Medicare Savings Programs in New York

Last updated: 7 April 2026

Bottom Line: In New York, a Medicare Savings Program can remove the monthly Medicare Part B premium, and for people who qualify for Qualified Medicare Beneficiary (QMB), it can also stop Medicare deductibles, coinsurance, and copays for Medicare-covered care. The biggest New York-specific rule is that the state says there is no resource test for New York MSPs, so savings alone do not knock most applicants out.

New York is also in the middle of a Medicaid eligibility modernization. That means some official pages still point seniors to a paper form and local county office, while newer state guidance says many Medicare Savings Program applications are now being taken through NY State of Health. In New York City, the route is different again because the Human Resources Administration (HRA) and ACCESS HRA are central.

Important note about the dollar figures below: On 7 April 2026, the most recent public New York Department of Health MSP income chart still showed the 2025 New York monthly limits. That is the latest public New York chart we could verify online that day, so this guide uses those state-posted numbers and clearly labels them. If your income is close to a limit, do not assume you are over. Call for a case review.

Emergency Help Now

• If you already have QMB and a doctor, hospital, or collection agency is billing you for a Medicare-covered service, call the billing office today, tell them you are in QMB, and if they do not fix it call 1-800-MEDICARE.
• If you filed an MSP application and have no decision after 45 days, call the New York Medicaid Helpline at 1-800-541-2831, or if you live in New York City call the HRA Medicaid Helpline at 1-888-692-6116.
• If you need free same-day help understanding what to do next, call HIICAP at 1-800-701-0501. If you are applying through the state marketplace route, call NY State of Health at 1-855-355-5777.

Quick Help

• Fastest statewide help: Call HIICAP at 1-800-701-0501 for free, unbiased Medicare counseling.
• If you are 65+, have Medicare, or want MSP screening outside NYC: Start with NY State of Health at 1-855-355-5777.
• If you live in NYC: Use ACCESS HRA or call 1-888-692-6116.
• If an office asks for paper: Use the official DOH-4328 Medicare Savings Program application and the state instructions.
• If you need your local office: Use New York’s Local Department of Social Services finder, or in NYC use the HRA Medicaid office locator.

What this help actually looks like in New York

Start here: In New York, the real first question is not “Do I have too much in savings?” It is “Am I applying through the right New York office?” The state’s main MSP page says there is no resource test for the New York Medicare Savings Program. That means many older adults who would be over an asset limit in another state can still qualify here.

Also important: many national articles are wrong for New York because they still talk about Specified Low-Income Medicare Beneficiary (SLMB) as if it is a normal current New York category. The official New York State Office for the Aging HIICAP counselor guide says SLMB is no longer available as a separate MSP in New York and was absorbed into New York’s 2023 expansion. That is why the public Department of Health MSP page now focuses on QMB and QI, plus QDWI in separate guidance.

New York also has a split system: the older public form instructions still say to mail the MSP application to your local county Department of Social Services or, in New York City, to HRA. But the state’s newer Medicaid modernization page says that starting on 30 September 2025, applications from people who are dual-eligible, age 65 or older and not seeking long-term care, or applying for MSP are being taken through the NY State of Health Customer Service Center, and that since December 2025 many of those consumers can also use the updated member portal.

What this means in plain language: if you are an older adult in Albany, Buffalo, Nassau, Suffolk, Rochester, Syracuse, or anywhere else outside New York City, call first and ask whether your case should start through NY State of Health or through your local district. If you live in one of the five boroughs, HRA and ACCESS HRA are still central for the seniors and Medicare groups HRA handles.

Example, not a statewide rule: a senior in Monroe County might still be told to use the paper DOH-4328 and send it to the county office, while a senior in Brooklyn might be told to file through ACCESS HRA or HRA. Because New York is mid-transition, both answers can be correct.

Quick Facts

• Best immediate takeaway: New York does not use an asset test for QMB or QI.
• Major rule: In New York City, seniors often use ACCESS HRA or HRA; outside NYC, many seniors should start with NY State of Health or their county DSS.
• Realistic obstacle: New York’s official websites still show both old paper routes and new modernization routes.
• Useful fact: New York says there are more than 700 trained HIICAP counselors across the state.
• Best next step: Gather your Medicare card, proof of income, proof of address, and any Medigap or Medicare Advantage premium bill before you call.

