If you have Medicare and a limited income, you may qualify for a Medicare Savings Program (MSP) that pays some or all of your Medicare premiums, deductibles, and copays for you. In 2026, the standard Part B premium alone is $202.90 per month, so qualifying for even the most basic MSP tier saves you over $2,400 per year.
MSPs are run by each state's Medicaid program. Federal law sets a minimum income floor, but many states have raised those limits or eliminated the resource test entirely, meaning more people qualify than the federal numbers suggest. This guide covers all four MSP tiers, the 2026 federal income and resource limits, which states are more generous, and exactly how to apply.
Coverage Breakdown
What Each MSP Program Covers in 2026
The four MSP tiers provide different levels of financial relief. QMB is the most comprehensive. For the full Medicare cost structure, see Medicare free or cost. SLMB and QI are narrower but still valuable because the Part B premium of $202.90 per month in 2026 adds up to $2,434.80 per year.
- QMB: Part A premium (if you do not have premium-free Part A), Part B premium ($202.90/mo), Part A inpatient deductible ($1,736 per benefit period in 2026), Part B deductible ($283 in 2026), and all Medicare coinsurance and copays.
- SLMB: Part B premium only. You still pay Part A costs, deductibles, and coinsurance.
- QI: Part B premium only, same as SLMB. QI is funded by a federal block grant and enrollment closes when funding runs out each year. Reapply annually.
- QDWI: Part A premium only (up to $565/month in 2026 for those with fewer than 30 quarters of Medicare-covered work). For working individuals under 65 who lost premium-free Part A when they returned to work.
States With Higher Income Limits or No Resource Test
Federal law sets a minimum floor for MSP eligibility, but states can be more generous. As of 2026, the following states have eliminated the resource test for MSPs, meaning you qualify based on income alone regardless of savings or other assets: Alabama, Arizona, Connecticut, Delaware, Louisiana, Maine, Massachusetts, Mississippi, New Mexico, New York, Oregon, Vermont, and the District of Columbia.
California has a very high resource limit of $130,000 for individuals and $195,000 for couples in 2026, which effectively functions like no limit for most applicants. Some states also use higher income thresholds than the federal floor, and a handful cover categories of people who do not qualify under the federal rules. If you live in any of the 40 states that have expanded Medicaid, you may also qualify for full Medicaid, which provides additional coverage on top of MSP benefits.
Extra Help and Part D: The Automatic Bonus of MSP Enrollment
When you are enrolled in QMB, SLMB, or QI, you automatically qualify for Extra Help (also called the Low Income Subsidy, or LIS) for Medicare Part D prescription drug coverage. This happens automatically, without a separate application. Extra Help in 2026 caps your out-of-pocket Part D drug costs and reduces or eliminates monthly plan premiums. In 2026, the Part D out-of-pocket cap for all beneficiaries is $2,100, and Extra Help beneficiaries pay far less, often $0 to $4.50 per generic and $0 to $11.20 per brand-name drug.
QDWI enrollment does not automatically confer Extra Help, but QDWI beneficiaries may apply separately for Extra Help if their income and resources fall within Part D LIS limits.
What Does Not Count as Income or a Resource for MSP
Many people incorrectly assume they do not qualify because they own a home or have some savings. The MSP rules exclude several common assets and income sources from the calculation.
- Resources NOT counted: your primary home, one car, household furnishings and personal items, life insurance with cash value up to $1,500, burial plot, and burial fund up to $1,500.
- Income NOT counted: $20/month general income disregard (applied first, before any other rule); $65/month earned income disregard for QDWI; SNAP benefits; energy assistance payments.
- Some states exclude additional income sources. For example, several states do not count part-time earned income or certain types of pension income. Check with your state Medicaid agency.
MSP and Medicaid: The Dual-Eligible Angle
If your income is low enough to qualify for QMB and you also meet your state's full Medicaid income limits, you may qualify as fully dual-eligible (Medicare plus full Medicaid). Full dual-eligibles get all MSP benefits plus Medicaid coverage for services Medicare does not cover, such as dental, vision, hearing, and long-term care. About 12 million Americans are currently dual-eligible. The 40 states that have expanded Medicaid under the ACA have higher Medicaid income limits, making dual eligibility more accessible.
Frequently Asked Questions
What is the income limit for the Medicare Savings Program in 2026?
The 2026 federal income limits are: QMB (100% FPL) up to $1,350/month individual or $1,824/month couple; SLMB (120% FPL) up to $1,616/month individual or $2,184/month couple; QI (135% FPL) up to $1,816/month individual or $2,455/month couple. These include the $20/month general income disregard. Many states have higher limits, so always check with your state Medicaid agency even if you think you are over the limit.
Does the Medicare Savings Program cover Part A costs?
QMB (the most generous tier) covers Part A premiums if you do not have premium-free Part A, plus the Part A inpatient deductible of $1,736 per benefit period in 2026, and all Part A coinsurance. SLMB, QI, and most other MSP tiers cover Part B premium only. QDWI covers Part A premium only for working disabled individuals under 65.
Do I have to apply for the Medicare Savings Program through Social Security?
No. You apply for MSPs through your state Medicaid agency, NOT the Social Security Administration. Look up your state's Medicaid office at medicaid.gov/about-us/contact-us or call 1-800-MEDICARE (1-800-633-4227) to be connected to your state. Once approved, your state notifies Social Security to stop billing you for the Part B premium.
What is the asset limit for the Medicare Savings Program in 2026?
For most states in 2026, the resource limit is $9,950 for individuals and $14,910 for couples (QMB, SLMB, QI). These limits exclude your home, car, household belongings, and a burial fund up to $1,500. However, 12 states plus DC have eliminated the resource test entirely: AL, AZ, CT, DE, LA, MA, ME, MS, NM, NY, OR, VT, and DC. California allows up to $130,000/$195,000.
Does QI enrollment renew automatically or do I have to reapply each year?
QI (Qualifying Individual) does NOT renew automatically. Because QI is funded by an annual federal block grant with a funding cap, you must reapply every year. Applications open at the beginning of each calendar year and close when the funding cap is reached. Apply early in the year to secure your spot. QMB and SLMB do renew through the standard Medicaid renewal process (annual review in most states).
If I qualify for an MSP, do I automatically get Extra Help for Part D?
Yes. Enrollment in QMB, SLMB, or QI automatically qualifies you for Extra Help (the Part D Low Income Subsidy) with no separate application needed. Extra Help in 2026 caps your Part D drug costs and typically reduces or eliminates your monthly plan premium. The 2026 Part D out-of-pocket cap is $2,100 for all beneficiaries; Extra Help members pay far less.
What is QDWI and who qualifies?
QDWI (Qualified Disabled Working Individual) is the fourth MSP tier, designed for a narrow group: people under age 65 with a disability who returned to work, lost their premium-free Part A as a result, and need help paying the Part A premium. In 2026, QDWI income limits are much higher than other MSPs (up to about $5,405/month individual with disregards). The program covers Part A premium only and has lower resource limits of $4,000 individual/$6,000 couple.
Can I qualify for an MSP if my state has not expanded Medicaid?
Yes. MSPs are separate from the ACA Medicaid expansion and exist in all 50 states and DC regardless of expansion status. Even in non-expansion states like Texas and Florida, you can qualify for QMB, SLMB, QI, or QDWI if you meet the income limits, because MSPs are federally mandated. What you cannot get in a non-expansion state is full Medicaid coverage alongside Medicare.
