QMB, SLMB, and QI: Which Medicare Savings Program Tier Do You Qualify For?

The Medicare Savings Program is not a single benefit — it is three distinct programs stacked by income. The lowest-income tier covers nearly everything Medicare charges you. The middle and top tiers each pay only your monthly Part B premium. Knowing which tier you fall into determines whether you save roughly $2,400 or close to $7,000 this year.

QMB — The Most Comprehensive Tier

QMB stands for Qualified Medicare Beneficiary. Medicaid pays almost every out-of-pocket cost Medicare would otherwise charge you: the Part B monthly premium ($202.90 in 2026), the Part A deductible ($1,736 per benefit period), the Part B deductible ($283 per year), and the coinsurance and copayments due after each medical service. Federal law prohibits providers who accept Medicare from billing you for these cost-sharing amounts — a protection known as the QMB billing rule.

QMB also automatically qualifies you for the Part D Extra Help program (Low Income Subsidy), which reduces your drug plan premiums and copays by around $800 per year. Combined, the total annual value of QMB typically reaches $6,975 or more for a single beneficiary.

2026 QMB Income Limits (Most States)

• Individual: up to $1,350 per month
• Married couple: up to $1,824 per month
• Alaska: up to $1,683 individual / $2,275 couple (higher FPL)
• Hawaii: up to $1,553 individual / $2,098 couple (higher FPL)

These are countable income limits, not gross income. A mandatory $20 general income disregard is applied to unearned income (like Social Security) before your income is compared to the limit — meaning your actual check can be slightly above these numbers and you may still qualify.

SLMB — Part B Premium Coverage

SLMB stands for Specified Low-Income Medicare Beneficiary. This tier covers one thing: your Medicare Part B monthly premium. At $202.90 per month in 2026, that is $2,434.80 returned to you each year — typically credited directly to your Social Security payment so you never see a premium bill. SLMB also qualifies you for Part D Extra Help, worth an additional $800 in reduced drug costs per year.

SLMB does not cover deductibles, coinsurance, or copays. If you have significant medical expenses, check whether QMB might still be within reach after income disregards are applied to your gross income.

2026 SLMB Income Limits (Most States)

• Individual: $1,351 to $1,616 per month
• Married couple: $1,825 to $2,184 per month

QI — Part B Premium, First-Come First-Served

QI stands for Qualifying Individual. It covers the same Part B premium as SLMB but has two critical differences. Funding comes from federal block grants that states renew each year, so enrollment is approved on a first-come, first-served basis — apply early in the year to secure your spot before funds run out. And unlike SLMB, QI does not include Part D Extra Help, which means the net annual value is limited to the Part B premium savings of $2,434.80.

If you already receive full Medicaid benefits for any other purpose, you are not eligible for QI. Apply for QMB or SLMB instead.

2026 QI Income Limits (Most States)

• Individual: $1,617 to $1,816 per month
• Married couple: $2,185 to $2,455 per month

Estimated Annual Savings by Tier in 2026

• QMB: up to $6,975/year (Part B premium + deductibles + coinsurance + Part D Extra Help)
• SLMB: up to $3,235/year (Part B premium + Part D Extra Help)
• QI: up to $2,435/year (Part B premium only, no Part D Extra Help)

Asset Limits — Do Your Savings Count Against You?

Most states also require you to pass an asset test. The standard 2026 limits are $9,950 for an individual and $14,910 for a married couple. Ten states have eliminated the asset test entirely: Alabama, California, Connecticut, Delaware, Maine, Massachusetts, Minnesota, New York, Vermont, and Washington. In those states, only income determines eligibility — savings accounts, CDs, and investments are not counted.

Even in states that do have an asset test, your primary home, one vehicle, and personal belongings are excluded. Only liquid financial assets — bank accounts, stocks, bonds, and similar holdings — count toward the limit.

How to Apply

You apply for all three MSP tiers through your state Medicaid office — not through Medicare or Social Security directly. Bring recent bank statements, proof of income (your Social Security award letter or recent pay stubs), and your Medicare card. Most states accept applications online, by phone, or in person at your local Medicaid office.

Not sure which tier fits your income and state? Use our free eligibility checker to find out in two minutes — check your MSP eligibility now.

Disclaimer: Income limits above reflect 2026 federal figures for the 48 contiguous states and DC. Alaska and Hawaii use higher state-specific limits. Contact your state Medicaid office or a free SHIP (State Health Insurance Assistance Program) counselor to confirm your eligibility before applying.