What Medicare Savings Programs are and why they matter for seniors in New York

A Medicare Savings Program, often called an MSP, is help through New York Medicaid that pays some Medicare costs. At a minimum, it can stop the standard 2026 Medicare Part B premium of $202.90 per month. That alone is more than $2,400 a year back in your budget.

For New Yorkers who qualify for QMB, the help is stronger. QMB can pay the Part B premium, can pay a Part A premium if you have to buy Part A, and also covers Medicare cost-sharing for Medicare-covered services. Cost-sharing means deductibles, coinsurance, and copays. That is why the New York State Office for the Aging says MSP can save a person with Medicare up to $8,400 a year.

MSP also matters because it triggers automatic Extra Help for Part D prescription drugs. That can lower drug plan premiums, deductibles, and copays. New York’s official HIICAP guide also says MSP enrollment removes the Part B late enrollment penalty and can let a person enroll in Part B outside the usual enrollment windows.

QMB vs SLMB vs QI vs QDWI explained simply

This comparison uses the official New York HIICAP counselor guide, the New York Department of Health MSP page, and Medicare.gov.

Program	Status in New York	What it pays	Key New York note
QMB	Active	Part B premium, Part A premium if needed, and Medicare deductibles, coinsurance, and copays for Medicare-covered care	You can have QMB by itself or QMB plus Medicaid. Providers cannot bill QMB members for Medicare-covered cost-sharing.
SLMB	Not separate now	Older national category that usually paid the Part B premium only	New York’s official HIICAP guide says SLMB is no longer a separate MSP in New York after the 2023 expansion.
QI	Active	Part B premium only	You must have Part A, and you cannot have Medicaid at the same time as QI.
QDWI	Active but narrow	Part A premium only	Mostly for people under 65 who returned to work after disability and lost premium-free Part A.

Plain English version: If you are a typical retired senior in New York, you are usually looking at QMB or QI. If you read an article that spends a lot of time on SLMB for New York, that article is probably old. If you are under 65, working, disabled, and lost free Part A after returning to work, then QDWI is the special category to ask about.

Income limits for seniors in this state

The table below uses the latest public New York MSP limits we could verify online on 7 April 2026 from the New York Department of Health MSP chart and the New York State Office for the Aging MSP page. Those New York figures already reflect the state’s standard $20 income disregard. For QDWI, New York’s public MSP page does not post a current separate chart, so the table uses the 2026 federal QDWI figures on Medicare.gov.

Latest verified New York MSP amounts available online on 7 April 2026.

Program	Single monthly income	Married couple monthly income	Asset rule in New York	Important note
QMB	$1,820	$2,453	No resource test	Strongest MSP level for most seniors
QI	$2,446	$3,299	No resource test	Pays Part B only; cannot also have Medicaid
Full Medicaid for dual eligibles	$1,820	$2,453	$32,396 single / $43,781 couple on the latest public DOH chart	Ask to be screened if you need more than MSP
QDWI	$5,405	$7,299	$4,000 single / $6,000 couple	Mostly for working disabled people under 65

What counts as income? New York’s public MSP materials use gross monthly income and ask for proof such as Social Security award letters, pensions, wages, annuities, and veterans’ benefits on the official application instructions. If you are very close to a limit, apply anyway. Budgeting rules can matter, especially if you work.

Asset limits and what counts toward the limit

For QMB and QI in New York, there is no resource test. That is one of the biggest differences between New York and many other states. The official state MSP page says there is no resource test, and the official NY HIICAP guide repeats that rule.

This means that for most seniors applying for MSP in New York, bank accounts, retirement accounts, and other savings do not block QMB or QI eligibility. That is why many national “asset limit” charts are wrong for New York MSP applicants.

But there are two big exceptions:

• Full Medicaid is different. If you want full Medicaid as well as MSP, full Medicaid can still have resource rules.
• QDWI is different. QDWI still has a resource limit. Under Medicare.gov and Social Security guidance, QDWI uses SSI-style resource rules, so items like your home and usually one car are not counted the same way as cash and similar resources.

