What are the Medicare Savings Programs (QMB, SLMB, QI)?
Three different Medicare Savings Programs cover three different income tiers — and a fourth (QDWI) covers working disabled adults. Here's the per-program breakdown, with what each one pays, who qualifies, and where to apply. The asset test is more generous than SSI, and most people who qualify never apply.
Dr. Ed Weir, PhD · 20 years inside Social Security · "Former" Sergeant, USMC
Updated April 2026
What are the Medicare Savings Programs (QMB, SLMB, QI)?
The Medicare Savings Programs (QMB, SLMB, QI) are state-administered Medicaid pathways that pay Medicare premiums and, for QMB, cost-sharing too. QMB covers people at or below 100% FPL, SLMB covers 100 to 120%, and QI covers 120 to 135%. A fourth program, QDWI, helps working disabled adults at or below 200% FPL.
Picking the right MSP track and getting through your state's application is where most people get stuck.
Free help from licensed Medicare advisors
Chapter Medicare's licensed advisors will sit with you, look at your income, and help you figure out which Medicare Savings Program you may qualify for — QMB, SLMB, QI, or QDWI. Free service, no plan-pushing. State Health Insurance Assistance Program (SHIP) counselors at the SHIP phone number provide the same unbiased help.
Here's what to do, in 4 steps.
If your monthly income is anywhere near 135% of the federal poverty level, one of these four programs probably has your name on it. Here's how to figure out which.
1. Compare your monthly income to the QMB / SLMB / QI thresholds
QMB takes you at or below 100% FPL (about $1,325 a month for an individual in 2026). SLMB stretches to 120%, QI to 135%. Pick the highest tier you qualify under — the program will route you to the right one.
Medicare.gov — Medicare Savings Programs ›2. Apply through your state Medicaid agency
MSPs are not on Healthcare.gov — every state runs its own application. Search your state's Medicaid agency website, or call them. Some let you apply online, some still want paper. Either way, the state runs the eligibility decision.
CMS — Medicare Savings Programs overview ›3. Get free SHIP help with your application
Every state has free SHIP counselors trained on MSPs. They will help you fill out the state application, gather documents, and follow up if the state denies. Call — unbiased, no plan-pushing.
SHIP National Locator ›4. If a provider bills you for Medicare cost-sharing as a QMB, push back
Federal law prohibits Medicare providers from billing QMBs for deductibles, coinsurance, or copays. If you get a bill, call the provider with your QMB notice and call your state Medicaid agency. The Qualified Medicare Beneficiary Improvement Act of 2017 is the citation.
CMS — QMB billing protection ›What the four MSP tracks look like in 2026.
Which of these sounds more like you?
MSPs split into four tracks. Find the one that matches your income.
My income is at or below 100% FPLQMB — the full-coverage tier
If your monthly income is at or below 100% FPL (about $1,325 for an individual in 2026), you may qualify for QMB — the full-coverage Medicare Savings Program. QMB pays your Medicare Part A premium (if you owe one), your Part B premium (about $202.90/mo in 2026), and the deductibles, coinsurance, and copays on the Medicare side.
It is the strongest of the four tracks. Apply through your state Medicaid agency.
I've seen people sit on QMB eligibility for years because nobody told them it existed. Free Part B premium plus protection against Medicare cost-sharing bills — that's life-changing money.
I'm a few hundred over QMB but under 120% FPLSLMB — Part B premium only
If your monthly income is between 100% and 120% FPL (roughly $1,325 to $1,585 for an individual in 2026), you may qualify for SLMB. SLMB pays your Part B premium each month — that's about $202.90/mo back in your pocket in 2026.
SLMB enrollees also get Extra Help (LIS) for prescription drug costs automatically. Same easy asset test as QMB. Apply through your state Medicaid agency.
I'm at 135% FPLQI — apply early in the year
If your income falls between 120% and 135% FPL (about $1,585 to $1,781 for an individual in 2026), QI is your tier. QI pays your Part B premium and triggers automatic Extra Help for Part D, just like SLMB.
