Medicare is not a low-income program. It’s federal health insurance based primarily on age (65 and older) or disability status, not on how much money you make. The program you may be thinking of is Medicaid, which does use income to determine eligibility. That said, if you’re already on Medicare and have a limited income, several programs exist to reduce or eliminate your out-of-pocket costs.
Medicare vs. Medicaid: The Key Difference
Medicare and Medicaid sound similar, and many people mix them up. Medicare is federal health insurance for people 65 or older, plus some people under 65 with certain disabilities or conditions. Your income doesn’t matter for basic eligibility. If you qualify by age or disability, you get Medicare.
Medicaid, on the other hand, is a joint federal and state program specifically designed to help people with limited income and resources cover medical costs. Income limits vary by state. Some people qualify for both programs at the same time, known as “dual eligibility.”
Low-Income Help for People on Medicare
Even though Medicare itself isn’t income-based, the premiums, deductibles, and copays can be a real burden on a tight budget. The standard Part B premium alone is $185 per month in 2025. That’s where Medicare Savings Programs come in. These are state-run programs that pay some or all of your Medicare costs if your income and savings fall below certain thresholds.
There are four Medicare Savings Programs, each covering different costs and serving different income levels. All income and resource limits listed below are for 2026.
Qualified Medicare Beneficiary (QMB)
This is the most comprehensive program. It covers your Part A premiums (if applicable), Part B premiums, and all deductibles, coinsurance, and copays for Medicare-covered services. If you qualify, providers are not allowed to bill you for any of these costs. To be eligible, your monthly income can’t exceed $1,350 as an individual or $1,824 as a couple, and your countable resources must stay under $9,950 (individual) or $14,910 (couple).
Specified Low-Income Medicare Beneficiary (SLMB)
SLMB covers your Part B premium only. You need both Part A and Part B to qualify. The income ceiling is higher than QMB: $1,616 per month for an individual or $2,184 for a couple. Resource limits are the same as QMB at $9,950 and $14,910.
Qualifying Individual (QI)
Like SLMB, this program pays your Part B premium. It’s available to people with slightly higher incomes, up to $1,816 per month for an individual or $2,455 for a couple. Resource limits remain $9,950 and $14,910. One important catch: you must reapply every year, and states approve applications on a first-come, first-served basis. Priority goes to people who received QI benefits the previous year. You also can’t be receiving any other Medicaid coverage to qualify for QI.
Qualified Disabled and Working Individual (QDWI)
This program is narrower. It’s specifically for people with a disability who returned to work and lost their premium-free Part A coverage as a result. QDWI pays only the Part A premium. Income limits are more generous here, at $5,405 per month for an individual or $7,299 for a couple, but resource limits are lower: $4,000 and $6,000.
Help With Prescription Drug Costs
If you have a Medicare Part D prescription drug plan, the Extra Help program (also called the Low-Income Subsidy) can significantly reduce what you pay for medications, including deductibles and copays. Starting in 2024, people with incomes up to 150% of the federal poverty level qualify for the full subsidy. Previously, people between 135% and 150% of poverty only received partial help, but the Inflation Reduction Act eliminated that gap. Everyone under the 150% threshold now gets the full benefit.
You can apply for Extra Help through the Social Security Administration. If you’re approved for one of the Medicare Savings Programs listed above, you typically qualify for Extra Help automatically.
Dual Eligibility: Medicare and Medicaid Together
Some people qualify for both Medicare and Medicaid at the same time. This is common among older adults with very low incomes. When you have both, Medicaid typically picks up costs that Medicare doesn’t cover, like long-term care, and may pay your Medicare premiums and copays depending on your state.
People with dual eligibility can also enroll in Dual Eligible Special Needs Plans (D-SNPs), which are Medicare Advantage plans designed specifically for this group. Some D-SNPs offer zero-dollar cost sharing on the Medicare side, meaning you pay nothing out of pocket for covered services. The exact benefits vary by plan and state.
How to Apply
Medicare Savings Programs are administered at the state level, typically through your state Medicaid office or department of social services. You apply through your state, not through Medicare directly. Each state may have slightly different application processes, but you’ll generally need to provide proof of income (like Social Security statements or pay stubs) and documentation of your savings and other countable resources.
Your home and one vehicle generally don’t count toward the resource limits, so don’t assume you’re over the threshold just because you own property. If you’re not sure whether you qualify, applying costs nothing, and the potential savings on premiums and copays alone can amount to several thousand dollars a year.