Medicare Savings Programs

Written by: Dr. Nate Favini; Chief Medical Officer
Last updated: October 12, 2026
Read time: 4 min

Key points

Medicare Savings Programs pay the $202.90 a month that Medicare costs most people in 2026. That money usually comes out of your Social Security check.
The biggest one, Qualified Medicare Beneficiary (QMB), also pays your copays at the doctor, the specialist and the hospital.
You apply through your state's Medicaid office.
In 2023, more than 8 million people on Medicare were in QMB, about 1 in 8, the Centers for Medicare & Medicaid Services says.

If you have Medicare and money is tight, three programs called Medicare Savings Programs can pay your Medicare costs for you. That matters when part of each Social Security check goes to Medicare and the rest barely covers rent and food. Your state runs these programs, so the exact numbers depend on where you live.

You may qualify if

You have Medicare.
You make less than about $1,350 a month if you live alone, or $1,824 as a couple. You can make a bit more and still get help with the monthly cost.
Your savings are under your state's limit. Many states use $9,950 for one person and $14,910 for a couple. Some states have higher limits or no limit at all.

Not sure you qualify? Apply anyway, because your state makes the call and some of your income may not count. If you would rather not do it alone, a Pair Team advocate can check with you in one call.

What each program pays for

Program	Who it is for (2026, most states)	What it pays for
QMB (Qualified Medicare Beneficiary)	Income up to about $1,350 a month for one person, $1,824 for a couple	Your copays and the rest of the bill at the doctor, the specialist and the hospital. The $202.90 a month Medicare costs you. Hospital insurance (Part A), if you pay for it.
SLMB (Specified Low-Income Medicare Beneficiary)	Up to about $1,616 / $2,184	The $202.90 a month Medicare costs you.
QI (Qualifying Individual)	Up to about $1,816 / $2,455	The $202.90 a month Medicare costs you. You sign up again each year. Not for people who have full Medicaid.

The $202.90 is the price of Medicare Part B, the part of Medicare that pays for doctor visits. Your state may use slightly different numbers, and Alaska and Hawaii use higher ones.

All three programs also get you Extra Help, which lowers what you pay for prescriptions. You don't need an extra form for it.

Find the rules for your state

The programs are federal, but your state runs them. Income limits, savings limits and where you apply change at the state line.

California: apply through your county Medicaid office. The savings limit is $130,000 for one person in 2026.
New York: apply through your county Department of Social Services. In New York City, apply at the Human Resources Administration. New York has no savings limit for these programs.
Nevada: apply through the Division of Social Services at accessnevada.nv.gov. In 2026, QMB covers one person with countable income up to $1,330 a month.

If your state isn't listed yet, call your State Health Insurance Assistance Program (SHIP) at 1-877-839-2675 for free help. You can also call your state Medicaid office.

If you have QMB, no one can bill you for Medicare copays

If you have QMB, doctors, hospitals and pharmacies cannot bill you for Medicare copays or the rest of the bill. That's the law, and it holds even if they don't take Medicaid, and even in a Medicare Advantage plan. If a bill comes anyway, don't pay it yet. Call the billing office, say you're a Qualified Medicare Beneficiary, and ask for a statement that shows you owe nothing. If they keep billing you, call 1-800-MEDICARE (1-800-633-4227).

What a Pair Team advocate does

Most people who call us about Medicare costs have something else going on too. Often it's a stack of county forms, no ride to the doctor, or a power bill they can't pay. This is what we do:

Figure out which program you can likely get, in one phone call.
Help you gather your papers and apply, then follow up with your state until you have an answer.
Help you fix bills you should not have gotten, and ask for your money back if you already paid.
Help with what usually comes with it: Extra Help for prescriptions, rides to appointments, food, utilities and housing.

An advocate is covered by Medicare if you qualify. It takes two minutes to find out.

Check if you qualify for a Pair Team advocate

Frequently asked questions

What is the difference between QMB, SLMB and QI?

The main difference between QMB, SLMB and QI is how much income you can have. QMB is for the lowest incomes and pays the most, including your copays. SLMB and QI are for somewhat higher incomes and pay only the $202.90 a month. QI has to be renewed each year.

Does a Medicare Savings Program pay for prescriptions?

A Medicare Savings Program does not pay for prescriptions directly. But if you get QMB, SLMB or QI, you also get Extra Help, which lowers what you pay for prescriptions. You don't have to fill out a separate form.

Where do I apply?

You apply at your state's Medicaid office. In California, you can apply online at BenefitsCal.com. Free help is available in every state through SHIP at 1-877-839-2675.

Can I have a Medicare Savings Program and Medicaid at the same time?

Yes, you can have QMB or SLMB and Medicaid at the same time. People with both are often called dual eligible. QI is the exception: you can't have QI and full Medicaid together. If you're not sure which fits you, ask your state Medicaid office.

What if I make a little too much?

If you make a little too much, apply anyway, because most states don't count the first $20 of your monthly income. SLMB and QI also have higher limits than QMB, and your state may have other programs that help.

Sources

About the author

Dr. Nate Favini

Chief Medical Officer

Dr. Nate Favini is Pair Team's Chief Medical Officer. He has led the clinical team since 2023.

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