The catch: QI is funded out of a capped federal allotment that runs on a calendar-year basis. Apply early in the year to make sure you get a slot.
Don't get caught by this — QI is first-come-first-served because Congress caps the federal allotment annually. If you wait until November to apply, your state may have already run out of QI slots for the year.
I'm working disabled and losing Medicare due to earningsQDWI — the fourth track
QDWI — Qualified Disabled Working Individual — is for working disabled adults under 65 who lost their free Medicare Part A because their earnings ended their disability cash benefits. If your income is at or below 200% FPL (about $2,650/mo for an individual in 2026), QDWI may pay your Part A premium so you keep hospital coverage.
QDWI does not cover Part B premium or cost-sharing. Apply through your state Medicaid agency.
A provider sent me a Medicare billQMB billing protection
If you're enrolled in QMB and a Medicare provider sends you a bill for the deductible, coinsurance, or a copay, that bill is illegal under federal law. The Qualified Medicare Beneficiary Improvement Act of 2017 prohibits Medicare providers from billing QMBs for Medicare cost-sharing.
Call the provider's billing office, tell them you are QMB-enrolled, and ask them to drop the charge. If they refuse, call your state Medicaid agency or 1-800-MEDICARE. Keep your QMB notice handy as proof.
Don't get caught by this — QMBs cannot be billed for Medicare cost-sharing under federal law. Providers sometimes try anyway. Push back, with the statute in hand.
I'm worried about my retirement accountAsset test on IRAs and 401(k)s
MSP asset limits (about $9,660 individual / $14,470 couple in 2026 federal floor) are higher than SSI's $2,000 / $3,000 cap, but retirement accounts cause confusion. Some states count an IRA's full balance against the asset limit. Others only count the monthly distribution as income, treating the principal as exempt.
This is state-specific. Talk to your state Medicaid agency or a SHIP counselor before you assume your retirement account disqualifies you.
I'm a flashlight, not a courtroom. MSP asset rules vary state to state, and treatment of retirement accounts is one of the biggest variances. Talk to your state Medicaid agency or SHIP before you walk away from a possible MSP.
I'm helping a parent qualify for an MSPBystander — supporting an aging parent
If you're filling out an MSP application for a parent, you'll need three things from them: monthly income (Social Security statement, pension statement, any wages), assets (bank balances, investment accounts, retirement accounts), and Medicare numbers (red, white, and blue Medicare card or MyMedicare account).
You'll also want their state Medicaid agency contact information — every state runs its own MSP application. SHIP counselors at will sit with you and your parent on the phone or in person and walk through the application together. Free service.
My situation is differentFallback — still figure it out
If your situation doesn't fit any of the cards above — maybe your income hovers right at one of the thresholds, or you have an unusual asset situation, or you're looking at this on behalf of a community member you don't share a household with — talk to a SHIP counselor.
SHIP counselors at are trained to look at the four MSP tracks side by side, walk through your state's specific eligibility rules, and tell you which one (if any) you may qualify for. Free, unbiased, no plan-pushing.
Programs that ride alongside your MSP.
MSP enrollment unlocks Extra Help automatically and often opens doors to other programs you didn't know you qualified for.
Medicare Savings Program (MSP) overview
If you want the entry-point explainer that walks through MSPs from a Medicare reader's angle (rather than the per-program mechanics on this page), start there. You may qualify for an MSP if your income is at or below 135% FPL.
Extra Help (Low Income Subsidy)
QMB, SLMB, and QI enrollees automatically qualify for Extra Help with Medicare Part D drug costs. If you're not in an MSP but earn under 150% FPL, you may qualify for Extra Help directly through Social Security.
Dual-eligible (Medicare + Medicaid)
QMB enrollees are technically dual-eligible — Medicare-Medicaid. SLMB and QI enrollees are partial-dual. You may qualify for full Medicaid (long-term care, vision, dental, transportation) on top of an MSP if your state's full-Medicaid limits are higher.
