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Medicare cost help
Last updated: 25 September 2026
A Medicare Savings Program (MSP) can help a person with limited income pay Medicare premiums. The strongest program, Qualified Medicare Beneficiary (QMB), can also protect you from Medicare-covered Part A and Part B deductibles, coinsurance, and copayments.
Bottom Line
If the Medicare Part B premium is taking too much from your Social Security payment, start with a Medicare Savings Program. The federal 2026 MSP limits are only a starting point. States may use more generous rules, so it is worth applying even when your income or savings look a little high.
Apply through your state Medicaid agency. If the forms are confusing, get free help from your local SHIP counselor.
Start Here
- Check the federal limits below. Do not stop if you are slightly over them.
- Apply with your state. Ask to be screened for QMB, SLMB, QI, and any full Medicaid coverage that may fit.
- Get help if needed. A SHIP counselor can explain the form and help you understand notices.
You can also use our Medicare savings checker to organize your next steps before you call.
Quick Reference
| Your problem | Best first step | Why |
|---|---|---|
| Part B premium is too high | Apply for an MSP | QMB, SLMB, or QI can pay the Part B premium if you qualify. |
| Doctor or hospital keeps billing you | Check QMB status | QMB protects you from Medicare Part A and Part B cost sharing for covered care. |
| Prescription costs are high | Check Extra Help | QMB, SLMB, and QI automatically include Extra Help. |
| Forms are confusing | Call SHIP | SHIP offers free, local, one-on-one Medicare counseling. |
What Has Changed
A major 2026 enrollment change is now fully in effect. By April 1, 2026, states had to implement federal rules that make MSP enrollment easier. The rules require states to use Medicare Part D Extra Help data as an MSP application and simplify parts of income and resource verification. CMS says the goal is to reduce duplicate paperwork and connect more eligible people with help.
That does not mean everyone is approved automatically. Your state may still need missing information and still makes the eligibility decision. The federal 2026 QMB, SLMB, QI, and QDWI limits shown below remain the current published limits as of this review. See the CMS streamlining rule for the federal enrollment changes.
2026 Medicare Savings Program Limits
Medicare publishes federal income and resource limits each year. The figures below are the 2026 federal limits for the continental states and the District of Columbia. Alaska and Hawaii have higher income limits. States may also use rules that are more generous than the federal chart.
| Program | Individual income | Couple income | Individual resources | Couple resources |
|---|---|---|---|---|
| QMB | $1,350/month | $1,824/month | $9,950 | $14,910 |
| SLMB | $1,616/month | $2,184/month | $9,950 | $14,910 |
| QI | $1,816/month | $2,455/month | $9,950 | $14,910 |
| QDWI | $5,405/month | $7,299/month | $4,000 | $6,000 |
These are federal screening figures, not a promise of eligibility. Medicare says a state may let you qualify with higher income or resources or may count some items differently. The 2026 Medicaid standards also show higher federal income figures for Alaska and Hawaii.
Do not self-reject over resources
The federal chart uses resource limits, but Medicare also warns that states may count income and resources differently. Some states use higher resource levels or do not count certain resources for QMB, SLMB, or QI. That is why the state application matters more than a quick estimate you do at home.
If you are close to a limit, ask the state which accounts or property it counts and which items it excludes. Give the agency the information it requests and let the state make the eligibility decision.
What Each Medicare Savings Program Pays
Qualified Medicare Beneficiary (QMB)
What it pays: QMB can pay a Part A premium if you owe one, the Part B premium, and Medicare-covered Part A and Part B deductibles, coinsurance, and copayments.
Why it matters: In 2026, the standard Part B premium is $202.90 per month, the Part B deductible is $283, and the Part A inpatient hospital deductible is $1,736 per benefit period. CMS lists these amounts in its 2026 Medicare cost sheet.
Billing protection: If you have QMB, Medicare providers and suppliers cannot bill you for Medicare Part A or Part B cost sharing for covered services. This protection applies in Original Medicare and Medicare Advantage. CMS explains the rule on its QMB billing page. A small Medicaid copayment may still apply in some situations.
If a provider keeps billing you, keep the bill and your QMB proof. Our QMB billing guide explains what to do next.
Specified Low-Income Medicare Beneficiary (SLMB)
What it pays: SLMB pays the Part B premium. It does not pay ordinary Medicare deductibles and coinsurance the way QMB does.
Who may fit: You must have both Part A and Part B and meet your state’s income and resource rules. SLMB can be a strong fit if your income is above the QMB level but the Part B premium still strains your budget.
Qualifying Individual (QI)
What it pays: QI also pays the Part B premium only.
Important rule: You must apply every year. Medicare says states approve QI on a first-come, first-served basis, with priority for people who had QI the previous year. QI is for people who do not qualify for other Medicaid coverage or benefits.
