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Delaware Medicare cost help
Last updated: 20 September 2026
Delaware Medicare Savings Programs can help people with limited income pay Medicare premiums. The Qualified Medicare Beneficiary program can also protect you from Medicare-covered deductibles, coinsurance, and copayments. Delaware uses its own 2026 income table, so do not rely only on a national chart.
Bottom Line: Start with Delaware ASSIST or call Delaware Medicaid Customer Relations at 1-866-843-7212. Ask to be screened for every Medicare Savings Program that may fit. Delaware’s current 2026 table lists monthly countable-income limits of $1,330 for one person for QMB, $1,596 for SLMB, $1,796 for QI-1, and $2,660 for QDWI. Delaware also disregards resources for all four MSP categories.
Start here:
- Apply through ASSIST or a Delaware State Service Center.
- Ask for screening across QMB, SLMB, QI-1, and QDWI when relevant.
- If you are unsure what a notice means, call the Delaware Medicare Assistance Bureau (DMAB) at 1-800-336-9500 for free Medicare counseling.
| Your situation | Best first step | Why |
|---|---|---|
| You want to apply | Use ASSIST | You can apply for medical assistance and track notices online. |
| You need phone help | Call Delaware Medicaid | Customer Relations can help with applications, status, and referrals. |
| You need Medicare counseling | Call DMAB | DMAB is Delaware’s State Health Insurance Assistance Program and counseling is free. |
| You got a wrong QMB bill | Use QMB billing rules | Providers may not bill QMB members for Medicare-covered cost-sharing. |
| You were denied | Request a fair hearing | Delaware accepts fair-hearing requests and lists the current email route. |
What Has Changed
This update corrects an important Delaware-specific point about QDWI. Delaware’s current income table and Medicaid rules use a 200% Federal Poverty Level limit for QDWI, not the higher general federal QDWI screening amount shown on Medicare.gov. For 2026, Delaware lists $2,660 a month for one person and $3,607 for a two-person household.
It also clarifies Delaware’s resource rule. The state’s approved Medicaid plan says resources are excluded for QMB, SLMB, QI-1, and QDWI. The prior version incorrectly treated QDWI as if the federal $4,000/$6,000 resource limits controlled in Delaware.
Delaware Medicare Savings Program Limits for 2026
Delaware posts a current 2026 income table for Medicare Savings Programs. The state calls these monthly countable-income limits. The table is the better starting point for a Delaware application than a general national chart.
| Program | One person | Two people | Main help | Resource rule |
|---|---|---|---|---|
| QMB | $1,330/month | $1,804/month | Part B premium, possible Part A premium, and Medicare-covered cost-sharing | Resources disregarded |
| SLMB | $1,596/month | $2,164/month | Part B premium | Resources disregarded |
| QI-1 | $1,796/month | $2,435/month | Part B premium | Resources disregarded |
| QDWI | $2,660/month | $3,607/month | Part A premium for certain working people with disabilities | Resources disregarded |
Delaware’s February 2026 official FPL notice confirms these 2026 figures. The notice says the updated QMB, SLMB, and QI-1 limits became effective in 2026 under Delaware’s annual poverty-level update.
Medicare.gov shows higher general federal QMB, SLMB, and QI figures for 2026. It also warns that states can use different income and resource rules. For Delaware, use the state’s published figures and let Delaware make the decision. See the federal MSP overview for the national framework.
Helpful tip: If your income is a little above the chart, apply anyway. Delaware uses countable-income rules, not a simple glance at gross monthly income. Income exclusions can matter.
What QMB, SLMB, QI, and QDWI Pay
Qualified Medicare Beneficiary (QMB)
What it helps with: QMB can pay the Part B premium, a Part A premium if you owe one, and Medicare-covered deductibles, coinsurance, and copayments. Delaware’s QMB program page describes this coverage.
Who may qualify: A person entitled to Medicare Part A whose countable income is within Delaware’s QMB rules may qualify.
Where to apply: Use ASSIST or contact Delaware Medicaid.
Reality check: QMB does not mean you receive every regular Medicaid medical benefit. Delaware says MSP-only recipients do not receive regular Medicaid services from MSP status alone.
