESS Florida.

Phone: Call your State Health Insurance Assistance Program (SHIP). SHIP counselors help with Medicare-related applications for free. Find your local SHIP at shiphelp.org or call 1-877-839-2675.

In person: Visit your local Medicaid or Department of Social Services office. You can also get help at your Area Agency on Aging.

By mail: Download your state's MSP application form, fill it out, and mail it to your local Medicaid office.

Step 4: Wait for a decision

Most states process MSP applications within 45 days. If approved, your benefits are backdated to the month you applied. The state will notify Social Security to stop deducting the Part B premium from your Social Security check.

Step 5: Start using your benefits

Once approved, your MSP benefits begin automatically. For QMB, show both your Medicare card and your Medicaid or QMB card when you visit a provider. For SLMB and QI, the premium savings will show up as a credit on your Social Security statement.

Tips for a Smooth Application

Apply as soon as you think you might qualify. Benefits start from your application date, not your approval date. If you are missing a document, submit the application anyway and provide the document later.

If your application is denied, you have the right to appeal. The denial notice will explain the reason and how to file an appeal. Many denials result from missing paperwork rather than actual ineligibility.

Social Security can also refer you to MSPs. When you apply for SSI or Medicare Extra Help, the Social Security Administration may forward your information to your state Medicaid agency for MSP screening.

Medicare Savings Programs and Other Programs

Many MSP recipients also qualify for other programs that lower their costs. Here are some worth checking:

• Medicaid: QMB recipients are automatically enrolled in Medicaid in most states. SLMB and QI recipients may also qualify for full Medicaid depending on their state's income limits.
• Medicare: MSPs help pay for costs within Original Medicare. If you have a Medicare Advantage plan, QMB still protects you from cost-sharing for covered services.
• SSI: Supplemental Security Income provides monthly cash payments to people with limited income who are 65 or older, blind, or disabled. SSI recipients in most states automatically qualify for Medicaid and often for QMB.
• SNAP: Many MSP recipients also qualify for food assistance through SNAP. A single person with income under $1,696 per month may qualify for both programs.
• LIHEAP: The Low Income Home Energy Assistance Program helps pay heating and cooling bills. MSP recipients frequently qualify for LIHEAP as well.
• Extra Help (Low-Income Subsidy): All MSP recipients automatically get Extra Help, which covers most Part D prescription drug costs. You do not need to apply separately.

Our free screener checks Medicare Savings Programs and all of these programs at once.

Frequently Asked Questions

Do I need to be 65 or older to qualify?

No. Anyone enrolled in Medicare can apply. If you are under 65 and receive Medicare because of a disability or End-Stage Renal Disease, you can qualify for an MSP based on your income and resources.

Will MSP benefits affect my other Medicare coverage?

No. An MSP does not change your Medicare coverage. It only helps pay the costs. You keep your same doctors, hospitals, and Medicare plan. If you have a Medicare Advantage or Medigap plan, your MSP works alongside it.

Can I have QMB and Medicaid at the same time?

Yes. In most states, QMB recipients are automatically enrolled in Medicaid. This gives you both Medicare and Medicaid coverage, which means very low out-of-pocket costs for medical care and prescriptions.

What happens if my income changes after I am approved?

You must report income changes to your state Medicaid agency. If your income goes up, you might move from QMB to SLMB or QI, or you might lose eligibility. If your income goes down, you might qualify for a more generous tier. States review your eligibility periodically, usually once a year.

How is the $20 income disregard applied?

The federal income limits already include a $20 per month general income disregard. This means Social Security subtracts $20 from your countable income before comparing it to the limit. The numbers listed on Medicare.gov already reflect this disregard.

Can I apply for all three MSP tiers at once?

You submit one application. Your state Medicaid agency determines which tier you qualify for based on your income. If your income is low enough for QMB, you get QMB. If it is too high for QMB but within the SLMB range, you get SLMB. You do not need to choose a tier yourself.

Does owning a home disqualify me?

No. Your primary residence is not counted as a resource for MSP eligibility. Neither is your car, household goods, or personal belongings. The resource limits apply only to countable financial assets like bank accounts, stocks, and bonds.

Where can I get free help with my MSP application?

Your State Health Insurance Assistance Program (SHIP) offers free, unbiased counseling on all Medicare-related topics, including MSP applications. SHIP counselors can walk you through the paperwork and help you gather documents. Find your local SHIP at shiphelp.org or call 1-877-839-2675. You can also contact your Area Agency on Aging or call the Eldercare Locator at 1-800-677-1116 for a referral to local assistance.