Medicare Savings Programs (MSPs) help eligible people with limited income and resources pay certain Medicare premiums and cost sharing. In 2026, the four programs are QMB, SLMB, QI and QDWI. The program you receive matters: QMB can cover Medicare deductibles, coinsurance and copayments, while SLMB and QI generally pay only the Part B premium and QDWI pays only the Part A premium. Federal figures are screening guidelines, not guaranteed national cutoffs, because states may use higher limits or disregard some income and resources.
What Medicare Savings Programs do
Medicare Savings Programs are state-administered benefits funded through Medicaid that help certain Medicare beneficiaries with Medicare expenses. They are not one single benefit. Each program has its own purpose, income and resource guidelines, Medicare-part requirements and, in one case, disability and work requirements.
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The Centers for Medicare & Medicaid Services (CMS) publishes federal figures each year. For 2026, those figures can help you estimate which program to ask about, but your state Medicaid or Medical Assistance office makes the actual eligibility decision. A state may set a higher limit, disregard some earnings or resources, or apply different counting rules. Medicare specifically advises people to apply even when they believe they are above the figures shown in federal guidance.
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Compare the four programs
| Program | Main costs covered | Important eligibility features |
|---|---|---|
| Qualified Medicare Beneficiary (QMB) | Part A premiums when a person does not qualify for premium-free Part A; Part B premiums; Medicare-covered deductibles, coinsurance and copayments | For people with limited income and resources who meet state rules; QMB protections apply to Medicare-covered services and items |
| Specified Low-Income Medicare Beneficiary (SLMB) | Part B premium | Must have both Part A and Part B and meet income and resource rules |
| Qualifying Individual (QI) | Part B premium | Must have Part A and Part B, cannot qualify for other Medicaid coverage or benefits, and must apply every year; funding is limited |
| Qualified Disabled and Working Individual (QDWI) | Part A premium only | For certain people with disabilities who work, lose disability benefits and lose premium-free Part A after returning to work |
None of these descriptions means that an MSP pays every health-care bill. Benefits are tied to the Medicare expense listed for the specific program. Full Medicaid eligibility is a separate question.
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QMB: the broadest Medicare cost-sharing help
QMB provides the most extensive Medicare cost-sharing assistance among the four MSPs. If approved, it can pay the Part B premium, Medicare-covered deductibles, coinsurance and copayments, and a Part A premium when the applicant does not have premium-free Part A.
Medicare says providers may not bill a QMB beneficiary for Medicare-covered services and items, including the deductibles, coinsurance and copayments that QMB covers. A small Medicaid copayment may still be allowed under state rules. When receiving care, show both your Medicare identification and your Medicaid or QMB identification so the provider can verify the protection.
QMB applies to Medicare-covered care. It does not automatically pay for services Medicare excludes, such as every form of long-term care, noncovered dental work or other services outside Medicare’s benefit rules.
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SLMB pays the Medicare Part B premium for eligible people. Medicare’s guidance says an applicant must have both Part A and Part B. SLMB does not provide the broad QMB protection against billing for Medicare deductibles, coinsurance and copayments.
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If your income is above the QMB guideline but within the SLMB guideline, ask your state to screen you for SLMB rather than assuming you are ineligible for all assistance. State rules can change the result, especially where income exclusions apply.
QI: Part B help with an annual, limited application
QI also pays the Part B premium, but it is designed for people who do not qualify for other Medicaid coverage or benefits. You must have both Part A and Part B and apply every year.
QI funding is limited. States approve applications on a first-come, first-served basis, and people who received QI the previous year receive priority. Submit a renewal or new application as early as your state permits; do not assume last year’s approval continues automatically.
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QI is not a cash payment. The benefit is the state’s payment of the Part B premium after approval, subject to the program’s rules and available funding.
QDWI: Part A premiums for certain disabled workers
QDWI is narrower than the other MSPs. It pays Part A premiums only. Medicare describes it for a person with a disability who returns to work, loses Social Security disability benefits and consequently loses premium-free Part A.
Because QDWI has a work-and-disability pathway and a lower resource limit than the other programs, someone who does not fit that situation should ask about QMB, SLMB or QI instead. QDWI does not pay the Part B premium or Medicare deductibles, coinsurance or copayments.
2026 federal income and resource guidelines
The following figures are the 2026 federal guidelines listed by Medicare and CMS. Income is monthly; resources are countable assets under the applicable rules. They are a screening guide, not a universal determination. Limits are slightly higher in Alaska and Hawaii, and some states use higher limits or exclude certain income or resources.
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Repair Windows errors before they cause bigger problemsFix Now →Scan for outdated or missing drivers - takes under a minuteDriver Scan →| Program | Individual monthly income | Married-couple monthly income | Individual resources | Married-couple resources |
|---|---|---|---|---|
| QMB | $1,350 | $1,824 | $9,950 | $14,910 |
| SLMB | $1,616 | $2,184 | $9,950 | $14,910 |
| QI | $1,816 | $2,455 | $9,950 | $14,910 |
| QDWI | $5,405 | $7,299 | $4,000 | $6,000 |
CMS’s 2026 figures are quoted as follows: QMB income is $1,350 per month for an individual and $1,824 for a married couple; SLMB is $1,616 and $2,184; QI is $1,816 and $2,455; and QDWI is $5,405 and $7,299. The QMB, SLMB and QI resource figures are $9,950 for an individual and $14,910 for a married couple. QDWI resources are $4,000 and $6,000.
