The unclaimed money
The programs that pay your Part B premium, and almost nobody claims
Short answer: Medicare Savings Programs are state-run programs that pay your Part B premium, and in the highest-benefit tier also cover your Part A and B deductibles, copays, and coinsurance. Because the Part B premium is deducted from Social Security, qualifying raises your monthly deposit immediately, by $202.90 in 2026. Qualifying also hands you Extra Help for prescriptions automatically. Millions of eligible people never apply, usually because they assume they earn too much or have never heard of it, and the income limits are higher than most people guess.
Key takeaways
- Four tiers exist: QMB, SLMB, QI, and QDWI, each with different income limits and benefits.
- QMB is the strongest: it pays the Part B premium plus deductibles, copays, and coinsurance, and providers may not bill you for covered services.
- Approval brings Extra Help for drugs automatically, which cuts prescription costs to a few dollars.
- Income limits sit roughly at 100%, 120%, and 135% of the federal poverty level, higher in Alaska and Hawaii, and some states have no asset test at all.
- You apply through your state Medicaid office; approval can also be retroactive in some cases.
The four programs
| Program | What it pays | Roughly who qualifies |
|---|---|---|
| QMB (Qualified Medicare Beneficiary) | Part B premium, Part A premium if any, plus deductibles, coinsurance, and copays | Income around or below 100% of the federal poverty level |
| SLMB (Specified Low-Income Medicare Beneficiary) | The Part B premium | Income roughly between 100% and 120% of poverty |
| QI (Qualifying Individual) | The Part B premium | Income roughly between 120% and 135% of poverty; funded annually, so apply early and reapply each year |
| QDWI (Qualified Disabled and Working Individual) | The Part A premium | People under 65 who lost premium-free Part A after returning to work |
Limits are set annually, are higher in Alaska and Hawaii, and several states apply more generous rules or no asset test. Your state Medicaid office administers the programs.
The dollar value is easy to underestimate. The Part B premium alone is $202.90 a month in 2026, roughly $2,435 a year, and because it is withheld from Social Security, a program paying it shows up as a larger deposit rather than a rebate you have to chase.
Why QMB matters most
QMB does something the other tiers do not: it protects you from balance billing. Providers who accept Medicare are not permitted to bill QMB enrollees for Medicare-covered services, which means deductibles, copays, and the 20% Part B coinsurance are not your responsibility. That 20%, uncapped on Original Medicare, is normally the largest financial risk in the program and the main reason people buy a supplement. If you qualify for QMB, you get that protection without a Medigap premium. If a provider bills you anyway, that is an error worth correcting: show them your QMB status and, if needed, call 1-800-MEDICARE.
Who should apply, including people who assume they cannot
- Anyone whose income is modest, even if it seems slightly too high: limits change annually, several states are more generous than the federal floor, and some disregard certain income entirely.
- Anyone with savings but low income. Asset limits exist federally but a number of states have eliminated them, so assets alone should not stop you from applying.
- Anyone already struggling with drug costs, because approval generally brings Extra Help automatically, cutting prescriptions to a few dollars and eliminating the Part D premium for many people.
- Anyone whose circumstances just changed: a spouse died, work ended, or income dropped. Eligibility is based on current circumstances, not last year’s.
The worst outcome of applying is being told no. Given that the programs are administered per state and the rules vary, "I probably do not qualify" is a guess, and it is the single most expensive guess in Medicare.
How to apply
- Contact your state Medicaid office, which administers all four programs. Your SHIP counselor can tell you the exact office and help with the form, free.
- Gather: proof of income (Social Security award letter, pensions, wages), your Medicare card, and information on savings and property if your state has an asset test.
- Apply for Extra Help separately too, through Social Security at ssa.gov or 1-800-772-1213, if the state application does not trigger it automatically.
- Reapply for QI each year, since that tier is funded annually and is awarded first come, first served.
One timing note: in some states approval can be retroactive for a period before your application, so the practical advice is to apply as soon as you think you might qualify rather than waiting for a perfect month.
Questions people also ask
What are Medicare Savings Programs?
Who qualifies for a Medicare Savings Program?
Does a Medicare Savings Program pay my Part B premium?
What is QMB and why does it matter?
Do Medicare Savings Programs give me Extra Help for drugs?
Sources for this article
- Medicare.govMedicare Savings Programs: the four programs, what each pays, and how to apply.
- SSA.govExtra Help with Medicare drug costs: the prescription subsidy that accompanies approval.
- CMS.gov2026 Medicare premiums and deductibles: the Part B premium these programs pay.
Figures checked against these sources on September 30, 2026. We update within days when CMS publishes new amounts.
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