QI Program 2026: Income Limits, the First-Come Rule, and Why You Must Reapply Each Year

The Qualifying Individual (QI) program pays your full Medicare Part B premium — $202.90 a month in 2026, about $2,435 a year (CMS, 2026 Medicare Parts A & B Premiums and Deductibles). It is the highest-income tier of the Medicare Savings Programs, with 2026 limits of $1,816 a month for an individual and $2,455 for a couple in most states. Two features set QI apart from QMB and SLMB: it is funded by a limited federal block grant on a first-come, first-served basis, and you must reapply for it every single year.

What Is the QI Program?

QI is the third rung of the Medicare Savings Program ladder. Like SLMB, it pays only the Part B premium — it does not cover deductibles, coinsurance, or copays. What makes it valuable is its higher income ceiling: it reaches people earning up to 135% of the federal poverty level, just above where SLMB cuts off. If your countable income is too high for QMB or SLMB but still modest, QI may be the only Medicare Savings Program you can use.

Because QI pays the same Part B premium as SLMB, the financial benefit is identical — roughly $2,435 a year in 2026. The difference is entirely in the eligibility rules and the way the program is funded.

2026 QI Income Limits

For 2026, the federal baseline QI income limits used by most states are $1,816 a month for an individual and $2,455 for a married couple. As with the other programs, Alaska and Hawaii apply higher limits, and the figure compared to the limit is your countable income after the mandatory disregards — not your gross income.

If your income falls below the QI limit, always check the lower tiers first: QMB (up to $1,350 single) and SLMB (up to $1,616 single) cover more or carry stronger funding guarantees. Our 2026 MSP income limits guide lays out all three tiers side by side.

Not sure where your income lands? Run the free eligibility check and it will tell you the exact tier you qualify for in your state.

The First-Come, First-Served Rule

Unlike QMB and SLMB, which are open-ended entitlements, QI is paid out of a capped federal block grant that Congress allocates to each state annually. When a state exhausts its QI funds for the year, it can stop accepting new enrollees. In practice, states rarely run out, and people already enrolled keep priority for the following year — but the rule is why applying early in the year and renewing on time both matter.

There is one hard eligibility line that trips people up: you cannot receive QI if you also qualify for Medicaid. QI is specifically for people who are not otherwise eligible for full Medicaid benefits. If your circumstances change and you become Medicaid-eligible, your Part B premium would be covered through Medicaid instead.

Why You Must Reapply Every Year

QI eligibility is granted one calendar year at a time, and renewal is not always automatic. Many states send a redetermination packet you must complete and return; miss the deadline and your premium coverage can lapse, leaving the $202.90 monthly charge back on your Social Security statement. People who were enrolled the prior year do get priority for continued funding, so the most important thing you can do is respond promptly to any renewal notice from your state Medicaid office.

A simple habit protects you: each year when your Social Security benefit amount changes — usually with the January cost-of-living adjustment — recheck whether your new income still fits under the QI limit. A COLA can nudge you above the threshold, and catching that early lets you plan rather than be surprised by a denial.

Make the annual recheck painless: re-run your numbers each January to confirm you are still under the limit before your renewal is due.

What QI Includes Beyond the Premium

QI enrollees, like everyone in a Medicare Savings Program, are automatically deemed eligible for the Part D Low-Income Subsidy — Extra Help — which the Social Security Administration estimates is worth roughly $5,700 a year (SSA, Extra Help with Medicare prescription drug costs). So while QI itself only pays the Part B premium, the prescription savings that ride along with it can be worth far more than the premium itself.

A Real Example

James, 68, lives alone in Florida with $1,790 a month from Social Security and a small pension. After the $20 disregard, his countable income is $1,770 — above the SLMB limit of $1,616 but under the QI limit of $1,816. He applies through Florida's Medicaid agency in January, qualifies for QI, and stops paying the $202.90 premium. The following year, a 2.5% COLA raises his benefit; he rechecks his income, confirms he is still under the limit, and returns his renewal packet on time to keep the benefit without a gap.

How to Apply for QI

Apply through your state Medicaid office. In most states an asset test applies — $9,950 for an individual and $14,910 for a couple in 2026 — though about ten states have eliminated it. Read our QI program overview for state-by-state notes, and check whether you live in one of the states with no asset test. Apply early in the year when funding is freshest, and mark your calendar to renew.

This article is for general educational purposes and is not legal, tax, or financial advice. Income limits, asset rules, premiums, and QI funding levels change annually and vary by state. Confirm your eligibility and renewal requirements with your state Medicaid agency or a licensed Medicare counselor.