How Medicare Savings Programs help pay your Medicare costs

What the programs are

Medicare costs can add up quickly over the course of a year. A premium is the amount you pay each month to keep coverage. A deductible is what you pay before Medicare starts to share the cost. Coinsurance is a percentage you pay for a service, and a copayment is a flat fee you pay at the visit. Together, the last three are your cost sharing.

Medicare.gov explains that a Medicare Savings Program is a way to get help from your state with these costs. If you qualify, the state pays your Part A and Part B premiums, and one program also covers your cost sharing. Your state Medicaid office runs the program, yet it is not the same as full Medicaid. Some people get both, and some get only the savings program.

States offer four of these programs in all, and we cover the three most common ones below. Our Medicaid vs Medicare guide explains how the larger programs differ.

QMB, SLMB and QI in plain words

Each program pays for a different set of costs, and each has its own income limit. Medicare.gov and Medicaid.gov list these 2026 federal limits, and the income limits are monthly. The resource limit is the total value of things you own, such as money in the bank.

• The Qualified Medicare Beneficiary program, called QMB, pays your Part A premium if you have to pay one. It also pays your Part B premium and your cost sharing for services Medicare covers. The 2026 limits are $1,350 a month in income and $9,950 in resources for one person. For a married couple they are $1,824 and $14,910.
• The Specified Low-Income Medicare Beneficiary program, called SLMB, pays your Part B premium only. You must have both Part A and Part B. The 2026 limits are $1,616 a month and $9,950 in resources for one person. For a married couple they are $2,184 and $14,910.
• The Qualifying Individual program, called QI, also pays your Part B premium only, and you must have both parts. The 2026 limits are $1,816 a month and $9,950 in resources for one person. For a married couple they are $2,455 and $14,910.

Medicaid.gov shows how the income limits are built. QMB is set at 100 percent of the federal poverty level plus $20. SLMB uses 120 percent plus $20, and QI uses 135 percent plus $20. The extra $20 is a small amount of income that does not count. The poverty level is a yearly income line that the government updates each January.

The fourth program is the Qualified Disabled and Working Individual program, called QDWI. It pays the Part A premium only, for certain people with disabilities who went back to work and lost premium-free Part A. The 2026 limits are $5,405 a month in income and $4,000 in resources for one person.

Good things to know before you apply

The limits above are the federal numbers, and Medicare.gov says you may still qualify when your income or resources are higher. Some states do not count certain income or resources. Alaska and Hawaii also have somewhat higher limits. Your state agency can tell you what it counts.

Medicare.gov says providers are not allowed to bill you for services and items that Medicare covers if you have QMB. That rule covers your cost sharing as well as your premiums. You may still get a bill for a small Medicaid copayment, if your state charges one. Show your Medicare card and your Medicaid or QMB card each time you get care.

QI works a little differently from the others, because Medicare.gov says you must apply every year to stay in it. States approve applications in the order they arrive, and people who got QI the year before come first. QI is also only for people who do not qualify for other Medicaid coverage. If you cannot get QI, ask your state whether you qualify for one of the other savings programs.

Extra Help with drug costs

Extra Help is a separate Medicare program that lowers the cost of Part D prescription drug coverage. Social Security runs the application, and Medicare.gov says Extra Help can lower your plan's premiums and your costs at the pharmacy.

Extra Help comes to you automatically in three cases. The first is full Medicaid coverage. The second is help from your state with Part B premiums through a Medicare Savings Program, and the third is Supplemental Security Income. That means anyone who qualifies for QMB, SLMB or QI gets it. Medicare.gov says you then pay no more than $12.65 in 2026 for each drug your plan covers.

Anyone who does not get Extra Help automatically can apply. For one person, Medicare.gov lists 2026 limits of yearly income below $23,940 and resources below $18,090. For a married couple, the limits are $32,460 in yearly income and $36,100 in resources. The numbers are different in Alaska and Hawaii.

You can apply online at the Social Security website, or you can call 1-800-772-1213, Monday through Friday. Deaf and hard of hearing callers can use TTY 1-800-325-0778. Social Security asks you to gather papers such as bank statements and tax returns for you and your spouse. Medicare.gov says you can apply for Extra Help and a Medicare Savings Program at the same time. Social Security passes your information to your state to start a savings program application unless you tell it not to.

How to apply through your state

You apply for a Medicare Savings Program through your state, and the state decides which program fits, according to Medicare.gov. Medicaid.gov has a directory of state Medicaid and CHIP offices. Pick your state to find the phone number and website.

Each state tells you which papers it needs. Keeping your Medicare card, proof of income and bank statements nearby usually makes the call easier. A SHIP counselor can also help you fill out forms at no cost. Medicare.gov lists SHIP as a free source of help with Extra Help and other costs.

Our guide on how to apply for Medicaid covers the steps for full Medicaid, and our Medicaid eligibility guide explains who qualifies for it. While you wait for an answer, a community health center charges by income, and you can search for a cash-pay doctor too. This page is general information and not medical advice. If you think you are having an emergency, call 911 or go to the nearest emergency room.