If you have a lower income, you may qualify for help paying your Medicare costs. The Medicare Savings Programs, called MSPs, cover premiums and sometimes copays. They are run by each state through the Medicaid office. Most people who qualify never apply because they do not know they exist.
What is a Medicare Savings Program?
A Medicare Savings Program is a state program that helps people on Medicare pay their Medicare costs. The federal government sets minimum income limits, and most states use those. Some states have higher limits.
You apply through your state Medicaid office. If you qualify, the state pays your Medicare costs directly, either fully or partially depending on which program you qualify for.
The four Medicare Savings Programs
1. Qualified Medicare Beneficiary (QMB)
QMB is the most generous program. If you qualify, the state pays:
- Your Part A premium (if any)
- Your Part B premium ($202.90 in 2026)
- Your Part A and Part B deductibles
- Most of your Part A and Part B coinsurance and copays
Doctors and providers are not allowed to bill QMB members for Medicare cost-sharing. That means most medical care comes at little or no cost to you. QMB saves seniors around $2,500 to $5,000 a year on average.
2. Specified Low-Income Medicare Beneficiary (SLMB)
SLMB has slightly higher income limits than QMB. If you qualify, the state pays your Part B premium ($202.90 in 2026). SLMB does not cover deductibles, copays, or coinsurance. The premium-only benefit is worth about $2,400 a year.
3. Qualifying Individual (QI)
QI has slightly higher income limits than SLMB. Like SLMB, it only pays your Part B premium. The catch is that QI is first-come, first-served each year. Funding is limited, so apply early.
QI cannot be combined with full Medicaid. If you are already on full Medicaid, you do not need QI because Medicaid covers your Part B premium.
4. Qualified Disabled and Working Individual (QDWI)
QDWI is for working disabled people under 65 who lost their free Part A because of returning to work. QDWI helps pay the Part A premium for this group. It is narrowly used.
2026 income limits
The federal floors for 2026 are:
- QMB: About $1,325 monthly for single, $1,783 for a couple
- SLMB: About $1,585 monthly for single, $2,135 for a couple
- QI: About $1,781 monthly for single, $2,400 for a couple
- QDWI: About $5,302 monthly for single, $7,135 for a couple
These are starting points. Many states allow higher income and ignore certain types of income. Some states have no asset limits at all.
Asset limits
The federal floors for assets in 2026 are:
- QMB, SLMB, QI: About $10,400 for single, $15,600 for a couple
Many things do not count as assets. Your house. One car. Personal items. A burial fund up to $1,500. Life insurance with limited cash value.
Some states have eliminated asset limits entirely for MSPs. Check with your state Medicaid office.
How to apply
Apply through your state Medicaid office. Most states let you apply online, by mail, or in person. The application asks about your income, assets, and household.
You will need:
- Proof of income (Social Security letter, pension statement, pay stubs)
- Bank statements
- Proof of Medicare enrollment
- Photo ID
The state usually decides within 30 to 45 days. If approved, the benefit starts the next month.
Common mistakes
Mistake 1: Assuming you make too much. The MSP income limits are higher than most people think, especially in states that have raised them. If you are unsure, apply. The worst case is you get told no.
Mistake 2: Not knowing assets are limited. The federal asset limits are higher than the Medicaid limits, and many things do not count. Some states have no asset limit at all for MSPs.
Mistake 3: Not reapplying. Some states require yearly renewal. If you do not respond to the renewal letter, your benefit ends.
Mistake 4: Doctors trying to bill QMB members for cost-sharing. QMB members cannot legally be billed for Medicare deductibles or coinsurance. If a provider tries, refer them to your QMB award letter.
How MSPs interact with Extra Help
If you qualify for QMB, SLMB, or QI, you automatically qualify for Extra Help with Part D prescription drug costs. The state files for you, so you do not need to apply separately.
Extra Help drops your prescription copays to a few dollars at most. Combined with QMB or SLMB, drug costs are usually under $5 a month total.
Read more in our Extra Help guide.
If you have full Medicaid
If you qualify for full Medicaid in your state, you get all the benefits of MSPs plus more. Full Medicaid usually covers:
- Long-term nursing home care
- Home and community-based services
- Dental, vision, and hearing care
- Transportation to medical appointments
Many states have higher income limits for full Medicaid than for MSPs. If you are over the MSP limits, check full Medicaid too.
How to start
Three options:
- Call your state Medicaid office and ask for an MSP application.
- Visit BenefitsCheckUp.org from NCOA, which screens you for MSPs and other programs.
- Talk to an independent Medicare agent who works in your state. Most will screen you for these programs as part of their service.
For the right family, MSP saves several thousand dollars a year. It is worth the 20 minutes it takes to find out if you qualify.