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Do not treat a paycheck as an automatic disqualifier. Medicare notes that income from work may not automatically make someone ineligible, and states may disregard portions of earnings or assets. The office will determine what counts, how a married couple’s finances are treated and whether an exclusion applies.
How to use the figures without misreading them
Income just above one line may fit another program
For example, an individual with $1,500 in monthly income is above the 2026 QMB guide of $1,350 but below the SLMB guide of $1,616. That person might be screened for SLMB, subject to Part A and Part B enrollment, resources and state rules. The example does not establish eligibility because the state must count the person’s actual income and resources.
Resources are separate from monthly income
A person can be under an income guideline and still exceed a resource guideline, or the reverse. Ask the state office which bank accounts, investments, vehicles, property and other assets are countable. Do not assume every asset is treated the same way nationwide.
State rules can be more generous
Federal figures do not set a hard national ceiling. A state may apply a higher income limit, disregard an amount of earnings or exclude a resource that federal screening tables do not explain. That is why Medicare’s instruction is to apply even when the listed figures appear too low for you.
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Who should consider applying
- You have Medicare Part A and Part B and struggle to pay the Part B premium.
- Your income appears near the QMB, SLMB or QI guideline, even if it is slightly above the federal figure.
- You have a disability, returned to work and lost premium-free Part A.
- You pay Medicare deductibles, coinsurance or copayments and may fit QMB rules.
- You were approved for QI last year and need to renew for the next year.
- You are helping a spouse, parent or client whose state-specific rules may be more favorable than the federal table.
How to apply through your state
- Find the state Medicaid or Medical Assistance office. That office, not a private insurer, determines MSP eligibility. Use your state’s current contact information and application instructions.
- Ask to be screened for all four MSPs. Tell the office whether you have Part A and Part B, whether you work, and whether a disability-related return to work caused you to lose premium-free Part A.
- Gather current records. The state may request proof of Medicare enrollment, Social Security or pension income, wages, bank or investment balances, marital status and identity. The exact paperwork varies by state, so confirm the list before submitting.
- Apply even if the federal table looks unfavorable. State exclusions and higher limits can change the result. Medicare’s official guidance says, “Even if you don’t think you qualify, you should still apply.”
- Track deadlines and renewals. QI requires an application every year. Because approvals are first-come, first-served and prior recipients receive priority, submit QI renewals promptly.
- Keep the decision notice. If approved, review the effective date, program name and covered expenses. If denied, read the state notice for appeal or reconsideration instructions.
What happens after approval
For QMB, tell every Medicare provider that you have QMB and show both identification cards. Providers should not bill you for Medicare-covered deductibles, coinsurance or copayments. If a provider sends a bill for a covered Medicare service, contact the provider’s billing office and your state Medicaid office rather than paying automatically.
For SLMB and QI, check that the Part B premium deduction or billing changes as expected after the state processes the enrollment. Processing times and effective dates can vary, so keep notices and premium statements until the change appears.
For QDWI, confirm that the Part A premium is the expense being paid. The program does not expand to Part B premiums or other Medicare cost sharing.
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Extra Help with Medicare prescription costs
Medicare says people enrolled in QMB, SLMB or QI also receive Extra Help with Medicare drug costs. This is separate from the MSP payment of Medicare premiums and medical cost sharing. It is not a cash payment.
Medicare’s 2026 guidance says beneficiaries with Extra Help pay no more than $12.65 for each covered drug under their Medicare drug plan. That amount applies to covered drugs under the plan; it is not a promise that every medicine costs $12.65 or that MSPs pay every Part D expense directly.
Common mistakes that delay or reduce help
- Assuming all MSPs pay the same bills: QMB, SLMB, QI and QDWI have different covered expenses.
- Stopping at the federal table: State limits and exclusions may be more generous.
- Confusing QMB with full Medicaid: QMB protects covered Medicare cost sharing but does not automatically provide every Medicaid service.
- Ignoring Part A and Part B status: SLMB and QI require both parts; QDWI concerns premium-free Part A lost after returning to work.
- Missing QI renewal: QI approval is annual and funding is limited.
- Paying a QMB bill without checking: A provider generally cannot bill a QMB beneficiary for Medicare-covered cost sharing, although a permitted small Medicaid copayment may apply.
- Expecting Extra Help to be cash: Extra Help reduces covered prescription-drug costs through the Medicare drug plan.
When your circumstances change
Report changes in income, employment, marital status, Medicare enrollment or resources according to your state’s instructions. A change can move you from one MSP category to another or affect renewal. Keep copies of applications, notices and proof submitted so you can resolve a missing-document request or appeal a decision.
The 2026 figures are useful for deciding whether to apply, but only the state can determine eligibility for your household. Start with the state Medicaid or Medical Assistance office and ask specifically about QMB, SLMB, QI and QDWI.
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