D-SNPs (Dual Special Needs Plans)
If you're enrolled in QMB and the full Medicaid your state offers, you may qualify for a Dual Special Needs Plan — a Medicare Advantage plan designed for dual-eligibles. SHIP counselors can walk you through D-SNP options without plan-pushing.
Medicare basics
If you're new to Medicare and want to understand Parts A, B, C, and D before applying for an MSP, the Medicare benefits overview is a good starting point.
IRMAA (high-income surcharge)
On the opposite end of the income scale: if you're a higher-income Medicare beneficiary paying an IRMAA surcharge on top of the standard Part B premium, you may qualify to appeal IRMAA after a life event such as retirement.
Everything people ask me about MSPs
What's the difference between QMB, SLMB, QI, and QDWI?
These are the four Medicare Savings Programs, each tied to a different income tier. QMB covers people at or below 100% FPL and pays Part A premium, Part B premium, and Medicare cost-sharing. SLMB covers 100 to 120% FPL and pays Part B premium only. QI covers 120 to 135% FPL and also pays Part B premium only. QDWI is a separate track for working disabled adults under 65 at or below 200% FPL and pays Part A premium only.
What does QMB cover?
QMB — Qualified Medicare Beneficiary — is the most generous of the four MSP tracks. It pays your Medicare Part A premium (most people don't owe one), your Part B premium (about $202.90/mo in 2026), Medicare deductibles, coinsurance, and copays. Federal law also prohibits Medicare providers from billing you for Medicare cost-sharing once you're enrolled.
What does SLMB cover?
SLMB — Specified Low-Income Medicare Beneficiary — pays your Medicare Part B premium each month. That's about $202.90/mo in 2026. It does not pay Part A premium, deductibles, or cost-sharing. SLMB enrollees also automatically qualify for Extra Help (LIS) on Part D drug costs.
What does QI cover?
QI — Qualifying Individual — also pays your Part B premium each month and triggers automatic Extra Help for Part D, exactly like SLMB. The difference: QI is for the next income tier up (120 to 135% FPL), and it is funded out of a capped federal allotment that is awarded first-come-first-served on a calendar-year basis. Apply early in the year.
What's QDWI?
QDWI — Qualified Disabled Working Individual — is a separate Medicare Savings Program for working disabled adults under 65 who lost their free Medicare Part A because their earnings ended their cash disability benefits. QDWI pays the Part A premium only. Income limit is 200% FPL (about $2,650/mo for an individual in 2026).
What are the income limits?
For 2026, the federal floor monthly income limits for an individual are approximately $1,325 (QMB, 100% FPL), $1,585 (SLMB, 120% FPL), $1,781 (QI, 135% FPL), and $2,650 (QDWI, 200% FPL). Couple limits are roughly $1,783 / $2,135 / $2,400 / $3,576. States may apply more generous income tests — check your state's Medicaid agency for the actual figure.
What are the asset limits?
Federal floor MSP asset limits are approximately $9,660 individual / $14,470 couple in 2026 (CMS publishes the annual update). These are higher than SSI's $2,000 / $3,000 cap, so MSP eligibility is more accessible. Your home, one car, household goods, and a burial allowance are typically excluded. Retirement accounts are state-specific — some states count them, some don't.
Where do I apply?
MSP applications go through your state Medicaid agency, not Healthcare.gov and not Social Security. Search your state's Medicaid agency website, or call them. Some states accept online applications; others require paper. Free SHIP counselors at will help you fill out the application and gather documents.
Can a provider bill me for Medicare cost-sharing as a QMB?
No. The Qualified Medicare Beneficiary Improvement Act of 2017 prohibits Medicare providers from billing QMB enrollees for Medicare deductibles, coinsurance, or copays. If you receive a bill, call the provider's billing office and tell them you are QMB-enrolled. If they refuse to drop the charge, call your state Medicaid agency or 1-800-MEDICARE.
Will MSP enrollment affect my Medicare?