Specified Low-Income Medicare Beneficiary (SLMB)
What it helps with: SLMB pays the Medicare Part B premium.
Who may qualify: A person entitled to Medicare Part A whose countable income is above QMB but within Delaware’s SLMB limit may qualify.
Where to apply: Use the same Delaware MSP application route.
Reality check: SLMB does not pay Medicare deductibles or coinsurance. But approved SLMB members also receive Extra Help with Medicare prescription drug costs under federal rules.
Qualifying Individual (QI-1)
What it helps with: QI-1 pays the Part B premium.
Who may qualify: A person within Delaware’s QI income band who is not eligible for another Medicaid benefit may qualify.
Where to apply: Ask Delaware to screen you for QI if QMB and SLMB do not fit.
Reality check: QI must be renewed every year. Medicare says states give priority to people who had QI the year before. Apply or renew promptly when Delaware asks.
Qualified Disabled and Working Individual (QDWI)
What it helps with: QDWI pays the Medicare Part A premium for certain people with disabilities who returned to work and lost premium-free Part A.
Who may qualify: Delaware’s current QDWI rule requires the person to be entitled to enroll in Part A, have income at or below 200% of the Federal Poverty Level under Delaware’s counting method, and not otherwise be eligible for Medicaid.
Where to apply: Contact Delaware Medicaid and ask for a QDWI review.
Reality check: QDWI is unusual for an older retiree. It mainly matters to a person with a disability who is working and has a Part A premium.
For a broader explanation of how these programs fit together, see the GFS Medicare Savings guide. If you may qualify for both Medicare and full Medicaid, the dual eligible guide explains the difference.
What approval can change each month
The standard Medicare Part B premium is 2026 Part B premium is $202.90 a month. For someone approved for QMB, SLMB, or QI, Delaware can pay that premium through Medicare’s state-payment system. If Social Security has been taking the premium from your monthly benefit, watch later payments and notices after approval.
If the deduction continues after the effective date shown on your approval notice, do not cancel Part B. Call Delaware Medicaid first and ask whether state payment has been sent to Medicare. Then ask DMAB or 1-800-MEDICARE to help trace the premium issue. Keep the approval notice and any Medicare premium bill until the problem is resolved.
How Delaware Counts Income and Resources
Do not self-deny because your gross income is a little above the table. Delaware’s current QMB rules use SSI-related countable-income methods. The state’s QMB income rules explain that certain income exclusions and disregards can apply.
For example, Delaware’s rules include a general income exclusion and special earned-income deductions. Spouse income can also be treated differently depending on the situation. The safest approach is to apply and ask Delaware to calculate countable income.
Resources are simpler for Delaware MSPs. Delaware’s approved Medicaid state plan says all resources of the applicant and spouse are excluded for QMB, SLMB, QI-1, and QDWI. This is a Delaware rule and is more generous than the general federal resource chart.
Reality check: The no-resource rule applies to these Medicare Savings Programs. It does not mean every Delaware Medicaid program ignores assets. Long-term care Medicaid and other categories can use different financial rules.
Phone script — income or assets
“I want a Medicare Savings Program decision. Please tell me how you counted my income and confirm whether this review is for QMB, SLMB, QI, or QDWI rather than a different Medicaid program.”
How to Apply Without Wasting Time
The fastest online route is usually ASSIST. Delaware says you can use the portal to apply for benefits, check application status, and view notices. GFS also has a plain-English Delaware ASSIST guide.
- Start the application. Do not wait until every document is perfect.
- Ask for all MSP levels. Do not assume you are only applying for QMB.
- Use current proof. Send the latest Social Security, pension, or wage information.
- Keep a receipt. Save the ASSIST confirmation, upload receipt, or a copy of anything mailed.
- Read every notice. A missing-document request can stop or delay a decision.
- Follow up. Delaware Medicaid Customer Relations is 302-571-4900 or 1-866-843-7212.
If online filing is hard, Delaware says you can visit a State Service Center for benefits help. You can also call Customer Relations and ask what application route is best for your situation.