Who qualifies in plain language

You may qualify for a New York Medicare Savings Program if most of these are true:

• You live in New York.
• You already have Medicare, or you need help buying Part A through QMB or QDWI.
• Your monthly income is within the correct New York limit.
• If you want QI, you have Medicare Part A and do not have Medicaid.
• If you want QMB, you may have QMB only or QMB plus Medicaid.
• If you are applying for QDWI, you are usually under 65, disabled, working, and lost premium-free Part A after going back to work.
• If you are married and living with your spouse, New York’s official instructions say you must complete the spouse section even if the spouse is not applying.

How married seniors are treated: New York uses couple income limits when spouses live together, and both spouses must sign if both are applying on the state instructions for DOH-4328. If only one spouse has Medicare, the household picture can still matter, so do not skip the spouse information.

Best programs and pathways for New Yorkers

Qualified Medicare Beneficiary (QMB)

• What it is: New York’s strongest MSP level for most seniors, paying the Part B premium and, if needed, the Part A premium plus Medicare cost-sharing for Medicare-covered services.
• Who can get it or use it: People with Medicare whose countable income fits the New York QMB limit. You can have QMB only, or QMB plus Medicaid, according to the state MSP chart.
• How it helps: It can stop the monthly Part B premium, trigger automatic Extra Help, and protect you from being billed for Medicare-covered deductibles, coinsurance, and copays.
• How to apply or use it: Ask for an MSP screen through NY State of Health, your local county DSS, or in NYC through HRA or ACCESS HRA.
• What to gather or know first: Bring your Medicare card, proof of income, proof of address, and proof of any other health insurance premium. If you get a bill after approval, do not pay it without checking first.

Qualifying Individual (QI)

• What it is: An MSP that pays the Medicare Part B premium only.
• Who can get it or use it: People whose income is above QMB but within the higher New York QI limit, and who have Part A.
• How it helps: It removes the Part B premium and gives you automatic Extra Help.
• How to apply or use it: Use the same New York application route as QMB. You do not pick QI yourself; New York decides which MSP level fits your income, according to the official HIICAP guide.
• What to gather or know first: You cannot have QI and Medicaid at the same time. The official New York guide also says QI may reimburse up to three months of Part B premiums within the same calendar year in some cases.

Qualified Disabled and Working Individual (QDWI)

• What it is: A narrow MSP that pays the Medicare Part A premium only.
• Who can get it or use it: Usually a person under 65 who is disabled, returned to work, and lost premium-free Part A.
• How it helps: It can keep Part A active when work caused the loss of free Part A.
• How to apply or use it: Ask the Medicaid office specifically about QDWI. The New York HIICAP guide says that if you also want Medicaid, you may need the full Medicaid application route.
• What to gather or know first: QDWI has a resource limit, unlike QMB and QI in New York. Bring proof of work history, Medicare status, income, and resources.

Part A Buy-In if you do not get free Medicare Part A

• What it is: A New York pathway for some people age 65 or older who need to buy Part A and want QMB to pay that premium.
• Who can get it or use it: The official New York HIICAP guide says this can help a current U.S. resident who is 65+, is a U.S. citizen or a lawful permanent resident with five continuous years in the U.S., is not eligible for free Part A, and meets QMB rules.
• How it helps: It can enroll you into conditional Part A and Part B so QMB can cover the premium.
• How to apply or use it: Tell the Medicaid office or HIICAP counselor that you need a Part A Buy-In review, not just a basic MSP screen.
• What to gather or know first: If you already have Part B, you may still be able to apply for QMB directly, but follow up if the Part A side is missed.

NY State of Health route for most statewide applications

• What it is: New York’s official health plan marketplace, now taking many Medicare Savings Program and age-65+ applications during the state’s modernization.
• Who can get it or use it: The state modernization page says this includes people who are dual-eligible, age 65 or older and not seeking long-term care, or applying for MSP.
• How it helps: Phone application, member portal access for many cases, appeals help, and free enrollment assistors.
• How to apply or use it: Call 1-855-355-5777 or use the Navigator Directory for free in-person help.
• What to gather or know first: Because public instructions still mention paper and county offices, ask the worker which system your case will live in and where to send follow-up proof.

