PharmSurance Field Guide
Medicare Savings
Programs Explained
Income slightly above the Medicaid limit doesn't mean you're on your own. Medicare Savings Programs have their own, often higher, thresholds.

Many people who don't qualify for full Medicaid still qualify for one of three Medicare Savings Programs (MSPs). These state-run programs reduce or eliminate what you pay for Medicare — and all three automatically qualify you for Extra Help with prescription costs.

📅 Reviewed and updated for 2026

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QMB
Qualified Medicare Beneficiary · the most comprehensive
What it covers

QMB is the most comprehensive level — covering your Part B premium, Part A and B deductibles, and all coinsurance and copays.

2026 income limits (approximate)
  • Individual: up to ~$1,350–$1,824/month (varies by state)
  • Couple: higher threshold — check with your state Medicaid office
  • Resource limits also apply — ask about what counts and what's excluded
What you get
  • Part B premium paid
  • Part A hospital deductible covered
  • Part B deductible covered
  • Medicare coinsurance and copays covered
  • Automatic qualification for Extra Help with Part D
Most Comprehensivecovers premium + all cost-sharing
SLMB
Specified Low-Income Medicare Beneficiary
Part B premium only — but still significant

SLMB pays your Part B premium — covering a real recurring cost for the entire year.

2026 income limits (approximate)
  • Individual: up to ~$1,616–$2,184/month (varies by state)
  • Automatic Extra Help for Part D included
  • Does NOT cover deductibles or coinsurance — only the Part B premium
Part B Premium Onlycovers a real recurring cost year-round
QI
Qualifying Individual · slightly higher income threshold
For slightly higher incomes

QI also pays your Part B premium but has a higher income threshold than SLMB — though it has limited funding and requires annual reapplication.

2026 income limits (approximate)
  • Individual: up to ~$1,816–$2,455/month (varies by state)
  • Automatic Extra Help for Part D included
  • Funding is limited — applications are first-come, first-served each year
  • Must reapply every year — approval doesn't automatically renew
  • Does NOT cover deductibles or coinsurance
Apply Annuallyfunding is limited and first-come, first-served
Important advice
Always apply — even if you think you're over the limit
State rules often differ from federal minimums

Several states use more generous income and resource rules than the federal minimums shown here. What disqualifies you under federal thresholds may still qualify you under your state's rules. Additionally, some resources — like your home, one vehicle, and certain retirement accounts — may be excluded from the resource calculation. It costs nothing to apply, and the potential savings are significant.

Want to find out if you qualify?

A PharmSurance advisor can check which Medicare Savings Programs you may qualify for in your state — and help you apply. At no cost to you.

PharmSurance.com

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048) to get information on all of your options. If you submit your information on this site, it will be provided to one or more licensed insurance agents, who may call, email, or text you about Medicare Advantage, Medicare Supplement, and Prescription Drug Plan options. This is a general educational overview only, not specific to any plan.

For consumer use · Not affiliated with the U.S. government or federal Medicare program.

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