Phone script — starting
“I have Medicare and want to apply for help with my Medicare costs. Please screen me for QMB, SLMB, QI-1, and QDWI if it applies. What proof do you need from me?”
If You Have QMB and Get a Medical Bill
QMB has a strong federal billing protection. Medicare providers and suppliers are not allowed to bill a QMB member for Medicare-covered deductibles, coinsurance, or copayments. A small Medicaid copayment may apply in limited cases, but the provider cannot collect ordinary Medicare cost-sharing from you.
- Do not ignore the bill.
- Call the billing office and say you are enrolled in QMB.
- Show your Medicare card and your Medicaid or QMB proof.
- Ask the office to correct the bill and rebill Medicare and Delaware Medicaid.
- If the office refuses, call 1-800-MEDICARE and DMAB.
The GFS QMB billing guide has more steps for repeated or collection-stage bills.
Phone script — wrong bill
“I am enrolled in the Qualified Medicare Beneficiary program. Federal QMB rules protect me from Medicare-covered cost-sharing. Please review this bill and correct the account.”
Documents and Information to Gather
Delaware can ask for proof before deciding eligibility. Missing proof is a common reason for delay. Gather what you have, then respond quickly if the state asks for something else.
| Item | Why it helps |
|---|---|
| Medicare card | Shows Medicare Part A and Part B information. |
| Social Security notice | Shows benefit income and Medicare deductions. |
| Pension statements | Shows retirement income Delaware may count. |
| Recent pay stubs | Important if you or a spouse still works. |
| Current address details | Helps Delaware send notices to the right place. |
| Denial or change notice | Needed when asking about an appeal or correction. |
| Medical bills | Useful when fixing a QMB billing problem. |
Reality Checks and Common Mistakes
- Do not use only Medicare.gov’s income chart. Delaware publishes its own 2026 MSP figures.
- Do not self-deny over savings. Delaware disregards resources for all four MSP categories.
- Do not assume MSP means full Medicaid. You may need a separate full-Medicaid decision.
- Do not pay a QMB cost-sharing bill automatically. Check whether the billing is prohibited.
- Do not ignore a proof request. Missing information can delay or end the application.
- Do not miss a renewal. QI must be renewed each year.
- Watch the October 2026 immigration change. If you are not a U.S. citizen, check Delaware’s Medicaid ENGAGE updates. Delaware says federal Medicaid immigration rules change October 1, 2026, and the state is still posting implementation details.
One less-known Delaware rule may matter if you apply late. Delaware rules allow potential retroactive eligibility for SLMB, QI, and QDWI when the requirements were met, while QMB is excluded from retroactive coverage. If an earlier month matters because a premium was due, ask the worker whether retroactive eligibility should be reviewed under Delaware’s retroactive coverage rules.
If You Are Denied, Delayed, or Cut Off
Read the Delaware notice first. Look for the reason, the date, and the fair-hearing instructions. A denial can happen because income was counted incorrectly, proof was missing, Medicare information did not match, or the application was placed in a different Medicaid category.
Delaware’s current fair-hearing notice states that a person generally has 90 days from the date on the notice to request a fair hearing. If existing benefits are being reduced or terminated, the request to keep benefits during the appeal must generally be made before the change takes effect. If the state later wins, Delaware may seek repayment of benefits continued during the appeal.
Delaware lists DHSS_DSS_FHRequest@delaware.gov for fair-hearing requests. For legal help with Medicare or Medicaid benefits, Community Legal Aid handles public-benefits matters for eligible Delaware residents.
Phone script — denial
“I received a Medicare Savings Program denial or reduction. Please explain the exact reason, how my income was counted, my fair-hearing deadline, and whether I can keep current benefits while the appeal is pending.”
Backup Help if MSP Is Not Enough
Medicare Savings Programs do not solve every medical-cost problem. If you do not qualify, or if the premium help is not enough, use these next steps.
- Extra Help: QMB, SLMB, and QI members also get Extra Help with Part D prescription costs. The GFS Extra Help guide explains the drug-cost benefit.
- Full Medicaid: Ask Delaware whether you should also be screened for regular Medicaid or another Medicaid category.
