Can I apply for Medicare Savings Programs if I have Medicare Advantage?

Yes, Medicare Savings Programs work with both Original Medicare and Medicare Advantage plans. The programs help pay your Medicare premiums and cost-sharing regardless of which type of Medicare coverage you have.

What happens if my income changes after approval?

Report income changes to your state Medicaid office. Benefits may be adjusted or terminated if your income rises above the program limits. Most states conduct annual reviews, but you are required to report significant changes promptly.

Can I be denied Medicare services if I have QMB?

Providers cannot refuse to treat QMB beneficiaries, and they cannot charge you for Medicare-covered services beyond what Medicare allows. Federal law prohibits balance billing for QMB enrollees.

How do I find my state's application office?

Contact your state's Medicaid office or call 1-800-MEDICARE (1-800-633-4227). You can also visit Medicare.gov to find local resources and State Health Insurance Assistance Programs (SHIPs) that offer free counseling.

Can married couples apply separately?

No, married couples living together must apply jointly. Income and asset limits for couples are higher than for individuals, reflecting the combined household resources.

Medicare Savings Programs: QMB, SLMB, and QI

Q: Do Medicare Savings Programs cover prescription drugs?

QMB, SLMB, and QI participants get Medicare Part D Extra Help (Low-Income Subsidy), which significantly reduces prescription drug costs. In 2026, covered drug copays are no more than $12.65 for each drug under these programs.

Medicare Savings Programs (MSPs) are state-administered programs that help low-income Medicare beneficiaries pay for Medicare premiums, deductibles, and coinsurance. If you qualify, these programs can save you thousands of dollars per year on healthcare costs.

Medicare Savings Programs help low-income beneficiaries pay Medicare costs through four programs: QMB, SLMB, QI, and QDWI.

Key facts:

QMB provides the most comprehensive coverage — premiums, deductibles, and coinsurance
SLMB and QI focus on Part B premium assistance for those with slightly higher incomes
QMB and SLMB enrollees automatically qualify for Part D Extra Help
Applications go through your state Medicaid office, not Medicare

Qualified Medicare Beneficiary (QMB) Program

QMB is the most comprehensive Medicare Savings Program. It covers Medicare Part A and Part B premiums, deductibles, coinsurance, and copayments for eligible beneficiaries. QMB enrollees also cannot be balance-billed by providers — they're protected by federal law.

For 2026, QMB income limits are $1,350 monthly for individuals and $1,824 monthly for married couples. Resource limits are $9,950 for individuals and $14,910 for couples.

Specified Low-Income Medicare Beneficiary (SLMB) Program

SLMB covers Medicare Part B premiums for people with incomes slightly above QMB limits. While it doesn't cover deductibles or coinsurance like QMB does, it still saves enrollees $202.90/month (the standard 2026 Part B premium).

For 2026, SLMB income limits are $1,616 monthly for individuals and $2,184 monthly for married couples.

Qualifying Individual (QI) Program

QI provides Part B premium assistance for people with incomes above SLMB limits but still below a threshold. Like SLMB, QI covers your Part B premium. Unlike QMB and SLMB, QI funding is limited — applications are processed on a first-come, first-served basis.

For 2026, QI income limits are $1,816 monthly for individuals and $2,455 monthly for married couples.

Program Comparison

Feature	QMB	SLMB	QI
Part A premium	Yes	No	No
Part B premium	Yes	Yes	Yes
Deductibles	Yes	No	No
Coinsurance/copays	Yes	No	No
Income limit (individual)	$1,350/mo	$1,616/mo	$1,816/mo
Income limit (couple)	$1,824/mo	$2,184/mo	$2,455/mo
Auto Extra Help	Yes	Yes	Yes

Application Process and Documentation

Medicare Savings Program applications are processed through state Medicaid offices, not through Medicare or Social Security. You'll typically need:

Proof of identity (driver's license, state ID, or passport)
Proof of Medicare enrollment (Medicare card)
Income documentation (Social Security benefit letter, tax returns, pay stubs)
Asset documentation (bank statements, investment account statements)
Proof of residency in your state

Income and Asset Counting Rules

Medicare Savings Programs use modified Medicaid income counting rules with specific exclusions. Not everything counts as income or assets:

Excluded from assets: Your home, one car, burial plots, up to $1,500 in burial funds
Excluded from income: First $20 of most income, first $65 of earned income

Counted as income: Social Security benefits, pensions, investment income
Counted as assets: Bank accounts, stocks, bonds, additional vehicles

Benefits Coordination with Other Programs

QMB and SLMB beneficiaries automatically qualify for Medicare Part D Low-Income Subsidies (Extra Help), which significantly reduces prescription drug costs. This dual benefit can save enrollees thousands of dollars annually on medications.

If you qualify for a Medicare Savings Program, you may also be eligible for other assistance programs like SNAP (food assistance) and LIHEAP (energy assistance). Your state Medicaid office can help identify additional programs.