New York City HRA and ACCESS HRA route

• What it is: The NYC Human Resources Administration Medical Assistance Program and the city’s online benefits portal.
• Who can get it or use it: According to NYC’s official HRA page, this includes NYC residents who are 65+, blind, disabled, or receiving Medicare and not a parent or caretaker relative of minor children.
• How it helps: You can apply online through ACCESS HRA, call the HRA Medicaid Helpline at 1-888-692-6116, or visit an HRA Medicaid office.
• How to apply or use it: The official NYC MSP brochure says MSP-only applications can be mailed to HRA/Medical Assistance Program, Initial Eligibility Unit, 5th Floor, P.O. Box 24390, Brooklyn, NY 11202-9814, while MSP plus Medicaid applications can be mailed to HRA/Medical Assistance Program, MSP-CREP, 5th Floor, P.O. Box 24330, Brooklyn, NY 11202-9801 as shown in the official NYC brochure.
• What to gather or know first: ACCESS HRA is NYC-only and is available in seven languages. If the portal gives you trouble, use paper, mail, or an office visit instead of waiting too long.

Free help from HIICAP and NY Connects

• What it is: New York’s free counseling and benefits help network for older adults and people with Medicare.
• Who can get it or use it: Seniors, caregivers, spouses, and adult children helping a parent.
• How it helps: The state says HIICAP has more than 700 trained counselors. They can help with MSP applications, Medicare bills, plan choices, and follow-up questions. NY Connects can route you to local aging and long-term supports help.
• How to apply or use it: Call HIICAP at 1-800-701-0501 or NY Connects at 1-800-342-9871.
• What to gather or know first: Have your Medicare card, premium bill, denial notice, and any county or HRA mail in front of you when you call.

How to apply without wasting time

• Pick the right front door first: If you live in NYC, start with HRA or ACCESS HRA. If you live elsewhere in New York and are 65+, dual-eligible, or applying for MSP, start by calling NY State of Health.
• Call before mailing anything: Because New York is still transitioning cases into the modern system, ask exactly where your application and proof should go.
• Use the official form if paper is required: Download DOH-4328 and the instructions.
• Fill out the spouse section if you are married and living together: New York’s instructions say to complete both “self” and “spouse” questions even if only one spouse is applying.
• Sign the back: The state’s MSP page warns that the signature block is on the back of the application.
• Ask to be screened for the right level: You do not choose QMB or QI yourself. New York assigns the level you qualify for.
• If your income is low enough and you need more than MSP: Ask to be screened for full Medicaid too, especially if you need dental, home care, or other Medicaid-only benefits.
• Keep copies of everything: The official instructions say to make a copy before mailing. Also keep proof of upload, fax, or mailing.
• Track the 45-day clock: The state instructions say the office should send a Notice of Action within 45 days after you file.

Application and proof checklist

• ☐ A copy of the front and back of your Medicare card
• ☐ Proof of date of birth such as a driver’s license, passport, birth certificate, or benefit ID card
• ☐ Proof of New York residence such as a utility bill, lease, rent receipt, property tax paper, or mortgage statement dated within 6 months
• ☐ Proof of income such as Social Security award letter, pension statement, 4 weeks of pay stubs, annuity proof, or veterans’ benefit letter
• ☐ Proof of any other health insurance premium you pay, such as Medigap or HMO premium statements
• ☐ If you are not a U.S. citizen, proof of current immigration status
• ☐ If married and living together, your spouse’s information and documents
• ☐ If names changed, proof of other names used, such as a marriage certificate
• ☐ A full copy of your finished application for your own records

How approval works and what happens after approval

New York does not let you “pick” the MSP category you want. The official HIICAP guide says applicants are awarded the MSP level they qualify for based on income. That means a person under the QMB line should be opened for QMB, while a person above that line but under the QI line should be opened for QI.

The state instructions say you should receive a Notice of Action within 45 days of filing. After approval, the public New York MSP page says your Part B premium should no longer be deducted from your Social Security benefit, and the same state page says MSP enrollment also gives you automatic Extra Help.