- Benefits screening: Use the GFS MSP and Extra Help checker to prepare questions. It is not an eligibility decision.
- Aging-network help: The GFS Delaware aging agencies guide can help you find local senior services.
- Urgent household needs: If the problem is food, utilities, rent, or another immediate bill, see Delaware emergency assistance.
Delaware and Official Resources
Delaware Medicaid Customer Relations: 302-571-4900 or 1-866-843-7212. Use this for application questions, case status, and referrals.
Delaware Medicare Assistance Bureau: 1-800-336-9500 or 302-674-7364. DMAB offers free Medicare counseling statewide.
Delaware State Service Centers: Use the state office finder if you need in-person benefits help.
Medicare: Call 1-800-MEDICARE for federal Medicare questions and QMB billing complaints.
Broader Delaware help: The GFS Delaware senior assistance guide covers other senior benefit paths beyond Medicare.
Resumen en Español
En Delaware, los Programas de Ahorro de Medicare pueden ayudar con las primas de Medicare. QMB también puede pagar costos cubiertos por Medicare, como deducibles, coseguro y copagos. Para 2026, Delaware publica estos límites mensuales de ingreso contable para una persona: QMB $1,330; SLMB $1,596; QI-1 $1,796; y QDWI $2,660.
Delaware no cuenta los recursos para QMB, SLMB, QI-1 ni QDWI. Puede solicitar ayuda por ASSIST o llamar a Medicaid al 1-866-843-7212. Para orientación gratuita sobre Medicare, llame a DMAB al 1-800-336-9500. Si recibe una factura médica mientras tiene QMB, pida que la oficina revise la protección de QMB antes de pagar. Si recibe una negación, lea la fecha de la carta y las instrucciones para pedir una audiencia.
Frequently Asked Questions
What are Delaware’s 2026 MSP income limits?
For one person, Delaware lists $1,330 a month for QMB, $1,596 for SLMB, $1,796 for QI-1, and $2,660 for QDWI. For a two-person household, the figures are $1,804, $2,164, $2,435, and $3,607. These are Delaware’s monthly countable-income figures.
Does Delaware have an asset limit for MSPs?
Delaware’s approved Medicaid state plan excludes all resources of the applicant and spouse for QMB, SLMB, QI-1, and QDWI. Other Medicaid programs can use different resource rules.
Why is Delaware’s QDWI limit lower than Medicare.gov?
Medicare.gov shows general federal QDWI screening figures, but Delaware’s current Medicaid rules use a 200% Federal Poverty Level income limit for QDWI. For 2026, Delaware lists $2,660 a month for one person and $3,607 for two people.
Can I apply without using the internet?
Yes. You can call Delaware Medicaid Customer Relations at 1-866-843-7212 or visit a Delaware State Service Center. DMAB can also provide free Medicare counseling.
What if a provider bills me after QMB approval?
Tell the billing office that you are enrolled in QMB and ask it to correct the bill. Providers cannot bill QMB members for Medicare-covered deductibles, coinsurance, or copayments. If the office will not fix the bill, call 1-800-MEDICARE and DMAB.
How long do I have to appeal a Delaware denial?
Delaware’s current fair-hearing notice says you generally have 90 days from the date on the notice to request a hearing. If benefits are being reduced or stopped, act sooner and ask about keeping benefits in place before the change takes effect.
About This Guide
Sources: This guide uses official federal, state, local, and other high-trust nonprofit and community sources linked in the article.
Editorial note
This guide is produced under the GFS Editorial Standards using official and other high-trust sources. GFS is not affiliated with a government agency and is not a substitute for official agency guidance. Individual eligibility outcomes cannot be guaranteed.
Corrections
Despite careful verification, errors may occur. Email info@grantsforseniors.org with corrections.
Disclaimer
This article is for informational purposes only and is not legal, financial, medical, tax, disability-rights, immigration, or government-agency advice. Program rules, policies, funding, and availability can change. Readers should confirm current details directly with the responsible official program before acting.
Last updated: 20 September 2026 · Next review: 20 January 2027
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