The Medicare Savings Programs let a person’s state pick up the monthly Part B premium in full, along with other costs, for people whose income and resources fall under set limits. Four separate programs exist under that umbrella, each with its own income ceiling and its own list of costs it covers, and every one of them is run by the state rather than by Medicare directly. Because the programs are administered locally, applying means contacting a state Medicaid office rather than Social Security or Medicare’s national call center.
The Four Medicare Savings Programs, By What They Cover
The Qualified Medicare Beneficiary program, or QMB, covers the widest range: Part A premiums for anyone who doesn’t already have premium-free Part A, plus Part B premiums, deductibles, coinsurance and copayments for anything Medicare covers. The Specified Low-Income Medicare Beneficiary program, SLMB, and the Qualifying Individual program, QI, cover only the Part B premium, and both require a person to already have both Part A and Part B.
A fourth program, the Qualified Disabled & Working Individual program, serves a narrower group: people with a disability who returned to work and lost premium-free Part A and Social Security disability benefits as a result. It covers only the Part A premium, and its income limits are set far higher than the other three programs — $5,405 a month for an individual and $7,299 for a married couple in 2026 — because it is designed for people who are earning wages rather than living on a fixed income alone.
For 2026, the monthly income limit for QMB is $1,350 for an individual and $1,824 for a married couple, with a resource limit of $9,950 and $14,910. SLMB allows a higher monthly income, up to $1,616 for an individual, and QI allows up to $1,816, according to Medicare’s current limits for the four Medicare Savings Programs. The Centers for Medicare & Medicaid Services updates these figures most years, income limits run slightly higher in Alaska and Hawaii, and states can count income and resources differently, so a person over the federal number listed is still encouraged to apply.
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What Happens Once A Program Picks Up The Premium
Once a state approves QMB, Medicare providers are barred from billing the enrollee at all for services and items Medicare covers, including deductibles, coinsurance and copayments. A small Medicaid copayment may still apply if the state charges one, but that is a fraction of ordinary Medicare cost-sharing, and providers who bill beyond it are violating federal rules. A beneficiary can show both a Medicare card and a Medicaid or QMB card at every visit, or point to a Medicare Summary Notice, as proof of the protection.
All four programs come with a benefit that isn’t always advertised: anyone approved for QMB, SLMB or QI is automatically enrolled in Extra Help for prescription drug costs, capping each covered drug at no more than $12.65 in 2026. That is a separate saving on top of the premium relief, and it applies without a second application. SLMB and QI enrollees keep normal Medicare cost-sharing everywhere else, since their coverage is limited to the Part B premium itself.
Applying Through The State, Not Medicare
Because each Medicare Savings Program is run by the state, the application goes to the state’s Medical Assistance or Medicaid office rather than to Medicare or Social Security, and the office decides which of the four programs an applicant qualifies for. States sometimes use their own name for these programs rather than the federal QMB, SLMB or QI labels, and the application itself is often folded into a state’s regular Medicaid paperwork rather than run as a separate standalone form.
Even a person who assumes they earn too much is encouraged to apply, since many states disregard certain income or resource types that count toward the federal limit. The Qualifying Individual program carries one added wrinkle: it is funded on a first-come, first-served basis each year, with priority given to people who received QI benefits the year before, and enrollees must reapply annually to stay covered. QMB and SLMB do not carry that same annual funding cap or reapplication requirement in the federal rule.
QI also has a restriction the other three programs don’t: it’s only available to someone who doesn’t already qualify for any other Medicaid coverage or benefits. A person who is denied QI for that reason isn’t necessarily shut out of help entirely, since the same application that ruled out QI may point toward QMB, SLMB or full Medicaid instead, depending on what the state finds when it reviews the file.
Taken together, the four programs mean a Part B premium that would otherwise come out of a fixed income every single month can be eliminated entirely, as long as the household falls under a state’s income and resource test. The paperwork is real, but for QMB and SLMB it happens once, and the size of the saving compounds every month a Social Security check goes further because of it.
Because eligibility is reassessed by the state and not fixed for life, a change in income — a smaller pension payout, a spouse’s death, rising medical costs that qualify for a spend-down under a state’s rules — can newly qualify a household for one of the four programs at any time during the year, not just during Medicare’s annual enrollment window.
Turning Four Savings-Program Names Into One State-Specific Answer
QMB, SLMB and QI each have their own income test, their own coverage list and their own state office, and a household can qualify for one without realizing another one exists. Working out which program fits — and what happens to Part D costs once it does — usually means comparing several separate government pages rather than one.
The Medicare Cost & Coverage Protection Kit is built around the 51 state Medicare cost-help packs and a medication and cost tracker, giving each state’s contacts and limits their own reference.
Look up a state’s Medicare savings contacts in The Medicare Cost & Coverage Protection Kit.
This article was researched and drafted with the assistance of AI and reviewed by The Money Overview editorial team.
