QDWI: The Fourth Medicare Savings Program Most People Have Never Heard Of

Most people who search for Medicare Savings Programs only find QMB, SLMB, and QI. There is a fourth program, the Qualified Disabled and Working Individuals (QDWI) program, built specifically for people under 65 with a disability who returned to work and lost their premium-free Medicare Part A as a result. In 2026, QDWI pays only the Part A premium — nothing else — for people who meet its income and resource limits.

QDWI at a Glance

• Pays the Medicare Part A premium only — it does not cover Part B premiums, deductibles, or coinsurance.
• Built for people under 65 with a disability who went back to work and lost free Part A because their earnings exceeded the substantial gainful activity (SGA) limit.
• 2026 countable income limit: about $2,680/month (individual) or $3,626/month (couple), using the same 200% federal poverty level plus $20 disregard formula CMS applies to other MSP tiers.
• Resource (asset) limit: $4,000 for an individual, $6,000 for a couple — twice the standard SSI resource limit, and lower than the roughly $9,950/$14,910 asset limits used for QMB, SLMB, and QI.
• Applied for and administered through your state Medicaid agency, the same as QMB, SLMB, and QI.

Who Qualifies for QDWI?

QDWI targets a narrow, specific situation. If you received Social Security Disability Insurance (SSDI) and premium-free Medicare Part A because of a disability, then returned to work and your earnings rose above the substantial gainful activity limit, Social Security eventually stops your cash SSDI payments. Because of a work incentive called the Extended Period of Medicare Coverage, your premium-free Part A can continue for up to 8½ years after your trial work period ends — but once that extension runs out, you would normally have to pay a monthly Part A premium to keep your coverage. QDWI exists to pay that premium for people whose income and resources are still limited.

To qualify, you generally must be: under 65, have a qualifying disability, be enrolled in (or eligible to buy into) Medicare Part A, have countable income and resources under your state's limits, and not otherwise be eligible for Medicaid (Centers for Medicare & Medicaid Services, medicare.gov).

2026 QDWI Income and Asset Limits

QDWI's income test is set at 200% of the federal poverty level, with the same $20 general income disregard used across Medicare Savings Programs. Using the 2026 federal poverty guidelines, that works out to roughly $2,680/month in countable income for an individual and $3,626/month for a couple (U.S. Department of Health and Human Services, ASPE poverty guidelines; SSA QDWI program rules).

That limit is on countable income, not gross income. QDWI, like SSI, disregards $65 of earned income plus half of whatever earnings remain. In practice, that means a single applicant whose only income is wages can earn roughly $5,400/month gross and still pass the countable-income test — significantly more than the $2,680 figure suggests. If you have both earned and unearned income (Social Security, a pension), the math is more involved; a benefits counselor can run the exact numbers for your situation.

The resource limit is $4,000 for an individual and $6,000 for a couple in most states — twice the standard SSI resource limit. Your home, one vehicle, and personal belongings are excluded, the same as under QMB, SLMB, and QI. A few states set higher QDWI resource limits or have eliminated the asset test for other MSP tiers; confirm your state's specific rule with your state Medicaid agency, since QDWI resource rules don't always track a state's QMB/SLMB/QI asset-test policy exactly.

What QDWI Pays For — and What It Doesn't

QDWI pays only your Medicare Part A premium, which can run up to several hundred dollars a month for people who don't qualify for it premium-free. It does not pay your Part B premium, and it does not cover Medicare deductibles, coinsurance, or copays the way QMB does. If you also have low enough income to qualify for QMB, SLMB, or QI, those programs offer broader help and you'd want to compare them — see our full breakdown of QMB, SLMB, and QI.

How to Apply for QDWI

• 1. Confirm you're in (or have recently exited) your Extended Period of Medicare Coverage after SSDI cash benefits ended due to work — your local Social Security office can confirm your status.
• 2. Apply through your state Medicaid agency, the same office that handles QMB, SLMB, and QI applications.
• 3. Bring proof of your disability status, income (pay stubs or award letters), and resources (bank statements).
• 4. If you're denied, you can request a Medicaid fair hearing — see our guide on appealing a Medicare Savings Program denial.

Not sure whether QDWI, QMB, SLMB, or QI fits your situation? Check your eligibility for the other three Medicare Savings Program tiers in about 90 seconds — it asks for no personal account.

Disclaimer: QDWI rules and dollar figures can change and vary somewhat by state. Confirm current limits with your state Medicaid agency or a free State Health Insurance Assistance Program (SHIP) counselor before applying. QDWI does not affect your underlying Medicare coverage.

QDWI isn't the only option if you're under 65 and on Medicare through a disability — see our guide to how QMB, SLMB, and QI eligibility works for people under 65 for the full picture.