Medicare Savings Programs: QMB, SLMB, and QI Explained, With the Exact 2026 Numbers
5 min read · Last updated August 13, 2026
- QMB pays your Part A and Part B premiums plus all Medicare deductibles, coinsurance, and copays – not just the premium – for individuals with income up to $1,350 a month ($1,824 for a couple) in 2026.
- SLMB and QI pay only the Part B premium, for individuals earning up to $1,616 and $1,816 a month, respectively.
- All three programs share the same 2026 resource limit: $9,950 for an individual, $14,910 for a couple – and your home and one car don’t count.
- If you have QMB, it is illegal for a Medicare provider to bill you for anything Medicare doesn’t cover through the program – a rule most providers’ billing departments don’t enforce correctly on their own.
Frank is 71 and lives on a Social Security check of about $1,300 a month. Every month, $185 comes out automatically for his Medicare Part B premium before the money ever reaches his bank account. He assumed that was just the cost of having Medicare – until a caseworker at his senior center mentioned a program called QMB that could eliminate that premium completely, along with his deductibles and copays.
In this article
- What these programs are
- Who qualifies
- What each one actually pays
- How to apply
- What people get wrong
- FAQ
What these programs are
Medicare Savings Programs (MSPs) are state-run programs, funded jointly with the federal government, that pay some or all of your Medicare costs if your income is low enough. There are three you’re likely to qualify for based on income: the Qualified Medicare Beneficiary (QMB) program, the Specified Low-Income Medicare Beneficiary (SLMB) program, and the Qualifying Individual (QI) program. A fourth, the Qualified Disabled and Working Individual (QDWI) program, applies only if you’re under 65, working, and lost premium-free Part A due to returning to work.
Who qualifies
Each program has its own income ceiling, and all three share the same resource limit. These are the 2026 federal limits for the 48 contiguous states and D.C. – Alaska and Hawaii use higher figures:
| Program | Monthly income (individual) | Monthly income (couple) | Resource limit |
|---|---|---|---|
| QMB | $1,350 | $1,824 | $9,950 individual / $14,910 couple |
| SLMB | $1,616 | $2,184 | $9,950 individual / $14,910 couple |
| QI | $1,816 | $2,455 | $9,950 individual / $14,910 couple |
Your home, one car, a burial plot, and up to $1,500 per person set aside for burial expenses don’t count toward the resource limit. Many states also disregard a portion of your income before comparing you to these figures, so don’t rule yourself out from a rough estimate – apply and let your state Medicaid agency run the real numbers.
Here’s why that matters in practice. Say a single retiree’s Social Security check is $1,450 a month – above the $1,350 QMB limit on paper. Some states disregard the first $20 of most monthly income before running the comparison, which would bring her countable income to $1,430, still over the line for QMB but comfortably under the $1,616 SLMB limit. She’d have missed a real benefit if she assumed her gross check disqualified her from every tier rather than checking each one against her actual countable income.
What each one actually pays
This is where the three programs genuinely differ, not just in who qualifies:
- QMB pays the most. It covers your Part A premium (if you have one), your Part B premium, and all Medicare deductibles, coinsurance, and copays – for Medicare-covered services, QMB enrollees pay nothing out of pocket.
- SLMB pays only the Part B premium. No deductible or coinsurance help.
- QI also pays only the Part B premium, but with one catch: QI is funded through a fixed federal allocation each year and is awarded first-come, first-served. If you apply late in the year after that year’s QI funding is exhausted, you may need to reapply the following January.
How to apply
You apply for all three programs through your state’s Medicaid agency, not through Medicare or Social Security directly – even though the benefit affects your Medicare costs. The application asks for the same income and resource information shown in the table above: recent bank statements, proof of income (Social Security award letter, pension statements, wage stubs if you’re still working), and a list of any other resources like a second vehicle or investment account. If you’re approved, the state notifies Medicare, and your Part B premium typically stops being deducted from your Social Security check within one to three months.
If you’re denied, ask specifically which program you were evaluated against. A denial letter that only says “over income limit” without naming QMB, SLMB, or QI specifically may mean you were only checked against the lowest tier. Request that the caseworker confirm you were evaluated against all three programs before accepting the denial as final.
What people get wrong
The most damaging mistake isn’t about eligibility – it’s not knowing your rights once you have QMB. Federal law bars any Medicare provider or supplier from billing a QMB enrollee for Medicare Part A or Part B cost-sharing, even if the provider doesn’t accept Medicaid. This is called “improper balance billing,” and CMS and the Consumer Financial Protection Bureau jointly took action in 2024 after finding that some providers, including ones relying on incorrect information from Medicare Advantage plans, were still sending these bills. If you have QMB and get a bill for a copay, deductible, or coinsurance on a Medicare-covered service, that bill is very likely wrong.
The second mistake is assuming a QMB denial means no help exists at all. QMB’s income cutoff is the lowest of the three programs. If your income is above the QMB limit, ask specifically about SLMB and QI rather than accepting “you don’t qualify” as the end of the conversation.
The same fixed-income math that qualifies someone for a Medicare Savings Program often clears other income tests too. If you qualify for QMB, SLMB, or QI, it’s worth checking whether you also qualify for home heating assistance through LIHEAP, which uses a similar income comparison.
If your medical costs run higher than what a Medicare Savings Program covers, SNAP has its own separate benefit worth checking: the excess medical expense deduction for seniors can lower your countable income by the same Medicare premium this program may already be paying.
Qualifying for a Medicare Savings Program also protects you from a separate cost. It generally waives the Medicare Part B late enrollment penalty that otherwise applies to anyone who delays signing up.
Frequently asked questions
Can I have QMB and Medicaid at the same time? Yes. Many QMB enrollees also qualify for full Medicaid benefits, in which case Medicaid covers services Medicare doesn’t, like most dental and long-term care, in addition to QMB’s premium and cost-sharing help. Dual-eligible enrollees who need a nursing-home level of care may also want to ask about PACE, a separate program that coordinates that care while letting most participants stay at home.
Does having a Medicare Savings Program affect my Extra Help eligibility? No, they’re separate programs, but qualifying for QMB, SLMB, or QI automatically qualifies you for full Extra Help with your Part D drug costs without a separate application.
What if my income is just over the QI limit? Some states apply income disregards that effectively raise the cutoff, and rules vary by state. Apply anyway and let your state Medicaid agency calculate your countable income rather than assuming a gross-income comparison rules you out.
I have QMB and a provider billed me for a copay. What do I do? Show the provider your QMB approval notice and ask them to reprocess the claim. If they refuse, file a complaint with your State Health Insurance Assistance Program (SHIP) or Medicare directly – improper billing of QMB enrollees is a federal violation providers are required to correct.