• If you get QMB: The official New York guide says you can receive a Medicaid card even if you do not have full Medicaid, and providers may use it to bill Medicaid for Medicare cost-sharing.
• If you get QI: New York’s HIICAP guide says QI can reimburse up to three months of Part B premiums paid earlier in the same calendar year in some cases.
• If you get MSP at any level: Keep every approval notice. You may need it to fix bills or premium deductions.
• Renewal: The state instructions say you need to renew or recertify your MSP every year.

What to do if a doctor bills a QMB enrollee

Do not ignore the bill, but do not assume you owe it. The Medicare QMB rules and CMS guidance say Medicare providers cannot bill QMB members for Medicare-covered deductibles, coinsurance, or copays.

• Check whether the service was Medicare-covered. QMB billing protection applies to Medicare-covered items and services.
• Call the provider’s billing office. Say: “I am in the Qualified Medicare Beneficiary program. Federal law does not allow you to bill me for Medicare-covered cost-sharing.”
• Show proof. Medicare says to show your Medicare card and Medicaid card or QMB proof, and if you have Original Medicare you can also show a Medicare Summary Notice.
• Ask for the bill to be corrected and any payment refunded. CMS says providers who billed improperly should stop and refund payments they should not have collected.
• If the provider will not stop: Call 1-800-MEDICARE. CMS says Medicare can advise the provider to stop billing and refund payments.
• If you want a local helper on the call: Ask HIICAP to help you work through the bill.

Reality checks

• System transition confusion is real: New York’s public pages do not all say the same thing yet. One page may tell you to mail forms to DSS, another may tell you to use NY State of Health. Call first and write down the name of the person who told you where to send your case.
• Missing proof and missing signatures still stop cases: The back signature, spouse information, Medicare card copy, and proof of address are common trouble spots on the official checklist.
• Some seniors delaying Social Security can hit a problem: The official New York HIICAP guide says some MSP applicants age 65+ who are eligible for Social Security retirement but are not taking it can be denied unless an exception applies, including a full-time work exception. Ask about this before you file if you delayed Social Security on purpose.
• SNAP can change later: The same New York HIICAP guide warns that when MSP starts paying your Part B premium, your SNAP medical expense deduction can shrink at your next recertification. Many households still come out ahead, but do not be surprised if your food benefit changes later.

Common mistakes to avoid

• Assuming you do not qualify because you have savings. In New York, that is often wrong for QMB and QI.
• Using an old national article that still lists SLMB as a normal New York option.
• Sending the form without signing the back.
• Leaving out spouse information when married and living together.
• Forgetting to keep copies of the application and proofs.
• Assuming QI and Medicaid can be kept together.
• Paying a QMB bill before asking whether it is illegal.
• Waiting past 45 days without calling for status.

Best options by need

• If you need the strongest protection from medical bills: Ask whether you qualify for QMB.
• If your income is above QMB but still modest: Ask for a QI screen.
• If you are under 65, disabled, working, and lost free Part A: Ask specifically about QDWI.
• If you need help paying for drugs while an MSP case is pending: Look at Extra Help and New York’s EPIC program.
• If you live in NYC and want the fastest online route: Use ACCESS HRA.
• If you need a human guide: Call HIICAP or NY Connects.

