Medicare Savings Programs: Getting the State to Pay Your Part B Premium
In 2026 the standard Part B premium is $202.90 a month, and for many retirees on a small Social Security check that's money they can't spare. A Medicare Savings Program can move that bill to the state. Many people who qualify never apply.
AT A GLANCE
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Medicare isn't free. Most people get Part A without a premium, but Part B carries a monthly premium, a yearly deductible and usually 20% coinsurance. For 2026, Medicare.gov lists the standard Part B premium at $202.90 a month and the deductible at $283 a year.
Medicare Savings Programs, often shortened to MSPs, are run by state Medicaid agencies. You can get one even if you don't qualify for full Medicaid. When you apply, the state decides which program fits.
The four programs side by side
These are the 2026 federal limits from Medicare.gov. Income limits are monthly and are slightly higher in Alaska and Hawaii.
Program | What it pays | Income limit, individual | Income limit, couple | Resource limit (individual / couple) |
|---|---|---|---|---|
QMB (Qualified Medicare Beneficiary) | Part A premium if you owe one, Part B premium, plus Medicare deductibles, coinsurance and copays | $1,350 | $1,824 | $9,950 / $14,910 |
SLMB (Specified Low-Income Medicare Beneficiary) | Part B premium only | $1,616 | $2,184 | $9,950 / $14,910 |
QI (Qualifying Individual) | Part B premium only | $1,816 | $2,455 | $9,950 / $14,910 |
QDWI (Qualified Disabled and Working Individual) | Part A premium only | $5,405 | $7,299 | $4,000 / $6,000 |
You need both Part A and Part B to qualify for SLMB or QI.
Your state may be more generous
Medicare.gov says you may still qualify in your state even if your income or resources are above the federal limits. Some states don't count certain kinds or amounts of income or resources. That's why the official advice is to apply rather than rule yourself out with a calculator.
Even if you don't think you qualify, you should still apply.
What QMB protects you from
QMB is the strongest of the four because it covers cost sharing, not just premiums. CMS states that federal law prohibits Medicare providers and suppliers, including pharmacies, from billing people in the QMB group for Medicare deductibles, coinsurance or copays on Medicare-covered items and services.
CMS also admits that people in QMB still get wrongly billed. If it happens to you:
Tell the provider or collector you're in QMB. Show your Medicare card and your Medicaid or QMB card each time you get care. With Original Medicare, a Medicare Summary Notice also shows you're in QMB.
Ask for a refund if you already paid a bill for Medicare-covered care. CMS's QMB tip sheet says you have a right to one.
Call 1-800-MEDICARE (1-800-633-4227) if the billing doesn't stop. Medicare can confirm your QMB status and ask the provider to stop.
You may still get a bill for a small Medicaid copayment if your state charges one. That's allowed.
SLMB and QI: help with the Part B premium
If your income is a little too high for QMB, SLMB or QI can still pay the Part B premium. For someone whose premium comes out of a Social Security check, that's $202.90 a month in 2026, or about $2,435 a year, staying in your pocket.
QI has two extra rules worth knowing:
You must reapply every year to stay in QI.
It's first-come, first-served. States approve QI applications in order, with priority for people who had QI the year before. QI is only for people who don't qualify for other Medicaid coverage.
QDWI: for people who went back to work
QDWI is narrow. Medicare.gov describes it as help for people with a disability who are working and lost their premium-free Part A because they returned to work. It pays the Part A premium only. If you don't qualify for premium-free Part A, Medicare.gov says buying it costs either $311 or $565 a month in 2026, depending on work history, so this program can be worth a lot.
Extra Help comes with it
People who qualify for QMB, SLMB or QI also get Extra Help paying for prescription drugs. Medicare.gov says you'll pay no more than $12.65 in 2026 for each drug your Medicare drug plan covers. You don't need a separate application for that part.
Three quick examples
These use the 2026 federal limits only. Your state's rules could put you in a better program.
Household | Monthly income | Likely starting point | What it could save |
|---|---|---|---|
Single, Social Security only | $1,250 | QMB | Part B premium plus Medicare deductibles and copays |
Single, Social Security plus small pension | $1,550 | SLMB | $202.90 a month Part B premium |
Married couple, both on Medicare | $2,400 | QI | Part B premium for each spouse who qualifies, if the state still has QI slots |
The resource limit matters too. A single person with $12,000 in savings is over the $9,950 federal resource limit even with low income, unless the state doesn't count part of it. Ask the state what counts as a resource before you assume you're out.
Questions people ask
Do I lose my doctor?
No. MSPs pay Medicare costs. They don't replace Medicare, so you keep using Medicare as before.
What if I have a Medicare Advantage plan?
The programs are listed on Medicare.gov for people with Medicare, and the QMB billing ban covers Medicare-covered items and services. CMS also publishes guidance for Medicare Advantage plans on QMB members, so tell your plan if you're approved.
Can I apply if I'm still working?
Yes, if your income and resources fit. QDWI is designed specifically for some working people with disabilities.
How to apply
Find your state Medicaid office. Medicare.gov says these programs are run by your state and links to a state-by-state contact list on Medicaid.gov.
Ask for a Medicare Savings Program by name. Say you're applying for help with Medicare premiums. The state will screen you for all four programs and for full Medicaid.
Have proof ready. Keep your Social Security benefit letter, pension statements and pay stubs nearby, plus bank statements for resources.
Answer follow-up requests by the date given. Keep copies of anything you send.
Keep your approval letter. It names the program you got, and if it's QI, it's a reminder that you'll need to reapply next year.
Before you call
☐ Your Medicare card and Social Security number
☐ Your Social Security benefit letter for this year, plus any pension, VA or wage income
☐ Recent statements for checking, savings and other accounts
☐ Your spouse's income and resources, if you're married and live together
☐ Any Medicare bills you've received for deductibles or copays
☐ A notepad for the name of the worker, the date and any reference number
WHAT TO DO THIS WEEK
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Related help
If your income is too high for these programs but medical bills are piling up, read our Medicaid spend-down guide with a worked example. If you lost Medicaid at renewal, there's a 90-day window to get it back. For hospital bills, see how hospital charity care works.
Official sources
Last checked: October 23, 2026 (Medicare.gov 2026 limits and costs, CMS QMB pages). Limits are updated each year.
Your state Medicaid agency makes the final decision and may use higher limits than the federal figures shown here.
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