Medicare Savings Programs in 2026: QMB, SLMB, QI, and QDWI Income Limits, Resource Caps, and What Each One Actually Pays

By Anthony Albert, Benefits Research Director | Published May 17, 2026 | Updated May 17, 2026

If you're on Medicare and your income is tight, there are four programs sitting in plain sight that pay your premiums, your deductibles, and (in one case) every copay you'd otherwise owe. They're called Medicare Savings Programs, and they're some of the most underused benefits in the federal system. CMS estimates more than two million people who qualify for at least one MSP aren't enrolled.

Each program targets a different income band. QMB is the most generous and the most income-restricted. SLMB and QI cover just the Part B premium. QDWI is the niche one for disability beneficiaries who lost free Part A when they went back to work. All four use the same resource limits except QDWI, which is tighter.

This article walks through who qualifies, what each program pays, the 2026 limits, how to apply, the relationship to Medicare Extra Help, and the most common mistakes people make when they file. If you're already on Medicare, this one's worth ten minutes of your time.

The Four MSPs at a Glance

All income figures are for the 48 contiguous states and DC. Alaska and Hawaii have higher limits because their cost-of-living adjusted federal poverty levels are higher. Source: SSA POMS HI 00815.023, dated February 26, 2026.

One thing worth flagging up front. The income numbers above already include a $20 general income disregard that SSA applies before counting. QDWI also bakes in a $65 earned income disregard. So when you do your own math, start with gross monthly income, then subtract $20, then check the limit. The numbers in the table are what you compare your adjusted figure to.

QMB: The Big One

QMB stands for Qualified Medicare Beneficiary. It's the most valuable of the four because it covers everything Medicare doesn't pay automatically.

If you have QMB, the state Medicaid program pays:

• Your Part A premium (if you owe one)
• Your Part B premium ($202.20 a month in 2026 for most beneficiaries)
• Your Part A inpatient hospital deductible ($1,736 per benefit period in 2026)
• Part A coinsurance: $434 a day for hospital days 61 to 90, $868 a day for lifetime reserve days 91 to 150, $217 a day for skilled nursing facility days 21 to 100
• Your Part B deductible ($283 a year in 2026)
• 20 percent Part B coinsurance on every doctor visit and outpatient service
• All cost sharing on Medicare Advantage plans you might be enrolled in

Providers cannot legally bill a QMB beneficiary for those amounts. Federal law calls this rule "no balance billing" and it's been in place since 1989 under Section 1902(n)(3) of the Social Security Act. If a doctor sends you a bill for a Medicare copay and they know you're QMB, that's a violation. CMS has a complaint process and most states have shut down providers for it.

SLMB and QI: Premium Help Only

SLMB (Specified Low-Income Medicare Beneficiary) and QI (Qualifying Individual) both pay just the Part B premium. They don't cover deductibles or coinsurance, and they don't trigger the no-balance-billing protection. What they give you is $202.20 a month, every month, that doesn't come out of your Social Security check.

The 2026 Part B premium gets deducted automatically from your SSDI or retirement check unless you're in MSP. If you sign up for SLMB or QI, the state pays Medicare directly and your gross Social Security amount flows through to you untouched. Over a year that's $2,426 back in your bank account.

The difference between SLMB and QI is just income. SLMB runs from 100 percent to 120 percent of the federal poverty level. QI runs from 120 percent to 135 percent. Same benefit. Slightly higher income band on QI. The other practical difference is funding. QI is a block grant. SLMB is an entitlement. If you fit SLMB, you're guaranteed the slot. If you fit QI, you compete for a finite pool of money. Most years it doesn't run out, but it can, and people who renew before new applicants get priority.

You also can't be on QI and full Medicaid at the same time. That's a hard rule under 42 CFR 435.135. SLMB and full Medicaid can coexist, in which case you're a "dual eligible." The state Medicaid program pays your Part B premium through the SLMB designation and covers Medicaid-eligible services on top.

QDWI: The One Most People Have Never Heard Of

QDWI is the niche program. It's for working disability beneficiaries who lost free Part A because they returned to work and went past the Extended Period of Eligibility.

Here's the setup. After 24 months on SSDI, you get Medicare Part A premium-free, plus Part B at the standard rate. If you go back to work and earn over SGA after your Trial Work Period, the SSDI cash benefit stops. You keep Medicare for 93 months (Section 1860D-14 protection plus the EPE extension), then it ends. After that, if you're still disabled but working, you can buy back into Medicare Part A by paying the premium ($541 a month in 2026 for those with fewer than 30 quarters of coverage).