What to do if denied, delayed, or blocked

• If there is no decision after 45 days: Call the office handling the case and ask, “Has my MSP application been registered? What proof is missing? Which office has the case right now?”
• If your case is outside NYC and you are not sure who has it: Start with NY State of Health at 1-855-355-5777. If they say it stayed local, use the LDSS finder or the Medicaid Helpline at 1-800-541-2831.
• If your case is in New York City: Call the HRA Medicaid Helpline at 1-888-692-6116, check ACCESS HRA, or use the HRA office locator.
• If you were denied by LDSS or HRA: The state’s How to Apply for Medicaid page says you can request a fair hearing by phone at 1-800-342-3334, by fax at 518-473-6735, online through the OTDA online request form, or by mail to NYS Office of Temporary and Disability Assistance, Office of Administrative Hearings, P.O. Box 1930, Albany, NY 12201-1930.
• If you were denied by NY State of Health: The same state page says you can call 1-855-355-5777, fax 1-855-900-5557, use NY State of Health, or write to New York State of Health, P.O. Box 11729, Albany, NY 12211. The state appeals page also says MSP and other Non-MAGI cases can request an agency conference through NY State of Health.
• If you were denied because of income: Ask for the exact budget and ask whether the caseworker screened you for QMB, QI, full Medicaid, and if relevant Part A Buy-In or QDWI.
• If the denial is really a missing-proof problem: Send the proof right away and ask whether the office will reopen the application or wants a new one.
• If the problem is an illegal QMB bill: Call 1-800-MEDICARE and HIICAP instead of arguing alone with the provider.

Plan B and backup options

• Apply for Extra Help separately: If MSP is delayed, Extra Help can still lower Part D costs.
• Look at EPIC: New York’s EPIC program can help seniors age 65+ with Part D costs if they are New York residents, meet the annual income rules, and are not getting full Medicaid.
• Ask for full Medicaid screening: If your income is around the QMB line and you need more than premium help, ask about full Medicaid too.
• Use hospital or provider financial assistance: If bills are piling up while the case is pending, ask the hospital or provider about financial assistance or a hold on collections.
• Get a Medicare plan review: A HIICAP counselor can also check whether your Part D or Medicare Advantage plan is adding to your cost problem.

Local resources in New York

• HIICAP statewide Medicare counseling: 1-800-701-0501
• NY Connects statewide local help line: 1-800-342-9871
• New York Medicaid Helpline: 1-800-541-2831 (the state says hours are Monday through Friday 8:00 a.m. to 8:00 p.m. and Saturday 9:00 a.m. to 1:00 p.m.)
• NY State of Health Customer Service Center: 1-855-355-5777 and TTY 1-800-662-1220
• NY State of Health free enrollment help: Navigator Directory
• New York City HRA Medicaid Helpline: 1-888-692-6116
• New York City online application: ACCESS HRA
• New York City Medicaid office locator: HRA Medicaid offices by borough
• Medicare billing and QMB bill complaints: 1-800-MEDICARE
• Medicare quality-of-care and complaint help: New York’s Office for the Aging Medicare page lists Commence Health at 1-866-815-5440

Diverse communities

Seniors with Disabilities

New York City’s HRA health assistance page says HRA accepts applications from people living with disability or blindness. The state’s Medicaid application page also says some Department of Health forms are available in alternative formats for people who are blind or visually impaired. If you use the marketplace route, NY State of Health lists TTY help at 1-800-662-1220.

Veteran Seniors

The official MSP instructions say veterans’ benefit letters can be used as proof of income. Veterans who use VA care can still ask HIICAP for help sorting out Medicare, MSP, and drug-cost help together.

Immigrant and Refugee Seniors

The official New York MSP page offers the MSP application in many languages, including Spanish, Chinese, Russian, Haitian Creole, Arabic, Bengali, French, Hindi, Japanese, Korean, Nepali, Polish, Urdu, and Yiddish. The instructions say non-citizens should include proof of current immigration status. If your immigration history is complicated, get help from HIICAP or ask for a legal-services referral before filing.

Rural Seniors with Limited Access

If the county office is far away, use the phone-based help built into New York’s system. NY Connects routes callers by county, and HIICAP routes callers to local counselors. That is often easier than driving to a DSS office just to learn where your case belongs.

Frequently asked questions

Does New York still have the SLMB program?

Not as a separate current New York category. The official New York HIICAP counselor guide says SLMB was absorbed into New York’s 2023 MSP expansion. That is why the public New York Department of Health MSP page now focuses on QMB and QI. If a website still lists SLMB as a normal New York option, treat it as outdated.

Is there an asset limit for Medicare Savings Programs in New York?

For QMB and QI, New York says there is no resource test. That is different from many national charts. But if you are being screened for full Medicaid too, or if you are applying for QDWI, resource rules can still matter.

Do I automatically get Extra Help if I get MSP in New York?

