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What's your situation right now?

Medicare Savings Programs and Extra Help can save you thousands per year. Let me help you find the right path based on your current situation.
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Program overview

5 Programs That Could Save You Thousands

Here's what's available. These programs work together — you might qualify for more than one.
Program What It Pays 2026 Income Limits (approx.)
QMB (Qualified Medicare Beneficiary)
Qualified Medicare Beneficiary
Part A premium, Part B premium ($202.90/mo), deductibles, copays ~$1,275/mo single
~$1,724/mo couple
SLMB (Specified Low-Income Medicare Beneficiary)
Specified Low-Income Beneficiary
Part B premium ($202.90/mo) ~$1,528/mo single
~$2,064/mo couple
QI
Qualifying Individual
Part B premium ($202.90/mo) ~$1,715/mo single
~$2,320/mo couple
QDWI
Qualified Disabled Working Individual
Part A premium (for working disabled) Higher limits if working
Extra Help/LIS
Low-Income Subsidy
Part D premiums, deductibles, copays ~$1,903/mo single
~$2,575/mo couple
Dr. Ed's Insider Tip
Millions of eligible people never apply for these programs. SSA estimates over 2 million people are missing out on Extra Help alone. If you're anywhere close to these income limits, it's worth applying.
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The Gold Standard

QMB (Qualified Medicare Beneficiary): The Best Medicare Savings Program

Qualified Medicare Beneficiary (QMB) is the most comprehensive help available. If you qualify, you get almost everything paid for.
QMB Pays For: Part A premiums • Part B premium ($202.90/month) • Part A & B deductibles • All copays and coinsurance

2026 QMB Income Limits (approximate)

  • Single person: ~$1,275 per month
  • Married couple: ~$1,724 per month
  • Resource limits: $9,430 individual / $14,130 couple
Dr. Ed's Insider Secret
QMB is the gold standard — it pays almost everything. And here's the secret: doctors and hospitals CANNOT bill QMB recipients for copays or deductibles. It's federal law. If a provider tries to bill you, remind them you're QMB-eligible and they must accept Medicare's payment as full payment.

Many income sources don't count or get special treatment:

  • $20 general income exclusion
  • $65 earned income exclusion + 1/2 remaining earnings
  • SNAP (Supplemental Nutrition Assistance Program)/food stamp benefits
  • Energy assistance payments
  • Some state supplements
  • Irregular or infrequent income under $20/month
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Premium Help

SLMB (Specified Low-Income Medicare Beneficiary): Specified Low-Income Medicare Beneficiary

If your income is too high for QMB (Qualified Medicare Beneficiary) but you still need help with Medicare premiums, SLMB might be perfect for you.
SLMB Pays For: Part B premium ($202.90 per month) — that's $2,435 per year in savings

2026 SLMB Income Limits (approximate)

  • Single person: ~$1,528 per month
  • Married couple: ~$2,064 per month
  • Resource limits: Same as QMB ($9,430/$14,130)
QMB vs SLMB QMB SLMB
Part B Premium ✅ Paid ✅ Paid
Deductibles ✅ Paid ❌ You pay
Copays/Coinsurance ✅ Paid ❌ You pay
Income Range (single) Up to ~$1,275/mo ~$1,275-$1,528/mo
Dr. Ed's Insider Tip
SLMB recipients also get automatic Extra Help for prescription drug costs. That's another $5,000+ in potential savings per year — and you don't need to apply separately.

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Limited funding

QI: Qualifying Individual Program

QI has higher income limits than SLMB (Specified Low-Income Medicare Beneficiary), but there's a catch — it's first-come, first-served with limited funding each year.
QI Pays For: Part B premium ($202.90 per month) — but funding runs out each year

2026 QI Income Limits (approximate)

  • Single person: ~$1,715 per month
  • Married couple: ~$2,320 per month
  • Resource limits: Same as QMB (Qualified Medicare Beneficiary)/SLMB
Important: QI funding is limited by federal appropriations. States typically run out of QI funding partway through the year. Apply early in the calendar year for the best chance.
1

January-March

Best time to apply — full funding available

2

April-June

Funding still available in most states

3

July-September

Many states start running low on funds

4

October-December

Most states have exhausted QI funding

Dr. Ed's Strategy
If you might qualify for QI, apply in January. Even if you get denied for QMB or SLMB, your application automatically gets considered for QI. Don't wait — once the money's gone, it's gone until next year.
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Prescription Drug Help

Extra Help: Low Income Subsidy (LIS)

Extra Help can save you $5,000+ per year on prescription drug costs. It's completely separate from the Medicare Savings Programs.
Extra Help Pays For: Part D premiums • Part D deductibles • Reduced copays ($1.55-$4.50 for most drugs)

2026 Extra Help Income Limits (approximate)

  • Single person: ~$1,903 per month
  • Married couple: ~$2,575 per month
  • Resource limits: $17,220 individual / $34,360 couple
Without Extra Help With Extra Help Annual Savings
Part D Premium: ~$600/year $0 premium $600
Part D Deductible: $590 $0 deductible $590
Brand name drugs: 25% of cost $4.50 per prescription $4,000+
Generic drugs: 25% of cost $1.55 per prescription $1,000+
Dr. Ed's Insider Tip
Extra Help can save you $5,000+ per year on prescription drugs. If you're anywhere close to the income limits, apply. You can apply online at ssa.gov, by phone, or at your local SSA office. The application is simple and worth thousands.

