A Medicare Savings Program (MSP) is a Medicaid-funded benefit that helps people with limited income pay some or all of their Medicare costs. Depending on which of the four programs you qualify for, your state may cover your Part A premiums, Part B premiums, deductibles, copayments, or coinsurance. For 2026, individuals earning up to $1,816 per month can qualify for the three main programs, with resources capped at $9,950.
The Four Programs and What They Cover
There are four distinct Medicare Savings Programs, each covering a different slice of Medicare costs. The broadest program picks up nearly all your out-of-pocket expenses, while the narrowest covers only one premium. Here’s how they break down:
- Qualified Medicare Beneficiary (QMB): The most comprehensive option. It pays your Part B premium, Part A premium (if you don’t get premium-free Part A), plus all deductibles, coinsurance, and copayments for Medicare-covered services.
- Specified Low-Income Medicare Beneficiary (SLMB): Covers your Part B premium only. You need both Part A and Part B to qualify.
- Qualifying Individual (QI): Also covers your Part B premium only. This program is reserved for people who don’t qualify for any other Medicaid coverage.
- Qualified Disabled and Working Individual (QDWI): Covers your Part A premium only. This is specifically for people under 65 who lost premium-free Part A because they returned to work after a disability.
QMB stands apart from the other three because it doesn’t just pay a premium. It eliminates virtually all cost-sharing when you use Medicare-covered services, which can save thousands of dollars a year for someone with ongoing medical needs.
Income and Resource Limits for 2026
Each program has its own monthly income ceiling, but the first three share the same resource limits. “Resources” generally means savings, investments, and similar assets, though your home, usually one car, and certain insurance policies don’t count. A burial fund exclusion of $1,500 per person ($3,000 for a couple) is also excluded from the resource calculation.
QMB
Individual monthly income: $1,350 or less. Married couple: $1,824. Resource limit: $9,950 for an individual, $14,910 for a couple.
SLMB
Individual monthly income: $1,616 or less. Married couple: $2,184. Same resource limits as QMB: $9,950 individual, $14,910 couple.
QI
Individual monthly income: $1,816 or less. Married couple: $2,455. Resource limits remain $9,950 and $14,910. Remember, you can’t already be receiving other Medicaid benefits to qualify for QI.
QDWI
This program has the highest income ceiling but the lowest resource limits. Individual monthly income can be up to $5,405 (married couple: $7,299). However, resources are capped at just $4,000 for an individual and $6,000 for a couple. You must still have a disabling impairment, be working, and not already be eligible for Medicaid.
Limits are higher in Alaska and Hawaii. Some states also use more generous thresholds than the federal minimums or have eliminated the asset test entirely, so it’s worth checking your state’s specific rules even if you think you’re over the line.
QMB Billing Protections
If you qualify for QMB, federal law gives you an unusually strong financial shield. No Medicare provider or supplier, including pharmacies, is allowed to bill you for Part A or Part B cost-sharing. That means no bills for deductibles, coinsurance, or copayments on any Medicare-covered service. This protection applies to all Medicare providers, not just those who accept Medicaid. A provider who bills you anyway is violating their Medicare agreement and can face sanctions.
These protections follow you across state lines. If your QMB benefit comes from one state and you receive care in another, the billing prohibition still applies. You also cannot voluntarily choose to pay these cost-sharing amounts, even if a provider asks you to. The protection is absolute.
Automatic Extra Help With Drug Costs
Qualifying for any of the three programs that pay your Part B premium (QMB, SLMB, or QI) triggers an additional benefit: you’re automatically enrolled in Extra Help, the federal program that lowers your Part D prescription drug costs. Extra Help can significantly reduce your premiums, deductibles, and copayments for medications. You don’t need to apply separately for it.
This automatic link makes the Medicare Savings Programs especially valuable. Even the SLMB and QI programs, which only cover your Part B premium directly, effectively unlock prescription drug savings on top of that.
How to Apply
Medicare Savings Programs are administered by your state Medicaid office, not by Medicare itself. You apply through your state, and the process varies by location. Some states allow online applications, while others require a phone call or in-person visit.
You can also start the process through Social Security. When you contact Social Security to apply, they can screen your eligibility and forward your information to your state Medicaid agency. Regardless of how you apply, you’ll typically need to provide proof of income (such as Social Security benefit statements or pay stubs) and documentation of your resources (bank statements, investment account balances). Your home value and basic vehicle generally won’t count against you.
There’s no enrollment period for MSPs. You can apply at any time during the year, and if you qualify, coverage can begin as early as the month your application is approved. If your income or resources change over time, you may become eligible even if you were previously denied, so reapplying after a life change is worth considering.