A Medicare Savings Program is not insurance and it is not a discount card. It is your state Medicaid agency paying your Medicare bills for you, using a federal eligibility floor that every state has to meet and many states exceed.
The money involved is not small. The standard Part B premium is $202.90 a month in 2026 per the CMS fact sheet published November 14, 2025, which is $2,434.80 over a year that comes straight out of a Social Security check. Every figure below was pulled on September 6, 2026 from Medicare.gov, SSA’s POMS manual and CMS.
The Four Programs and What Each One Pays
There are four categories. They share a naming convention that tells you nothing, so the useful way to read them is by what they cover.
| Program | 2026 monthly income limit (single / married) | Resource limit (single / married) | What it pays |
|---|---|---|---|
| QMB (Qualified Medicare Beneficiary) | $1,350 / $1,824 | $9,950 / $14,910 | Part B premium, Part A premium if you owe one, plus Medicare deductibles, coinsurance and copays |
| SLMB (Specified Low-Income Medicare Beneficiary) | $1,616 / $2,184 | $9,950 / $14,910 | Part B premium only |
| QI (Qualifying Individual) | $1,816 / $2,455 | $9,950 / $14,910 | Part B premium only, must reapply every year |
| QDWI (Qualified Disabled and Working Individual) | $5,405 / $7,299 | $4,000 / $6,000 | Part A premium only |
Those limits are identical on Medicare.gov’s Medicare Savings Programs page and in SSA POMS HI 00815.023, the internal manual Social Security staff work from, which carries an effective date of February 26, 2026.
QMB is the one worth the most. On top of the $202.90 Part B premium it covers the $283 annual Part B deductible, the $1,736 Part A inpatient hospital deductible per benefit period, the $434 daily hospital coinsurance for days 61 through 90, the $868 daily rate for lifetime reserve days, and the $217 daily skilled nursing coinsurance for days 21 through 100. If you are one of the small number of people who has to buy Part A, QMB covers that too, and the 2026 Part A premium is $311 or $565 a month depending on your work history.
SLMB and QI pay the Part B premium and stop there. No deductibles, no coinsurance, no copays. That is $2,434.80 a year in 2026, which is still real money, but it is a much narrower benefit than QMB. Both require that you already have Part A.
QI carries a catch. It is funded through a capped federal allotment rather than an open-ended match, so states award it on a first come first served basis and you have to file again every year to keep it.
QDWI is a narrow category for people under 65 who lost premium-free Part A because they went back to work. Its income limit looks wildly out of step with the others because it is a gross earnings figure for working applicants, and NCOA’s 2026 cheat sheet describes the standard as roughly 400% of the poverty line.
How the 2026 Limits Are Built
The income limits are not arbitrary. They are percentages of the 2026 HHS poverty guidelines plus a $20 monthly general income disregard, which is why they look like odd numbers. QMB is 100% of poverty plus $20, SLMB is 120% plus $20, and QI is 135% plus $20. NCOA’s core benefits cheat sheet, dated February 1, 2026, spells the formula out that way.
That $20 matters more than it looks. It means someone earning exactly the poverty line still clears the QMB bar, and it means the published figure already includes the disregard rather than sitting on top of it.
Alaska and Hawaii run on separate tables because their poverty guidelines are higher. POMS HI 00815.023 lists QMB in Alaska at $1,683 single and $2,275 married, and in Hawaii at $1,550 and $2,095. SLMB and QI scale up the same way.
Resources means countable liquid assets: checking and savings, stocks, bonds, and real estate that is not your primary home. The house you live in and your vehicle are not counted.
Your State May Be More Generous, Sometimes Far More
This is the single most common reason people wrongly assume they do not qualify. States are permitted to be less restrictive than the federal floor, and a lot of them are.
Per NCOA’s 2026 cheat sheet, twelve states plus the District of Columbia have eliminated the asset test entirely: Alabama, Arizona, Connecticut, Delaware, DC, Louisiana, Maine, Mississippi, New Mexico, New York, Oregon and Vermont. California, Massachusetts, Maine and Minnesota have raised their asset limits instead of scrapping them. KFF noted that as of November 2022 eleven states had already dropped the asset test, so the count has been drifting upward.
