Written & Reviewed by
Last updated: 27 May 2026
Bottom Line: In New York, a Medicare Savings Program (MSP) can pay your Medicare Part B premium. If you qualify for Qualified Medicare Beneficiary (QMB), it can also protect you from Medicare deductibles, coinsurance, and copays for Medicare-covered care. New York’s 2026 MSP limits are higher than the federal minimums, and New York does not use a resource test for QMB or Qualifying Individual (QI). That means savings in the bank do not block many seniors from this help.
Emergency Help Now
- If you already have QMB and got a medical bill: Do not ignore it, but do not assume you owe it. Call the billing office and say you are in QMB. If the bill is for Medicare-covered cost sharing, ask them to correct it. The CMS QMB billing rules say providers must not bill QMB members for Medicare Part A or Part B cost sharing.
- If your Part B premium is still being taken out: Call the office that approved your MSP and ask when the Medicare buy-in will update. Keep the approval notice.
- If you filed and heard nothing: New York’s MSP instructions point to a Notice of Action after a case decision. If you are near or past 45 days, call and ask whether proof is missing.
- If you need a human helper today: Call HIICAP at 1-800-701-0501. The NYSOFA MSP page says HIICAP gives free, objective help with MSP applications.
Quick Help
| Your situation | Start here | What to ask |
|---|---|---|
| You live outside NYC and want MSP screening | Call NY State of Health at 1-855-355-5777 | Ask if your MSP case should be handled through NY State of Health or your county DSS. |
| You live in New York City | Use ACCESS HRA or call HRA at 1-888-692-6116 | Ask whether you should file MSP-only or MSP plus Medicaid. |
| You want free Medicare counseling | Call HIICAP at 1-800-701-0501 | Ask for MSP screening and help with bills or application steps. |
| You need a paper form | Use the DOH-4328 form | Ask where to send it before mailing. |
| You need your county office | Use the local DSS finder | Ask for the Medicaid unit that handles MSP. |
Contents
- What New York MSP pays
- 2026 income limits
- Who should apply
- QMB, QI, and QDWI
- Where to apply
- How to start
- After approval
- Reality checks
- Denied or delayed
- Local resources
- FAQs
What New York MSP Pays
A Medicare Savings Program is Medicaid help for Medicare costs. Medicare says these programs are run by states and can help pay Part A and Part B premiums. Some levels may also pay deductibles, coinsurance, and copays. You can still apply even if you are not sure you qualify. See the national Medicare.gov MSP page for the federal overview.
In New York, most older adults are looking at QMB or QI. The 2026 New York HIICAP counselor guide says New York has QI, QMB, and Qualified Disabled and Working Individual (QDWI). It also says Specified Low-Income Medicare Beneficiary (SLMB) is no longer a separate New York MSP because it was absorbed into the 2023 expansion.
| Program | What it can pay | Main reality check |
|---|---|---|
| QMB | Part B premium, Part A premium if needed, and Medicare-covered deductibles, coinsurance, and copays | Best protection for medical bills. It does not cover every service, only Medicare-covered cost sharing. |
| QI | Part B premium only | You must have Medicare Part A. You cannot have QI and Medicaid at the same time. |
| QDWI | Part A premium only | Narrow program for some disabled people under 65 who returned to work and lost free Part A. |
| Full Medicaid plus MSP | May pay more health costs, based on Medicaid eligibility | Full Medicaid can have resource rules and more paperwork. |
For broader terms, our MSP guide explains the basics. If you may qualify for both Medicare and Medicaid, our dual eligible guide explains how the systems fit.
2026 Income and Resource Limits in New York
The New York Department of Health posted 2026 MSP income figures for QMB and QI. The 2026 New York HIICAP guide also lists QDWI. The amounts below include New York’s standard $20 disregard where listed. If your income is close, apply or ask for a budget.
| Program | Single monthly income | Couple monthly income | Resource rule | What to know |
|---|---|---|---|---|
| QMB | At or below $1,856 | At or below $2,509 | No resource test | Can cover Part B and Medicare-covered cost sharing. |
| QI | $1,857 to $2,494 | $2,510 to $3,375 | No resource test | Pays Part B only. Cannot be used with Medicaid. |
| Full Medicaid for dual eligibles | At or below $1,856 | At or below $2,509 | $33,038 single / $44,796 couple | Ask for full Medicaid screening if you need dental, home care, or other Medicaid help. |
| QDWI | Under $2,680 | Under $3,627 | $4,000 single / $6,000 couple | New York’s HIICAP guide says earned income disregards may matter. Ask for a budget if you work. |
Use the state 2026 income chart for QMB, QI, and full Medicaid figures. For the no-resource-test rule and forms, use the New York MSP page. For QDWI, the 2026 HIICAP MSP guide gives the New York counselor chart.