Yes. The New York MSP page says MSP enrollment automatically gives you Extra Help for Medicare Part D prescription drug costs. That is one reason MSP can save much more than just the Part B premium.

Can I have QMB and Medicaid at the same time in New York?

Yes. The official New York MSP chart says a person can be eligible for QMB only or QMB and Medicaid. That matters if you also need dental, home care, or other services Medicare does not fully cover.

How do married seniors apply in New York?

The state instructions say that if you are married and living with your spouse, you must complete both the “self” and “spouse” sections even if the spouse is not applying. If both spouses are applying, both must sign. New York also uses couple income limits when spouses live together.

How do I apply if I live in New York City?

For seniors and other HRA-handled categories, New York City points applicants to ACCESS HRA, the HRA Medicaid Helpline at 1-888-692-6116, or an HRA Medicaid office. The official city MSP brochure also gives separate mailing addresses for MSP-only cases and MSP-plus-Medicaid cases.

How long does approval usually take in New York?

The official state instructions say the local office should send a Notice of Action within 45 days after you file. In real life, delays still happen if proof is missing, if the case is routed between systems, or if the office is unclear whether NY State of Health or the local district owns the case. If you hit day 45 with no answer, call.

What should I do if a doctor bills me after I get QMB?

Start by calling the provider’s billing office and telling them you are in QMB. Then show your Medicare card and Medicaid or QMB proof. If they keep billing you for Medicare-covered cost-sharing, call 1-800-MEDICARE. Medicare says it can tell the provider to stop billing and refund money collected in error. You can also ask HIICAP to help you with the call.

Will MSP affect my estate or put a lien on my home in New York?

MSP by itself is not the same as long-term care Medicaid. The official New York HIICAP guide says states cannot recover the cost of MSP premiums from estates, and it explains that New York guidance exempts QMB Medicare cost-sharing from estate recovery for covered services after 1 January 2010. Full Medicaid long-term care rules are different, so ask for advice if you are also applying for that kind of coverage.

Resumen en español

En Nueva York, el Programa de Ahorros de Medicare puede pagar la prima mensual de la Parte B y, si usted califica para QMB, también puede cubrir deducibles, coseguro y copagos de servicios cubiertos por Medicare. La regla más importante para muchas personas mayores es que Nueva York dice que no hay prueba de recursos para QMB y QI, así que tener ahorros no descalifica automáticamente. Si vive fuera de la Ciudad de Nueva York y tiene 65 años o más, o quiere solicitar MSP, muchas veces conviene empezar llamando a NY State of Health al 1-855-355-5777. Si vive en la Ciudad de Nueva York, puede usar ACCESS HRA o llamar a HRA al 1-888-692-6116.

Antes de solicitar, reúna su tarjeta de Medicare, prueba de ingresos y prueba de domicilio. Si necesita ayuda gratis para entender formularios, facturas o apelaciones, llame a HIICAP al 1-800-701-0501 o a NY Connects al 1-800-342-9871. Si ya tiene QMB y un médico le manda una factura por un servicio cubierto por Medicare, no asuma que la debe pagar; primero llame al proveedor y, si no corrigen la cuenta, llame a 1-800-MEDICARE. Como Nueva York todavía está cambiando su sistema de inscripción, si recibe instrucciones diferentes de dos oficinas, pida el nombre de la persona que le habló y guarde copias de todo lo que entregue.

About This Guide

This guide uses official federal, state, and other high-trust nonprofit and community sources mentioned in the article.

• Editorial note: This guide is produced based on our Editorial Standards using official and other high-trust sources, regularly updated and monitored, but not affiliated with any government agency and not a substitute for official agency guidance. Individual eligibility outcomes cannot be guaranteed.
• Verification: Last verified April 7, 2026, next review August 2026.
• Corrections: Please note that despite our careful verification process, errors may still occur. Email info@grantsforseniors.org with corrections and we respond within 72 hours.

Disclaimer: This article is for informational purposes only. It is not legal, financial, medical, tax, disability-rights, immigration, or government-agency advice. Program rules, policies, application routes, billing practices, and availability can change. Always confirm current details directly with the official New York program, Medicare, or the office handling your case before you act.