Several states also set higher income limits. NCOA lists Alaska, Connecticut, DC, Hawaii and Maine in that group, and Illinois, Maine and Mississippi use a larger income disregard than the federal $20.
The practical rule: the federal numbers in the table above are a floor, not a ceiling. Medicare.gov says it directly, that you may still qualify in your state even if your income or resources are higher than the federal limits listed. Apply and let the state run the math.
The QMB Billing Protection
QMB comes with a legal shield that the other three do not have. Federal law bars Medicare providers and suppliers, including pharmacies, from billing anyone in the QMB group for Medicare cost sharing. CMS states this plainly on its QMB program page, and it applies to all Original Medicare and Medicare Advantage providers, including ones that do not accept Medicaid at all.
CMS also reports that more than 8 million people were in the QMB group in 2023, which is more than one in eight Medicare beneficiaries.
Wrongful billing of QMB enrollees is a documented, persistent problem, so if a bill shows up anyway, the fix is to tell the provider you are in the QMB program and ask them to reverse the charge. If it has already gone to collections, the same tactics that work on any hospital bill apply, and our guide to negotiating medical bills covers the script.
Enrolling Turns On Extra Help Automatically
Anyone enrolled in QMB, SLMB or QI is automatically deemed eligible for the Part D low income subsidy. SSA POMS HI 03001.005 lists Medicare Savings Program participation as a deeming category alongside full Medicaid and SSI, and Medicare.gov’s MSP page confirms it: qualify for one of those three and you will also get Extra Help paying for your prescription drugs.
That is a second benefit stacked on the first. Deemed status means a $0 Part D premium up to your region’s benchmark, a $0 deductible, and generic and brand copays capped at $5.10 and $12.65 in 2026. The full mechanics are in our Extra Help guide.
The one exception is QDWI. POMS is explicit that Qualified Disabled Working Individuals are not deemed eligible for Extra Help, so a QDWI enrollee who wants the drug subsidy has to apply for it separately.
How and Where to Apply
Two paths lead to the same place.
Direct, through your state. Medicare.gov’s instruction is one line: these programs are run by your state, contact your state to apply. That means your state Medicaid agency or county social services office, not Medicare and not Social Security. Application forms, asset rules and processing times all vary by state.
Indirect, through Social Security. Under the Medicare Improvements for Patients and Providers Act, filing the Extra Help application (form SSA-1020, or the online i1020) also starts an MSP application. POMS HI 00815.024 spells out the mechanism: unless you refuse on the application itself, data from your Extra Help determination is sent daily to the appropriate state Medicaid agency to begin the MSP application process. SSA does not decide the outcome. Only the state can determine if you qualify.
That second path is why filing one form can be worth doing even if you are unsure which program fits. It puts you in front of both agencies at once.
What It Adds Up To
For a single person on QMB with premium-free Part A, the recurring benefit is the $202.90 Part B premium plus the $283 Part B deductible, so roughly $2,718 in a year before a single hospital or doctor bill is counted. For someone who has to buy Part A at the full $565 rate, the annual premium relief alone runs past $9,200.
For SLMB and QI it is $2,434.80 a year, flat.
None of this touches dental, vision or hearing, which Original Medicare largely does not cover either. If those are your costs, start with Medicare dental coverage and free and sliding-scale clinics instead.
If drug costs are the pressure point and you are above the MSP limits, the Medicare Prescription Payment Plan spreads Part D out over the year at no interest, manufacturer assistance programs fill other gaps, and cash prices at Cost Plus Drugs sometimes beat any insurance route. If a higher income is what disqualified you, and that income was a one-time event, the IRMAA appeal is the tool for that problem. Missing a signup window is a different problem entirely, covered in the late enrollment penalty guide.
One last timing note. The 2026 figures above are the current published numbers as of September 2026. CMS announces the following year’s Part B premium and deductible in a November fact sheet, and the MSP income limits reset each January when HHS publishes new poverty guidelines, so expect all of these to move.