The 2026 Medicare Part B premium is $202.90 per month. CMS posted that figure in its Part B premium notice. If MSP pays that premium, it can put more than $2,400 a year back into a senior’s budget. New York’s Office for the Aging says MSP can save some Medicare beneficiaries up to $8,400 a year when all savings are counted.
Who Should Apply
Ask for MSP screening if you live in New York, have Medicare, and your monthly income is near the numbers above. Also ask if you need help buying Part A through QMB.
New York is different from many states because QMB and QI do not have a resource test. Bank accounts, retirement accounts, or other savings do not block these two MSP levels. Full Medicaid and QDWI are different. They can still use resource rules.
- Apply if: Your income is near the QMB or QI level and you want help with the Part B premium.
- Apply if: You have medical bills from Medicare cost sharing and may be under the QMB limit.
- Apply if: You delayed Part B and have a late enrollment penalty. The New York HIICAP guide says MSP enrollment can remove the Part B late enrollment penalty.
- Ask before filing if: You are 65 or older, eligible for Social Security retirement, but delayed taking it. New York HIICAP warns this can create an eligibility issue unless an exception applies.
- Ask for more screening if: You also need Medicaid dental care, home care, or long-term services. Our New York care guide explains related long-term care paths.
QMB, QI, and QDWI in Plain English
Qualified Medicare Beneficiary (QMB)
What it helps with: QMB is the strongest MSP level for most New York seniors. It can pay the Part B premium, the Part A premium if you must buy Part A, and Medicare-covered deductibles, coinsurance, and copays.
Who may qualify: People with Medicare whose countable income is at or below the New York QMB limit. You can have QMB only, or QMB plus Medicaid.
Where to apply: Use NY State of Health, your county DSS, or HRA in New York City, depending on where your case belongs.
Reality check: QMB billing protection does not mean every bill is wrong. It protects you from Medicare-covered cost sharing. If the service was not covered by Medicare, other rules may apply. Our QMB billing guide gives more steps for refunds and collections.
Qualifying Individual (QI)
What it helps with: QI pays the Medicare Part B premium only. It also brings automatic Extra Help for Part D drug costs.
Who may qualify: People with Medicare Part A whose income is above QMB but within the New York QI range. You cannot have Medicaid and QI at the same time.
Where to apply: Use the same MSP application route. You do not choose QI. New York budgets the case and assigns the level.
Reality check: QI may reimburse up to three months of Part B premiums within the same calendar year in some cases. It does not pay deductibles or copays.
Qualified Disabled and Working Individual (QDWI)
What it helps with: QDWI pays the Medicare Part A premium only.
Who may qualify: Usually a person under 65 who has a disability, is working, and lost premium-free Part A because of work.
Where to apply: Ask the Medicaid office or HIICAP counselor to review QDWI. If you also want Medicaid, you may need a full Medicaid application.
Reality check: QDWI has resource limits. It is not the usual MSP path for retired seniors.
Where to Apply in New York
New York has more than one front door. The official 2026 state chart says Local Departments of Social Services, HRA in New York City, and NY State of Health can assist with Medicare premiums. That is why calling first can save time.
| Where you live | Best first step | Backup step |
|---|---|---|
| Outside New York City | Call NY State of Health at 1-855-355-5777 | Use your county DSS if told to mail paper or if the case stays local. |
| New York City | Use ACCESS HRA or call 1-888-692-6116 | Use an HRA Medicaid office if online filing is hard. |
| Not sure who has your case | Call the last office that sent a notice | Ask HIICAP or NY Connects to help you find the right office. |
| Need local aging help | Contact your Area Agency on Aging | Start with our New York aging offices guide. |
NYC residents age 65 or older, living with a disability or blindness, or in other HRA-handled groups can apply through HRA. The NYC HRA page lists the HRA helpline as 1-888-692-6116. The city HRA MSP brochure gives separate mailing addresses for MSP-only and MSP plus Medicaid cases.