That premium is what QDWI helps with. If your income is up to $5,405 a month (individual) or $7,299 (couple), and your resources are under $4,000 (individual) or $6,000 (couple), the state Medicaid agency pays the Part A premium for you. You keep Medicare. You keep working. The cash benefit doesn't restart, but the health coverage stays.

QDWI doesn't pay Part B. You're on your own for that unless your earnings are also low enough to qualify for QMB, SLMB, or QI on top. In practice, very few people are at $5,000 a month income with only $4,000 in resources because earning that much usually generates savings. But for people in expensive states or with high recurring medical costs that drain assets, QDWI sometimes lines up.

The Resource Test

QMB, SLMB, and QI all use the same resource limit: $9,950 individual, $14,910 couple. The CMS Centers for Medicare and Medicaid index this figure each year alongside the Part D Low Income Subsidy limits, so it ticks up roughly with inflation. The 2026 figure rose from $9,660 in 2025.

What counts:

• Checking and savings accounts
• Stocks, bonds, mutual funds, and brokerage account balances
• CDs and money market accounts
• Real property other than your primary home
• A second car, if you have one

What doesn't count:

• Your primary residence (no equity cap for MSP)
• One vehicle, regardless of value
• Household goods, personal effects, wedding and engagement rings
• Burial space (your plot and headstone)
• Up to $1,500 per person in burial funds, properly designated
• Life insurance with face value under $1,500
• Retirement accounts that are paying out as periodic distributions (rules vary by state)

A common move for borderline applicants: pay off credit card debt, pre-pay a burial plan, or move excess cash into a properly titled funeral trust to bring resources under the limit. None of those are gaming the system. They're legitimate steps the rules anticipate.

How to Apply

The application doesn't go to Social Security. It goes to your state Medicaid agency. The same office that handles regular Medicaid handles MSP. Some states use one application form for both, some run them separately. You can usually file online, by mail, or in person. Medicare.gov's locator tool at medicare.gov sends you to the right state office.

What to bring:

1. Your Medicare card
2. Your Social Security award letter or current SSA benefit verification (you can pull this from your my Social Security account)
3. Bank statements for the past two or three months for every account
4. Retirement account statements
5. Proof of any other income: pension stubs, annuity statements, rental income records
6. Birth certificate or proof of citizenship
7. Photo ID

The state has up to 45 days to decide. SLMB and QI applications can be backdated up to three months before the application date if you would have been eligible during that window, so don't delay applying just because you're not sure you'll qualify. Even a partial backdating recovers real money.

QMB doesn't backdate. Eligibility starts the first day of the month after the state determines you qualify. That's a meaningful difference. If you're on the QMB borderline, file the moment your income drops or your resources fall under the limit.

How MSP Stacks With Other Programs

Extra Help (LIS)

Anyone in QMB, SLMB, or QI is automatically deemed eligible for Medicare Extra Help, the Part D Low Income Subsidy. CMS notifies SSA, SSA notifies your Part D plan, and your drug costs drop to $5.10 generic and $12.65 brand in 2026, with a $2,100 annual out-of-pocket cap under the IRA's Section 11201. That's worth about $5,700 a year on top of the MSP savings.

QDWI does not auto-deem for Extra Help. You'd have to apply separately on SSA-1020 if your income and resources fit.

Full Medicaid

QMB and SLMB can coexist with full Medicaid. If your state has a Medicaid for the Aged, Blind, and Disabled (MABD) program, or a medically-needy spend-down, and you qualify for that on top of MSP, you become a "full dual eligible." Medicaid covers what Medicare doesn't (long-term care, dental, vision, transportation in many states). QMB covers Medicare cost sharing. Together they amount to near-zero out-of-pocket medical spending for the year.

QI is incompatible with full Medicaid. The federal rule says you can't be in both.

Section 1619(b)

SSI beneficiaries who go to work and lose their SSI cash benefit but keep Medicaid under Section 1619(b) of the Social Security Act don't need MSP because they already have full Medicaid. But if their income climbs above the 1619(b) state threshold, they lose Medicaid, and MSP becomes the next safety net. The transition can be tricky and is one place where calling an expert before quitting a job, raising hours, or taking a raise can save four figures a year.

What MSP Doesn't Cover

MSPs are narrow. They don't pay for:

• Medigap (Medicare Supplement) premiums
• Part D drug premiums (Extra Help does that)
• Long-term care, nursing homes, or in-home aide services (Medicaid does that)
• Dental, vision, or hearing services not covered by Medicare
• Over-the-counter medications
• Items Medicare denies as not medically necessary

If you need help with any of those, you're looking at Medicaid, Medicare Advantage with supplemental benefits, or a charity program. The MSPs are a slice, not the whole pie.