You automatically get Extra Help if you have:

  • Full Medicaid coverage
  • QMB (Qualified Medicare Beneficiary), SLMB (Specified Low-Income Medicare Beneficiary), or QI benefits
  • Supplemental Security Income (SSI)
  • Medicare Savings Program benefits

No separate application needed!

Quick screening

Which Program Might You Qualify For?

Enter your monthly income and household size for a quick estimate. This is just a screening — you'll need to apply officially.
Remember: These are approximate 2026 income limits. Your state may have higher limits, and there are income exclusions that could help you qualify even if you're over the limit.
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Application process

How to Apply for These Programs

Different programs, different applications. Here's where to apply for each one.

Apply through your state Medicaid office

1
Contact your state Medicaid office or visit their website
2
Complete the Medicare Savings Program application
3
Provide income and resource documentation
4
Wait for approval (usually 45-90 days)

Apply through Social Security

1
Online: Apply at ssa.gov/medicare/part-d-extra-help
2
Phone: Call 1-800-MEDICARE (1-800-633-4227)
3
In person: Visit your local Social Security office
4
Decision usually within 2-3 weeks
Dr. Ed's Pro Tip
Apply for both! You can apply for Medicare Savings Programs through your state AND Extra Help through Social Security at the same time. They don't affect each other, and you might qualify for multiple programs.
Good news: If you get approved for QMB, SLMB, or QI, you automatically get Extra Help too. No separate application needed.
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What to expect

Application Timeline & Process

Here's what happens after you apply and how long each step typically takes.
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Application Submitted

You've submitted your Medicare Savings Program or Extra Help application

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Review Period (2-6 weeks)

Agency reviews your application and may request additional documentation

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Decision Letter (45-90 days)

You'll receive approval or denial letter. If approved, benefits start retroactive to application date

Benefits Begin

Medicare Savings Programs: Usually next month after approval
Extra Help: Can be retroactive up to 3 months

If you're denied: You have appeal rights. Many denials are due to missing documentation or calculation errors. Don't give up — get help with your appeal.
Dr. Ed's Insider Advice
Keep paying your premiums while you wait. If approved, you'll get refunded for any premiums paid during the application process. Don't let your Medicare lapse while waiting for a decision.
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Important details

What Counts as Income & Resources?

Understanding what counts (and what doesn't) can make the difference between qualifying and not qualifying.
  • Social Security benefits
  • Pensions and retirement income
  • Wages and self-employment income
  • Investment income (interest, dividends)
  • Rental income
  • Unemployment benefits
  • Alimony received
  • $20 general income exclusion (first $20 doesn't count)
  • $65 earned income exclusion + 1/2 of remaining earnings
  • SNAP (Supplemental Nutrition Assistance Program)/food stamp benefits
  • Energy assistance — LIHEAP (Low Income Home Energy Assistance Program)
  • Housing assistance value
  • Irregular income under $20/month
  • Income tax refunds
  • Gifts under $20/month
  • Bank accounts (checking, savings)
  • Stocks, bonds, mutual funds
  • Real estate (other than home you live in)
  • Additional vehicles (beyond one car)
  • Cash value of life insurance over $1,500
  • Home you live in (any value)
  • One vehicle (any value)
  • Personal belongings and household goods
  • Wedding/engagement rings
  • Burial plots for you and family
  • Burial funds up to $1,500 per person
  • Life insurance with face value $1,500 or less
Dr. Ed's Pro Tip
Your state may have higher income limits than the federal minimums. Always check with your state Medicaid office. Some states have expanded eligibility with more generous income limits or resource exclusions.
Final questions

Frequently Asked Questions

Last-minute questions answered, plus resources to get you started.

Yes! In fact, if you qualify for QMB (Qualified Medicare Beneficiary), SLMB (Specified Low-Income Medicare Beneficiary), or QI, you automatically get Extra Help too. These programs complement each other — one helps with Medicare premiums and costs, the other helps with prescription drug costs.

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Built by Dr. Ed Weir, former SSA District Manager, to help you navigate the system with confidence.

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