Our New York portal guide explains the main benefits sites. In the five boroughs, our NYC senior guide covers other city help.
How to Apply Without Wasting Time
- Check the right route. Call first. Ask, “Should my MSP case be filed through NY State of Health, my county DSS, or HRA?”
- Ask for all screening. Say, “Please screen me for QMB, QI, full Medicaid if appropriate, Part A Buy-In, and QDWI if it applies.”
- Use the right form. Use DOH-4328 for MSP-only. If you need full Medicaid too, ask if a longer Medicaid application is needed.
- Do not skip spouse questions. The MSP instructions say that if you are married and living with your spouse, you must complete both self and spouse questions even if only one spouse applies.
- Sign before sending. The state warns that the signature block is on the back of the application.
- Keep proof. Make a copy. Keep fax proof, upload proof, mailing receipt, or the name of the worker who took it.
Documents to gather
- Front and back of your Medicare card
- Proof of date of birth
- Proof of New York address, such as a lease, utility bill, rent receipt, or mortgage statement
- Proof of income, such as Social Security award letter, pension statement, pay stubs, annuity proof, or veterans benefit letter
- Proof of other health insurance premiums, such as Medigap or Medicare Advantage premium bills
- Immigration proof if you are not a U.S. citizen
- Spouse information if married and living together
- Any denial, bill, or old MSP notice you want reviewed
Phone scripts that work
Application route script: “I live in New York and have Medicare. I want to apply for the Medicare Savings Program. Should I apply through NY State of Health, my county DSS, or HRA? Where should I send proof?”
Budget script: “My income is close to the limit. Please do not tell me no by phone. Can you budget the case and tell me whether any disregards apply?”
QMB bill script: “I am in the Qualified Medicare Beneficiary program. This bill appears to be for Medicare-covered cost sharing. Please check my QMB status, correct the bill, and recall it from collections if it was sent out.”
Delay script: “I filed an MSP application on [date]. Has it been registered? What proof is missing? Which office has the case right now? When should I expect a written notice?”
After Approval and Billing Problems
After approval, the Part B premium may stop coming out of Social Security, but systems can take time to update. Keep your approval notice. If deductions continue, ask whether the Medicare buy-in has been sent.
MSP also gives automatic Extra Help for Medicare Part D drug costs. The Medicare Extra Help guide explains what Extra Help can do for drug plan premiums, deductibles, and copays. Our drug cost guide covers other prescription help. New York seniors may also want to check EPIC rules, especially if MSP is delayed or you need more help with Part D costs.
If you get QMB, show both your Medicare card and your Medicaid or QMB proof when you get care. If you use Original Medicare, your Medicare Summary Notice may also show QMB status. If a provider keeps billing you, call Medicare contact page at 1-800-MEDICARE and ask for help with an improper QMB bill.
Reality Checks Before You File
- New York has split routes. One worker may say paper form. Another may say NY State of Health. Ask where your case will live and where proof should go.
- SLMB is not a separate New York MSP now. If a site lists SLMB for New York without explaining the 2023 change, it may be old.
- SNAP may change later. New York HIICAP warns that when MSP pays your Part B premium, your SNAP medical expense deduction can change at recertification. Many households still come out ahead.
- QI and Medicaid do not go together. If you have Medicaid or a spenddown, ask how QI would affect you before choosing a path.
- Full Medicaid is a separate screen. MSP can help with Medicare costs. Full Medicaid may help with dental, home care, and other services, but it may have resource rules.
- NYC mailing addresses differ. HRA has one address for MSP-only and another for MSP plus Medicaid. Use the address that fits your case.
Common Mistakes to Avoid
- Assuming you cannot qualify because you have savings.
- Using a national chart instead of New York’s 2026 limits.
- Filing QI while also trying to keep Medicaid without asking how the two interact.
- Sending the form without the back signature.
- Leaving out spouse information when married and living together.
- Mailing papers without keeping a copy.
- Paying a QMB bill before asking whether it is allowed.
- Waiting months without asking for case status.