Common Mistakes

1. Not applying because you assume you won't qualify. The resource limit is generous compared to SSI ($9,950 vs $2,000) and the home and one car are exempt. A lot of homeowners with modest savings qualify and don't know it.
2. Applying through SSA instead of the state Medicaid office. SSA can't process MSP applications. Filing with the wrong agency wastes time.
3. Missing the backdating window on SLMB and QI. You can get up to three months of retroactive premium reimbursement. Apply as soon as your income drops.
4. Not reporting income changes. If your income drops mid-year, you may move from SLMB to QMB and pick up cost-sharing protection. If it rises, you might lose eligibility entirely. Either way, report it.
5. Letting a balance bill slide if you're on QMB. Providers aren't allowed to bill you. Call your state Medicaid office and file a complaint. CMS takes these seriously.

What's the Cash Value Over a Year?

Let's run the numbers for a single SSDI beneficiary in 2026.

The QMB number assumes you're also in the small share who owe a Part A premium and have one hospital stay during the year. Even strip out the hospital admission and the Part A premium, and QMB is worth $9,500 a year. SLMB and QI sit at roughly $8,100, almost all of which is the Part B premium plus auto-deemed Extra Help. QDWI is a narrow case.

Frequently Asked Questions

What are the four Medicare Savings Programs?

QMB (Qualified Medicare Beneficiary) covers Part B premiums plus all Medicare deductibles, copays, and coinsurance. SLMB (Specified Low-Income Medicare Beneficiary) covers Part B premiums only. QI (Qualifying Individual) also covers Part B premiums only, but at higher income levels and funded through a block grant that can run out. QDWI (Qualified Disabled and Working Individual) covers Part A premiums for people who lost free Part A because they returned to work after disability.

What are the 2026 MSP income limits?

For 48 states and DC: QMB caps at $1,350 monthly income for an individual and $1,824 for a couple. SLMB at $1,616 individual and $2,184 couple. QI at $1,816 individual and $2,455 couple. QDWI at $5,405 individual and $7,299 couple. Alaska and Hawaii run higher because of cost-of-living adjustments. These figures already include the $20 general income disregard, and QDWI also includes a $65 earned income disregard.

What does QMB save me in real dollars?

QMB pays the 2026 Part B premium ($202.20 a month for most beneficiaries, $2,426 a year) plus the Part B deductible ($283 a year), the Part A inpatient hospital deductible ($1,736 per benefit period), days 61 to 90 of hospital coinsurance ($434 a day), and all Part A and B copays and coinsurance. For a beneficiary with even one hospital stay or several specialist visits, QMB can erase $5,000 to $10,000 in annual cost sharing.

What's the resource limit and what counts?

For QMB, SLMB, and QI in 2026, the resource limit is $9,950 for an individual and $14,910 for a couple. QDWI is tighter, $4,000 and $6,000. Countable resources include checking, savings, stocks, bonds, and CDs. Excluded: your home, one car, household goods and personal effects, burial space, and up to $1,500 per person in designated burial funds. The home exclusion has no equity cap for MSP purposes the way some Medicaid programs do.

Does QI run out of money?

Yes, technically. The QI program is funded by a federal block grant. Once a state hits its annual cap, the program can stop enrolling new applicants. In practice most states don't run out, but if you're at the QI income level and you have months left in the calendar year, file as soon as possible. People already in QI for the prior year get first claim on the new year's funding. New applicants compete for what's left. It's the only one of the four MSPs that doesn't have a guaranteed funding stream.

Can I have QMB, SLMB, or QI plus Medicaid?

QMB and SLMB can both coexist with full Medicaid, in which case you're a "dual eligible." The MSP picks up Part B premiums and (for QMB) cost sharing, while Medicaid covers everything else, including services Medicare doesn't, like long-term care. QI is the exception. You can't be on QI if you qualify for full Medicaid; the rule is in 42 CFR 435.135. If your income drops or your medical needs grow into Medicaid territory, you switch from QI to full Medicaid plus QMB or SLMB.

How does MSP relate to Medicare Extra Help (LIS)?

MSP and Extra Help are different programs but they overlap. Anyone in QMB, SLMB, or QI is automatically deemed eligible for Extra Help, the Part D drug subsidy. The auto-deeming saves an application. You also get auto-deemed if you have full Medicaid or get SSI. You can qualify for Extra Help without being in MSP, and you can also qualify for MSP without auto-deeming if your income is below the Extra Help limit but above MSP. The two systems back each other up so check both.

The Medicare Savings Programs aren't glamorous. They don't make headlines. They just quietly redirect a few thousand dollars a year from out-of-pocket medical bills back into your bank account. For a Medicare beneficiary at the low end of the income scale, that's the difference between paying for groceries and paying for the doctor. File the application. Get the proof together. Use the backdating where it applies. It's one of the highest-value federal programs we cover.