No. MSP enrollment does not change your Medicare — you keep your same Medicare card, same providers, same Original Medicare or Medicare Advantage choice. The MSP simply pays your Part A premium (if any), Part B premium, and — for QMB — cost-sharing on your behalf. You may also see Extra Help (LIS) automatically reduce your Part D drug copays.
Sources
Every figure and rule on this page is verified against primary sources. Last verified 2026-04-28.
- QMB (Qualified Medicare Beneficiary) covers Medicare Part A premium (if any), Part B premium, and Medicare cost-sharing (deductibles, coinsurance, copays) for individuals with income at or below 100% … —medicare.gov(verified 2026-04-28)
- SLMB (Specified Low-Income Medicare Beneficiary) covers Medicare Part B premium for individuals with income between 100% and 120% FPL. —medicare.gov(verified 2026-04-28)
- QI (Qualifying Individual) covers Medicare Part B premium for individuals with income between 120% and 135% FPL. QI is funded by a capped federal allotment, so applications are processed … —medicare.gov(verified 2026-04-28)
- QDWI (Qualified Disabled Working Individual) covers Medicare Part A premium for working disabled adults with income at or below 200% FPL. The pathway exists for individuals under 65 who lost free Part … —medicare.gov(verified 2026-04-28)
- The 2026 MSP federal floor resource (asset) limit is $9,950 individual / $14,910 married couple, per CMS 2026 figures published at medicare.gov. —medicare.gov(verified 2026-04-28)
- MSP applications are processed by state Medicaid agencies, not by the federal government, Healthcare.gov, or Social Security. —medicare.gov(verified 2026-04-28)
- CMS publishes annual MSP income and resource limit updates for Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), Qualifying Individual (QI), and Qualified … —medicare.gov(verified 2026-04-28)
- QMB, SLMB, and QI enrollees automatically qualify for Extra Help (Low Income Subsidy) for Medicare Part D prescription drug costs under 42 CFR § 423.773. —ecfr.gov(verified 2026-04-28)
- Medicare Savings Programs are state-administered Medicaid pathways under 42 USC § 1396a(a)(10)(E) that pay Medicare premiums (and, for QMB, cost-sharing) for low-income Medicare beneficiaries. —law.cornell.edu(verified 2026-04-28)
- The 2026 QMB monthly income limit (federal floor) is approximately $1,330/mo individual / $1,803/mo couple at 100% FPL, derived from the 2026 ASPE Federal Poverty Guidelines (annual: $15,960 … —aspe.hhs.gov(verified 2026-04-28)
- The 2026 SLMB monthly income limit (federal floor) is approximately $1,596/mo individual at 120% FPL, derived from the 2026 ASPE Federal Poverty Guidelines (100% FPL HH1 = $15,960/yr). —aspe.hhs.gov(verified 2026-04-28)
- The 2026 QI monthly income limit (federal floor) is approximately $1,795.50/mo individual at 135% FPL, derived from the 2026 ASPE Federal Poverty Guidelines (100% FPL HH1 = $15,960/yr). —aspe.hhs.gov(verified 2026-04-28)
- Federal law at 42 USC § 1396a(n)(3)(B) prohibits Medicare providers from billing Qualified Medicare Beneficiary (QMB) enrollees for Medicare deductibles, coinsurance, or copayments for services … —law.cornell.edu(verified 2026-04-28)
- State Health Insurance Assistance Programs (SHIP) provide free unbiased counseling for MSP applications and Medicare-Medicaid coordination. The national SHIP locator is reachable at . —shiphelp.org(verified 2026-04-28)
- State Medicaid agencies determine MSP eligibility and may apply more generous income or asset limits than the federal floor under 42 USC § 1396a(a)(10)(E). —law.cornell.edu(verified 2026-04-28)
Helping a parent with their MSP application?
If you're sitting at the kitchen table with a parent trying to figure out which Medicare Savings Program they may qualify for, you're in the right place. The state application asks for income, assets, and Medicare numbers — bring all three.
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