QMB — Qualified Medicare Beneficiary
QMB (Qualified Medicare Beneficiary) is the most comprehensive Medicare Savings Program tier. It covers your Part B premium ($202.90/month in 2026), Part A premium if applicable, all Medicare deductibles, coinsurance, and copays — and automatically qualifies you for Extra Help on prescriptions.
Estimated annual savings: up to $6,368
Based on 2026 Medicare costs and average utilization.
2026 QMB Income Limits
| Household size | Monthly limit |
|---|---|
| Individual | $1,350/mo |
| Married couple | $1,824/mo |
| Alaska (individual) | $1,688/mo |
| Hawaii (individual) | $1,553/mo |
These are countable income limits. The $20 general income disregard is already factored in.
What QMB Covers
- ✓ Medicare Part B premium ($202.90/month in 2026)
- ✓ Medicare Part A premium (if applicable)
- ✓ Part A deductible ($1,676 per benefit period)
- ✓ Part B deductible ($257/year)
- ✓ Medicare coinsurance and copays
- ✓ Extra Help for Part D prescription drug costs (automatic)
What QMB Does NOT Cover
- ✗ Services not covered by Medicare (dental, vision, hearing)
- ✗ QDWI (Qualified Disabled Working Individual) — a separate program
- ✗ Medigap (Medicare Supplement) premiums
The QMB Billing Protection Rule
Federal law protects QMB enrollees from provider billing.
Under federal law, healthcare providers — including Medicare Advantage plans — cannot bill QMB enrollees for Medicare cost-sharing (deductibles, coinsurance, copays). This applies to all Medicare-covered services. If a provider bills you, show your QMB card and cite 42 U.S.C. § 1396a(n). You can dispute the charge with your state Medicaid office.
How to Apply for QMB
Apply through your state's Medicaid office. Use our eligibility checker to get your state's direct application link and phone number.
What to bring: Proof of income (Social Security award letter, pay stubs), recent bank statement, Medicare card, and proof of identity/residency.
What to Expect After Approval
Most states process applications within 45 days. Benefits often begin retroactively to the month you applied. You will receive a QMB card to show providers. QMB enrollment is renewed annually — your state will send a renewal notice before your coverage ends.
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