Medicare Savings Programs: How to Apply Through Your State

Four state programs can pay your Medicare premium for you. They are called Medicare Savings Programs. A lot of people who qualify never get the help. The main reason is simple. They look for the application in the wrong place. Medicare does not take this application. Your state Medicaid office does. This guide shows the four programs, the 2026 limits for each one, and the steps to apply through your state. Our Paying for Care section holds more guides on help with Medicare costs.

The four programs in short

QMB is the Qualified Medicare Beneficiary program. It pays the widest set of costs. It pays your Part B premium. It pays your Part A premium if you owe one. It pays Medicare deductibles, coinsurance, and copays. A provider who takes Medicare cannot bill a QMB member for those Medicare cost shares. That billing ban is a strong shield. The 2026 limits for QMB are in Ledger J1.

SLMB is the Specified Low-Income Medicare Beneficiary program. It pays the Part B premium only. It does not pay cost shares. The 2026 limits for SLMB are in Ledger J2.

QI is the Qualifying Individual program. It also pays the Part B premium only. Its funds are capped. States grant it first come, first served, in most years. People who had QI last year get first claim in the new year in most states. The 2026 limits for QI are in Ledger J3.

QDWI is the Qualified Disabled and Working Individuals program. It pays the Part A premium only. It fits a narrow group. The person has a disability, lost premium-free Part A when they went back to work, and still meets the limits. The 2026 limits for QDWI are in Ledger J4.

Our guide on Medicare Savings Programs: QMB, SLMB, and QI explained goes deep on what each program pays. This guide stays on the application path.

What counts as income and resources

The limits in the Ledger are federal limits. Most states use them as they stand. Some states set higher limits. Some states drop the resource test in full. Your state rules decide your case. That is one more reason to apply even if your sums look high.

Income means money that comes in each month. Social Security counts. A pension counts. Pay from work counts. The state applies set rules on what counts and what is set aside. Do not trim your own sums before you apply. State the full sums and let the office apply its rules.

Resources mean things you own that the program counts. Money in bank accounts counts. Stocks and bonds count. A retirement account counts. Some things do not count. Your home does not count. One car does not count. A burial plot does not count. Up to $1,500 set aside for burial does not count. Your furniture and household goods do not count.

The resource limit for QMB, SLMB, and QI is $9,950 for one person and $14,910 for a couple in 2026 (Ledger J1, J2, J3). The resource limit for QDWI is $4,000 for one person and $6,000 for a couple in 2026 (Ledger J4). Limits are higher in Alaska and Hawaii.

Steps to apply through your state

You do not need a plan agent for this. You do not pay a fee to apply. If a caller asks for a fee to file this form, hang up and call the state office on its own number.

• Find your state Medicaid office. Your state may call it by a state name. The work is the same. It takes Medicare Savings Program applications.
• Ask for the Medicare Savings Program application. Some states use one form for all four programs. The office sorts you into the right program from your sums.
• Fill in your income and resources in full. List each source. List each account. Do not leave out a sum because you think it does not count. The office makes that call.
• Send proof with the form. Proof can be a Social Security letter, a bank statement, or a pay stub. The office will tell you what it needs if a piece is missing.
• Watch for a letter back. The letter states which program you got, or why you did not get one. It states how to appeal if you think the call was wrong.
• Keep the help in view each year. You may need to renew. A change in income or resources can change your program. Report changes the office asks you to report.

What starts when you are approved

The state pays your Part B premium for you. That premium is $202.90 per month in 2026 (Ledger A1). If the sum was held from your Social Security check, the hold stops. Your check grows by that sum each month. It can take a few months for the change to show. The state and Social Security trade files on a set cycle.

Approval brings one more gain. People in a Medicare Savings Program get Extra Help with drug costs on their own, with no new form. Extra Help cuts Part D costs in a large way. Our guide on applying for Extra Help through Social Security shows that program in full, for people who apply on their own.

If you are in QMB, show your QMB card or letter when you get care. A Medicare provider cannot bill you for Medicare deductibles, coinsurance, or copays. If a bill comes in error, call the provider and state that you are in QMB. The state office can back you up.

Who pays for what

• Your state Medicaid office pays your Part B premium of $202.90 per month in 2026 (Ledger A1) if you are in QMB, SLMB, or QI.
• Your state Medicaid office pays your Part A premium if you owe one, if you are in QMB or QDWI.
• Original Medicare pays its share of your care first. Medicare Advantage plans pay for care for their members under plan rules.
• QMB pays Medicare deductibles, coinsurance, and copays for its members. SLMB and QI pay the premium only.
• A Medigap policy pays toward the costs Original Medicare leaves. It does not cover a service on its own. Some people hold Medigap and a savings program at the same time.
• Medicaid pays in full for people who have both Medicare and full Medicaid. That is a wider cover than a savings program.
• Private pay covers care that no program covers. Check cover before you book care.

Sample situation

Marge is 76. She lives on Social Security and a small pension. Her monthly income is $1,580. Her savings stand at $7,000. She pays the Part B premium of $202.90 per month in 2026 (Ledger A1) out of her check. A friend tells her about the savings programs. Marge calls her state Medicaid office and asks for the form. Her income is over the QMB limit of $1,350 for one person (Ledger J1). It is under the SLMB limit of $1,616 for one person (Ledger J2). Her resources of $7,000 are under the $9,950 limit (Ledger J2). The state approves her for SLMB. The state starts to pay her Part B premium. Her Social Security check grows by $202.90 each month once the change posts. She also gets Extra Help with drug costs on its own. Marge files her approval letter with her Medicare card. She notes the renewal date on her calendar so the help does not lapse.

If you are turned down

Read the letter with care. It must state the reason. A missing proof page is a common reason. Send the missing page and ask the office to look again. An income count you dispute is one more reason. The letter states how to appeal and the last date to do it.

Apply again if your sums change. A drop in income can move you into a program. A move from QI to QMB can occur if your income falls. The office can tell you which program fits your new sums.

Ask your State Health Insurance Assistance Program for free help. Its staff know these programs well. They can sit with you and the form at no cost.

The premium is a real sum each month. For a person on a tight income, $202.90 back in the check can pay for food, rent, or drugs. If your sums sit near the limits in this guide, file the form. The state office makes the call. You lose nothing by asking.