Do not ignore renewal mail. If your Part B premium starts appearing again, use our Medicare premium guide to organize the problem while you contact your state.
Qualified Disabled and Working Individual (QDWI)
What it pays: QDWI pays the Part A premium only. It is a narrow program for certain people with disabilities who returned to work and lost premium-free Part A.
In 2026, people who buy Part A can pay either $311 or $565 per month, depending on work history. Medicare’s current cost page explains the two Part A premium levels.
MSPs and Extra Help for Prescriptions
If you qualify for QMB, SLMB, or QI, you automatically qualify for Medicare Extra Help with Part D drug costs. You do not need to meet a second set of Extra Help income and resource limits after your MSP status gives you automatic eligibility.
If you do not already get Extra Help automatically, the 2026 application limits are $23,940 yearly income and $18,090 in resources for one person, and $32,460 income and $36,100 in resources for a married couple. Medicare lists these figures on its Extra Help page.
In 2026, Extra Help provides a $0 plan premium and $0 deductible under the program rules, with covered-drug copays of no more than $5.10 for a generic and $12.65 for a brand-name drug. Once total covered drug costs reach $2,100, covered drugs drop to $0 for the rest of the year.
You can apply through Social Security. Social Security can send your information to your state to start an MSP determination unless you say no. Our Extra Help guide covers the prescription side in more detail, while our Part D cap guide explains the 2026 $2,100 drug-cost threshold.
What an MSP Can Save in 2026
| Medicare cost | 2026 amount | MSP help |
|---|---|---|
| Standard Part B premium | $202.90/month | QMB, SLMB, or QI may pay it. |
| Part B deductible | $283/year | QMB can cover Medicare-covered cost sharing. |
| Part A hospital deductible | $1,736/benefit period | QMB can cover Medicare-covered cost sharing. |
| Part A premium | $311 or $565/month | QMB or QDWI may help, depending on why you owe the premium. |
These are Medicare amounts, not guaranteed savings. Your coverage, state rules, and MSP level determine what gets paid.
How to Apply Without Wasting Time
- Contact your state Medicaid agency. Say you want to apply for a Medicare Savings Program and be screened for all MSP levels.
- Do not stop at the federal chart. States can use higher limits or different counting rules.
- Send requested proof quickly. The 2026 streamlining rules reduce duplicate paperwork, but a state can still ask for information it does not already have.
- Keep a copy of everything. Save confirmation numbers, upload receipts, fax receipts, notices, and names of people you speak with.
- Check your Medicare costs after approval. Watch your Social Security payment or Medicare bill to see whether the Part B premium stops.
If you want a counselor to review the process with you, our SHIP and SMP guide explains where to get free Medicare counseling and fraud help.
After You Apply
Keep watching both your mail and your Medicare costs. A state may ask for more information before it can finish the case. Respond by the deadline on the notice, even if you already sent similar papers before.
If you are approved for help with the Part B premium, compare your next Social Security payment or Medicare premium bill with the approval notice. If the premium is still being charged after the state says coverage started, call the state first and keep the notice in front of you. Then call Medicare if the problem continues.
If you are approved for QMB, tell doctors, hospitals, pharmacies, and other Medicare providers that you have QMB. Show your Medicare card and any Medicaid or QMB proof you received. This can prevent billing problems before they start.
Documents and Information to Gather
- Medicare card or Medicare number.
- Photo ID and Social Security number.
- Social Security award letter, pension statement, or pay stubs.
- Bank and retirement account statements if your state asks for resources.
- Proof of address.
- Spouse income and resource information if required.
- Recent Medicare premium bill or proof of the Part B deduction.
- Any provider bills if you may already have QMB.
Do not send original documents unless the agency specifically requires them. Ask whether uploads, copies, or electronic verification are accepted.
Reality Checks
State rules matter. The federal limits are not the whole story. A state may disregard some income, use higher resource limits, or not count certain resources for QMB, SLMB, or QI.
Approval can take time. There is no single national MSP processing time. Missing information and state workload can delay a decision.
Premium changes can lag. Keep your approval notice if the Part B deduction continues after approval. Follow up with the state and Medicare rather than assuming the case failed.
QMB does not erase every medical charge. QMB protects you from Medicare Part A and Part B cost sharing for Medicare-covered services. It does not turn noncovered services into covered services.
Common Mistakes to Avoid
- Assuming you earn too much. State rules may be more generous than the federal chart.
- Applying only for drug help. Extra Help does not replace an MSP when the Part B premium is the main problem.
- Ignoring QI renewal mail. QI must be renewed each year.
- Paying an improper QMB bill. First confirm the service was Medicare-covered and your QMB status was active on the date of service.
- Throwing away notices. Approval and denial letters are important if you need a correction or appeal.
