The 4 Medicare Savings Programs
Each MSP has different income limits and covers different Medicare costs. Most people should apply for QMB first since it offers the most comprehensive coverage.
QMB is the most generous MSP. If you qualify, Medicare providers are legally prohibited from billing you for any Medicare cost-sharing — no premiums, no deductibles, no copayments, no coinsurance for Medicare-covered services. If a provider bills you for Medicare cost-sharing when you have QMB, you have the right to dispute the bill.
- Medicare Part A premiums (if applicable)
- Medicare Part B premiums ($185.00/month in 2026)
- Medicare Part A and Part B deductibles
- Medicare Part A and Part B coinsurance and copayments
- Automatic qualification for Extra Help (Low Income Subsidy for Part D)
SLMB covers your Medicare Part B premium only. At $185.00/month in 2026, that's $2,220/year in savings. You also get automatic Extra Help for prescription drugs.
- Medicare Part B premium only ($185.00/month)
- Automatic qualification for Extra Help (Part D)
- Does NOT cover deductibles, copayments, or Part A costs
QI covers your Medicare Part B premium, same as SLMB, but is available to people with slightly higher incomes. Important: QI enrollment may be limited based on state funding and eligibility rules — apply early in the year and reapply every year. Priority is typically given to people who received QI benefits the prior year.
- Medicare Part B premium only
- Automatic qualification for Extra Help (Part D)
- Does NOT cover deductibles, copayments, or Part A costs
- Only available to people who don't qualify for any other Medicaid
QDWI is for people under 65 who have a disability, are working, and lost premium-free Medicare Part A because they returned to work. It pays the Part A premium only.
- Medicare Part A premium only
- Does NOT cover Part B, deductibles, or copayments
- For disabled workers under 65 who lost free Part A by returning to work
MSP Income Limits 2026 — Comparison Table
Income limits include the standard $20/month general income disregard. Actual limits may be slightly higher in Alaska and Hawaii. Some states have more generous limits — check with your state Medicaid office.
| Program | FPL % | Single income limit | Couple income limit | Single assets | Couple assets | What it covers |
|---|---|---|---|---|---|---|
| QMB | ~100% | $1,350/mo | $1,824/mo | $9,660 | $14,470 | Premiums, deductibles, copays |
| SLMB | ~120% | $1,616/mo | $2,184/mo | $9,660 | $14,470 | Part B premium only |
| QI | ~135% | $1,816/mo | $2,455/mo | $9,950 | $14,910 | Part B premium only |
| QDWI | ~200% | $1,997/mo | $2,694/mo | $4,000 | $6,000 | Part A premium only (disabled workers) |
Extra Help — Medicare Part D Low Income Subsidy
Enrolling in any Medicare Savings Program automatically qualifies you for Extra Help (also called the Low Income Subsidy or LIS) for Medicare Part D prescription drug coverage. This benefit can be worth $5,700/year or more.
Pay $0 premium for a benchmark Part D plan as long as you have Extra Help.
Pay no more than $5.10/month for generic drugs and $12.65 for brand-name drugs in 2026.
No Part D deductible — coverage starts from your first prescription.
No late enrollment penalty for Part D if you receive Extra Help, even if you sign up late.
How to Apply for Medicare Savings Programs
MSPs are run by state Medicaid agencies. Visit Medicare.gov/savings-programs or call 1-800-MEDICARE (1-800-633-4227) to find your state's contact information.
You'll need: Medicare card, proof of income (Social Security award letter, pay stubs), proof of assets (bank statements), and proof of residency.
Apply online through your state's Medicaid portal, by phone, by mail, or in person. You can also apply through the Social Security Administration for Extra Help directly.
Your State Health Insurance Assistance Program (SHIP) offers free, unbiased help with MSP applications. Call 1-800-MEDICARE to find your local SHIP counselor.
Frequently Asked Questions
Who qualifies for Medicare Savings Programs?
To qualify for any MSP you must: (1) be enrolled in Medicare Part A, (2) have income at or below the program's income limit, and (3) have assets at or below the asset limit. Most people who qualify are 65 or older, but younger people with disabilities who have Medicare can also qualify.
What counts as income for MSP eligibility?
MSPs follow SSI (Supplemental Security Income) rules for counting income. This means approximately half of your earned income from work is NOT counted. Social Security retirement and disability benefits DO count. The programs also allow a standard $20/month general income disregard — that's already included in the income limits shown above.
What counts as assets for MSP eligibility?
Countable assets include bank accounts, stocks, bonds, and most savings. Assets that do NOT count include your home (primary residence), one car, household goods, life insurance with face value under $1,500, burial funds up to $1,500 per person, and retirement accounts in many states. Several states have eliminated asset tests entirely.
Can I have both Medicare and Medicaid?
Yes — people who qualify for both are called "dual eligible." If you qualify for full Medicaid in addition to Medicare, you automatically get QMB benefits and Extra Help without needing to apply separately. Medicaid covers costs that Medicare doesn't pay.
How long does it take to get approved for MSP?
States have up to 45 days to process MSP applications (90 days for disability-based applications). SLMB and QI benefits can be retroactive up to 3 months before your application date. QMB benefits generally begin the month after approval.
Do I need to reapply every year?
It depends on the program and state. QI always requires annual reapplication. QMB and SLMB may be renewed automatically in some states through the Medicaid renewal process, but you should confirm with your state. If your income or assets change significantly, report it to your state Medicaid office.
What is the difference between MSP and Extra Help?
MSPs help pay Medicare Part A and Part B costs (premiums, deductibles, copays). Extra Help (also called the Low Income Subsidy or LIS) specifically helps pay Medicare Part D prescription drug costs. Enrolling in any MSP automatically qualifies you for Extra Help. You can also apply for Extra Help separately through the Social Security Administration if you don't qualify for an MSP.