Does Social Security Count as Income for a Medicare Savings Program in 2026?

Yes, Social Security counts as income for a Medicare Savings Program (MSP), but not dollar-for-dollar. Your state starts with your gross monthly benefit, subtracts a $20 general income disregard (and more if you also work), and only then compares the result to the program limit. So your countable income — the number that actually decides eligibility — is almost always lower than your Social Security check.

The short answer

Social Security retirement, Social Security Disability Insurance (SSDI), and survivor benefits all count as unearned income when your state Medicaid agency decides MSP eligibility. But the program never compares your full check to the limit. After the standard $20 disregard, a single person could receive up to $1,370 a month in Social Security in 2026 and still land within the $1,350 QMB limit, because $1,370 minus $20 equals $1,350.

Which Social Security benefits count

• Social Security retirement — counted as unearned income.
• SSDI (disability) — counted as unearned income, the same as retirement.
• Survivor and widow(er) benefits — counted as unearned income.

One important exception: Supplemental Security Income (SSI) is not Social Security. SSI is a separate needs-based program, and in most states people who receive SSI are automatically enrolled in full Medicaid, which already covers the Medicare costs an MSP would. The Social Security Administration explains what does and does not count on its Understanding SSI income page. If you get SSI, you usually do not need to apply for an MSP separately.

The $20 disregard: your first $20 never counts

Nearly everyone gets a $20 general income exclusion, and the rules apply it to unearned income — like Social Security — first. It is the single biggest reason your countable income is lower than your gross check. We break the math down in our guide to the $20 income disregard.

If you also earn wages, you get even more set aside: the first $65 of earnings plus half the remainder is excluded, on top of the $20. That is why working part-time rarely disqualifies you outright.

Is it your gross or net Social Security check?

MSP eligibility is based on your gross Social Security benefit — the amount before your Part B premium is withheld. In 2026 the standard Part B premium is $202.90 a month, and for most people it is deducted straight from their Social Security deposit. Your state counts the benefit before that deduction. The upside: once an MSP approves you, it pays that $202.90 premium for you, so it stops coming out of your check.

A real 2026 example

Margaret is single and her only income is a $1,360 monthly Social Security retirement check. Her state subtracts the $20 general disregard, leaving $1,340 in countable income. Because $1,340 is below the 2026 QMB limit of $1,350 a month, Margaret qualifies for QMB — the most generous tier, which erases her Part B premium, deductibles, and coinsurance. You can compare every tier in our 2026 MSP income limits guide.

What else counts as income

• Pensions and annuities
• Withdrawals and required distributions from IRAs and 401(k)s, in most states
• Wages from work (with the extra earned-income disregards above)
• Interest, dividends, and rental income

Your home, your car, and your savings are judged by a separate asset test — and in 10 states there is no asset test at all. Not sure where you land? Check your eligibility free in about two minutes.

This article is for general education and is not legal, tax, or medical advice. Income limits, premiums, and program rules change and vary by state. Confirm your situation with your state Medicaid office, a free SHIP counselor, or Medicare.gov before acting.