What to Do if Denied, Delayed, or Overwhelmed
If you get a denial, read the reason first. Some denials are really missing-proof problems. Others are income budget issues. Ask for the exact budget in writing. If you disagree with a local DSS or HRA decision, the OTDA hearing page explains how to ask for a fair hearing online, by phone at 1-800-342-3334, by fax, by mail, or in person in NYC or Albany.
If the issue is no decision, call the office and ask whether the application was received, whether it was entered, and whether proof is missing. If the issue is wrong routing, call NY State of Health, the county DSS, or HRA and ask which office owns the case.
If you need legal or case help, ask HIICAP for a referral or call NY Connects. If you need disability-related help beyond MSP, our New York disability guide may help.
Plan B and Backup Options
- Apply for Extra Help separately: If MSP is delayed, Extra Help may still lower drug costs while you wait.
- Check EPIC: EPIC is New York’s drug help program for residents age 65 or older who meet its income rules and other requirements.
- Ask for full Medicaid screening: If you need dental, home care, or other Medicaid services, MSP alone may not be enough. Our New York dental guide covers dental help paths.
- Ask about charity care: If hospital bills are already in collections, ask the hospital for financial assistance while the MSP issue is being fixed.
- Get a plan review: A HIICAP counselor can check whether a Part D or Medicare Advantage plan is adding to your cost problem.
Local Resources in New York
- HIICAP: Call 1-800-701-0501 or use the HIICAP page for free Medicare counseling.
- NY Connects: Call 1-800-342-9871 or use NY Connects for aging and long-term services help.
- NY State of Health: Call 1-855-355-5777. TTY users can call 1-800-662-1220.
- Enrollment helpers: Use the Navigator Directory to find local marketplace help.
- NYC HRA: Call 1-888-692-6116 or use the HRA office locator.
- Other senior help: Our New York benefits guide covers food, housing, utilities, home repair, and other help.
- Senior veterans: Our New York veteran guide covers veteran-specific offices and support.
Resumen en Espanol
En Nueva York, un Programa de Ahorros de Medicare puede pagar la prima mensual de la Parte B. Si usted califica para QMB, tambien puede protegerle de deducibles, coseguro y copagos por servicios cubiertos por Medicare. Para QMB y QI, Nueva York no usa una prueba de recursos, asi que tener ahorros no lo descalifica automaticamente.
Si vive fuera de la Ciudad de Nueva York, llame a NY State of Health al 1-855-355-5777 y pregunte donde debe presentar su solicitud. Si vive en la Ciudad de Nueva York, use ACCESS HRA o llame a HRA al 1-888-692-6116. Antes de llamar, tenga su tarjeta de Medicare, prueba de ingresos, prueba de domicilio y cualquier factura medica. Si ya tiene QMB y recibe una factura por un servicio cubierto por Medicare, no pague sin preguntar. Llame al proveedor y diga que esta en QMB.
Frequently Asked Questions
Does New York still have SLMB?
Not as a separate current New York MSP. The 2026 New York HIICAP guide says SLMB was absorbed into New York’s 2023 MSP expansion. Most seniors are now screened for QMB or QI.
Is there an asset limit for New York MSP?
For QMB and QI, no. New York says there is no resource test for MSP. Full Medicaid and QDWI can still have resource rules.
Can QMB stop doctor bills?
QMB can stop billing for Medicare-covered deductibles, coinsurance, and copays. It does not mean every medical bill is wrong. Check whether Medicare covered the service.
Can I have QI and Medicaid?
No. New York HIICAP says an individual cannot have QI and Medicaid at the same time. If you have Medicaid or a spenddown, ask for a full budget review before making changes.
How long does MSP approval take?
Many applications should be decided within about 45 days, but delays can happen if proof is missing or the case is routed between offices. Call for status if you do not receive a notice.
Will MSP give me Extra Help?
Yes. MSP enrollment gives automatic Extra Help for Medicare Part D drug costs. This can lower drug plan costs, even if your MSP level only pays the Part B premium.
About This Guide
This guide uses official federal, state, local, 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 27 May 2026, next review 27 August 2026.
Corrections: Please note that despite our careful verification process, errors may still occur. Email info@grantsforseniors.org with corrections and we will respond within 72 hours.
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, and availability can change. Readers should confirm current details directly with the official program before acting.
Last updated: 27 May 2026
Next review: 27 August 2026
Choose your state to see senior assistance programs, benefits, and local help options.
About the Authors