Denied, Delayed, or Overwhelmed
If the state denies your MSP application, read the notice before giving up. Look for the reason, the income or resource figure the state used, the deadline to appeal, and instructions for requesting a hearing or review. Appeal deadlines and methods vary by state, so use the notice you actually received.
If you think the state counted the wrong income or resources, ask for the calculation in writing. If you recently lost income, explain the change and ask what proof the state needs.
If you may qualify for both Medicare and full Medicaid, our dual eligible guide explains how the two programs can work together. Our Medicaid guide covers broader Medicaid help beyond Medicare premiums.
Backup Options
If you do not qualify for an MSP, still check Extra Help if prescriptions are expensive. You can also ask SHIP whether your state has a State Pharmaceutical Assistance Program, Medicaid pathway, or other low-income Medicare help. If you live in Alaska and also need help with dental costs, our Alaska dental assistance guide covers state-specific options.
If the problem is a high-income Medicare surcharge rather than low income, an MSP is usually not the right route. A large drop in income after retirement, divorce, death of a spouse, or another life-changing event may instead call for an income-related premium review. If equipment is a separate need, Utah readers can use our Utah medical equipment guide, and Georgia readers can use our Georgia medical equipment guide for local loan and reuse options.
Official Resources
- Medicare MSP page — federal limits and program descriptions.
- State Medicaid contacts — find the agency that takes the application.
- Find local SHIP — free Medicare counseling; the national locator line is 1-877-839-2675.
- QMB billing rules — what to do if a provider bills you.
Phone Scripts You Can Use
State Medicaid office
“I have Medicare and I want to apply for a Medicare Savings Program. Please screen me for QMB, SLMB, QI, and any other Medicaid help I may qualify for. What documents do you need from me?”
SHIP counselor
“I need help understanding a Medicare Savings Program application. Can you help me compare the state rules with my income and explain what documents I should gather?”
Improper QMB bill
“I am enrolled in QMB and I am being billed for Medicare-covered Part A or Part B cost sharing. My QMB was active on the date of service. Can you confirm my status and help stop the billing?”
Call 1-800-MEDICARE at 1-800-633-4227. TTY: 1-877-486-2048.
Social Security Extra Help
“I want to apply for Medicare Part D Extra Help. Please tell me what financial information I need and whether my information will be sent to my state to start a Medicare Savings Program application.”
Social Security: 1-800-772-1213. TTY: 1-800-325-0778.
Resumen en Español
Los Programas de Ahorros de Medicare pueden ayudar a pagar las primas de Medicare. QMB también puede cubrir deducibles, coseguro y copagos de las Partes A y B para servicios cubiertos por Medicare.
En 2026, el límite federal mensual de QMB es de $1,350 para una persona y $1,824 para una pareja. Los estados pueden usar reglas más generosas. Por eso, solicite ayuda aunque sus ingresos o ahorros sean un poco más altos.
Solicite por medio de la agencia estatal de Medicaid. Si necesita ayuda con el formulario, pida asesoría gratuita de SHIP. Si ya tiene QMB y recibe una factura por costos compartidos de Medicare, llame a Medicare al 1-800-633-4227.
Frequently Asked Questions
What is the income limit for QMB in 2026?
The federal 2026 QMB monthly income limit is $1,350 for one person and $1,824 for a married couple, with federal resource limits of $9,950 and $14,910. Your state may use rules that let you qualify with more income or resources, so apply even if you are a little over the federal chart.
What is the difference between QMB, SLMB, and QI?
QMB can pay Part A and Part B premiums and Medicare-covered Part A and Part B cost sharing. SLMB and QI pay the Part B premium only. All three can also make you automatically eligible for Extra Help with Medicare drug costs.
Can a doctor bill me if I have QMB?
A Medicare provider or supplier may not bill a QMB member for Medicare Part A or Part B deductibles, coinsurance, or copayments for Medicare-covered items and services. A small Medicaid copayment may apply in some cases. If an improper bill continues, call 1-800-MEDICARE at 1-800-633-4227.
Do Medicare Savings Programs have the same limits in every state?
No. Medicare publishes federal income and resource limits, but states may use higher limits or count income and resources differently. Some states do not count certain resources for QMB, SLMB, or QI. Your state Medicaid agency makes the final eligibility decision.
Does an MSP also help with prescription drugs?
If you qualify for QMB, SLMB, or QI, you also qualify automatically for Medicare Extra Help. In 2026, Extra Help has a $0 plan premium and $0 deductible for covered Part D plans up to the program rules, with copays of no more than $5.10 for generic drugs and $12.65 for brand-name drugs.
How do I apply for a Medicare Savings Program?
Apply through your state Medicaid agency. You can also ask your local State Health Insurance Assistance Program, or SHIP, for free one-on-one help. If you apply for Extra Help through Social Security, your information can also be sent to your state to start an MSP application unless you tell Social Security not to do that.
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. Readers may 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: 25 September 2026 · Next review: 25 January 2027
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