The QMB Program: Free Medicare Coverage If You Qualify
What Does QMB Cover?
QMB is one of the Medicare Savings Programs (MSPs) — federal programs administered by states to help lower-income beneficiaries afford their coverage.
QMB pays:
- Your Medicare Part A premium (if applicable — most people get Part A free)
- Your Medicare Part B premium ($185/month in 2025 for most people)
- Part A and Part B deductibles
- Part A and Part B coinsurance and copays
Income and Asset Limits (2025)
| Monthly Income Limit | Asset Limit | |
|---|---|---|
| Individual | $1,255 | $9,430 |
| Married couple | $1,703 | $14,130 |
Assets counted: checking/savings, stocks, bonds. NOT counted: your home, one car, personal belongings, burial funds. Some states have higher limits. Limits updated annually.
Other Medicare Savings Programs
If you don't qualify for full QMB, you may qualify for:
- SLMB (Specified Low-Income Medicare Beneficiary): Pays Part B premium only. 2025 limits: $1,526/mo individual, $2,064/mo couple.
- QI (Qualifying Individual): Pays Part B premium only (limited slots, funded separately). 2025 limits: $1,715/mo individual, $2,309/mo couple.
- QDWI (Qualified Disabled and Working Individuals): Pays Part A premium for disabled people who have returned to work. Narrow eligibility.
Does QMB Affect Extra Help or Part D?
Yes — automatically and favorably. QMB enrollment automatically qualifies you for Extra Help (the Low Income Subsidy for Part D), which significantly reduces drug costs. No separate application needed.
How to Apply
Apply through your state Medicaid office — not through Medicare directly. Options:
- Call your state Medicaid office
- Apply online through your state's Medicaid portal
- Visit a local Social Security office
Medicare (1-800-MEDICARE) can give you your state office's contact information. Processing typically takes 45–90 days. If approved, coverage is usually retroactive to the month you applied.
Frequently Asked Questions
What is the QMB program?
The Qualified Medicare Beneficiary (QMB) program is a Medicaid benefit that pays your Medicare premiums, deductibles, and cost-sharing if your income is below the eligibility threshold. One of several Medicare Savings Programs.
How do I know if I qualify for QMB?
In 2025, you may qualify if your monthly income is at or below $1,255 (individual) or $1,703 (couple) and your assets are below the limits. Some states have higher limits. Check your eligibility →
Can a doctor bill me if I have QMB?
No — it's federally prohibited. If you're billed for Medicare cost-sharing and you have QMB, you can refuse to pay and report it to 1-800-MEDICARE.
Does QMB automatically qualify me for Extra Help on Part D?
Yes. QMB enrollment automatically qualifies you for Extra Help (Part D LIS). No separate application needed.
Where do I apply for QMB?
Through your state Medicaid office — not Medicare. Call 1-800-MEDICARE to get your state's contact information, or apply online through your state's Medicaid website.