Medicare is not free. Between Part A premiums (for those who did not earn enough work credits), Part B premiums, deductibles, coinsurance, and copays, the costs can add up quickly, especially for beneficiaries living on a fixed income. Fortunately, if you have limited income and resources, you may qualify for a Medicare Savings Program (MSP) that helps pay some or all of your Medicare costs.
What Are Medicare Savings Programs?
Medicare Savings Programs are state-run programs funded by Medicaid that help eligible Medicare beneficiaries cover certain out-of-pocket Medicare expenses. These programs are not the same as full Medicaid coverage, but they can significantly reduce the financial burden of Medicare.
There are four MSPs, each with different eligibility requirements and different levels of assistance. The programs are available in every state, though income and asset thresholds may vary slightly depending on where you live.
The Four Medicare Savings Programs
1. Qualified Medicare Beneficiary (QMB) Program
The QMB program provides the most comprehensive assistance. If you qualify, the program pays for:
- Your Part A premium (if you have one)
- Your Part B premium
- Deductibles for Part A and Part B
- Coinsurance and copays for Medicare-covered services
In practical terms, QMB covers nearly all of your cost-sharing under Original Medicare. Providers who accept Medicare are not allowed to bill QMB members for deductibles, coinsurance, or copays, even if the state Medicaid program pays less than the full amount.
2026 income limit: Approximately $1,275 per month for individuals or $1,724 per month for married couples (varies by state).
Resource limit: Approximately $9,430 for individuals or $14,130 for married couples. Some states have eliminated the asset test entirely.
2. Specified Low-Income Medicare Beneficiary (SLMB) Program
The SLMB program is more limited. It covers only your Part B premium, which in 2026 is $203.90 per month for most beneficiaries. It does not pay for deductibles, coinsurance, or copays.
Even though the benefit is narrower, saving over $2,400 per year on Part B premiums alone makes a meaningful difference for many people.
2026 income limit: Approximately $1,525 per month for individuals or $2,061 per month for married couples.
Resource limit: Same as QMB, approximately $9,430/$14,130, though some states have removed the asset test.
3. Qualifying Individual (QI) Program
The QI program also pays your Part B premium only, similar to SLMB. However, it has slightly higher income limits, making it available to beneficiaries who earn too much to qualify for SLMB.
One key difference: the QI program is first-come, first-served and depends on available federal funding. You must reapply every year, and benefits are not guaranteed if funding runs out, though historically most applicants have been approved.
You cannot receive QI benefits if you are already enrolled in Medicaid.
2026 income limit: Approximately $1,715 per month for individuals or $2,320 per month for married couples.
Resource limit: Same as QMB and SLMB.
4. Qualified Disabled and Working Individuals (QDWI) Program
The QDWI program is the most targeted of the four. It pays the Part A premium for a very specific group: people under age 65 who have a disability, have returned to work, and have lost their premium-free Part A coverage because of their employment income.
This is a narrow scenario, but for those who qualify, it prevents the loss of Part A coverage when returning to the workforce.
2026 income limit: Approximately $5,108 per month for individuals or $6,900 per month for married couples.
Resource limit: Approximately $4,000 for individuals or $6,000 for married couples.
Quick Comparison of the Four MSPs
| Program | What It Pays | Income Limit (Individual) | |---|---|---| | QMB | Part A premium, Part B premium, deductibles, coinsurance, copays | ~$1,275/month | | SLMB | Part B premium only | ~$1,525/month | | QI | Part B premium only | ~$1,715/month | | QDWI | Part A premium only | ~$5,108/month |
Limits shown are approximate 2026 federal guidelines. Your state may use slightly different figures.
What Counts as Income and Resources?
When determining eligibility, your state Medicaid office will look at:
Income includes:
- Social Security benefits
- Pensions and retirement income
- Wages and self-employment income
- Interest, dividends, and rental income
Resources include:
- Bank accounts (checking and savings)
- Stocks, bonds, and mutual funds
- Real estate other than your primary home
Resources that typically do NOT count:
- Your primary residence
- One vehicle
- Burial plots and up to $1,500 in burial funds per person
- Personal belongings and household items
- Life insurance with a face value of $1,500 or less
Many states have moved to eliminate the resource test altogether for MSP eligibility, focusing only on income. Check with your state to see if asset limits still apply.
An Important Bonus: Extra Help With Part D
Qualifying for any of the four Medicare Savings Programs automatically enrolls you in Extra Help (Low-Income Subsidy), which significantly reduces your prescription drug costs under Part D. This includes:
- Little to no monthly Part D premium
- Reduced or eliminated deductibles
- Low copays for covered medications (often just a few dollars per prescription)
This automatic enrollment is a significant added benefit that can save you hundreds or even thousands of dollars per year on prescription drugs.
How to Apply
You apply for Medicare Savings Programs through your state Medicaid office, not through Medicare or Social Security directly. Here is how to get started:
- Contact your state Medicaid agency. You can find your local office by calling 1-800-MEDICARE (1-800-633-4227) or visiting your state's Medicaid website.
- Gather your documentation. You will need proof of income (pay stubs, Social Security benefit statements), bank statements, and identification.
- Complete the application. Applications can often be submitted online, by mail, in person, or by phone, depending on your state.
- Ask your local State Health Insurance Assistance Program (SHIP) for free help. SHIP counselors can walk you through the application process and answer questions at no charge.
Processing times vary by state, but most applications are reviewed within 45 days. If approved, benefits may be applied retroactively to the date of your application.
Final Thoughts
If you are struggling to afford Medicare premiums, deductibles, or copays, the Medicare Savings Programs are one of the best resources available. Even if you are unsure whether you qualify, it is worth applying. The financial relief, combined with automatic enrollment in Extra Help for prescription drugs, can make a substantial difference in your overall health care costs.