An estimated 2 to 4 million Medicare beneficiaries who qualify for help paying their Medicare costs never receive it because they do not know these programs exist or do not realize they qualify. Medicare Savings Programs, administered through your state Medicaid office, can pay your Part B premium, cover your deductibles, and eliminate cost-sharing for Medicare services. For people near the income thresholds, applying takes perhaps 30 minutes and can save thousands of dollars per year permanently.
The MSP programs are among the most underutilized benefits in Medicare. I have worked with clients who qualified for QMB and did not know it for years, years during which they were paying copays they were legally entitled to have waived. The application takes 30 minutes. If your income is anywhere near the threshold, it is worth 30 minutes to check.
The four Medicare Savings Programs
There are four distinct programs, each with different income thresholds and coverage levels. The Qualified Medicare Beneficiary program, or QMB, is the most comprehensive. It covers Part A and Part B premiums, deductibles, and copays or coinsurance. The Specified Low-Income Medicare Beneficiary program, SLMB, covers the Part B premium only. The Qualifying Individual program, QI, also covers the Part B premium but has limited enrollment slots and requires annual reapplication. The Qualified Disabled and Working Individuals program, QDWI, covers the Part A premium for people with disabilities who are working and no longer eligible for premium-free Part A.
Income and asset limits for 2025
Federal income limits serve as the floor; many states set their own higher thresholds. At the federal level in 2025, QMB eligibility requires income at or below approximately 100% of the federal poverty level, which is about $1,255 per month for a single person and $1,704 for a couple. SLMB income limits extend to approximately 120% FPL ($1,506 single, $2,045 couple). QI extends to approximately 135% FPL ($1,695 single, $2,301 couple). Many states including Connecticut, Maine, Massachusetts, New York, and several others have expanded eligibility to higher income levels, so check your specific state. Asset limits also apply but have been loosened in recent years in most states.
What QMB specifically covers
If you qualify for QMB, providers are prohibited by law from billing you for Medicare cost-sharing, including copays, coinsurance, and deductibles for Medicare-covered services. This applies to Original Medicare services and, in coordination with Medicare Advantage plans, to Advantage plan cost-sharing as well. A QMB enrollee seeing a Medicare-accepting physician should pay nothing out of pocket for covered services. QMB also automatically qualifies you for Part D Extra Help, which reduces prescription drug costs significantly.
How to apply
Apply through your state Medicaid office, not through Medicare or Social Security directly. You can find your state Medicaid office through medicare.gov or by calling 1-800-MEDICARE. Many states offer online applications. Bring documentation of income, assets, Medicare enrollment, and identification. Processing times vary by state but are typically 45 to 90 days. Coverage is retroactive to the application date in most states, not the approval date.
Think you might qualify for help with Medicare costs?
Medicare Savings Programs are underutilized because most people do not know to look for them. I can help you understand whether you qualify and how to apply in your state.
Book a Free CallThe Extra Help connection
Qualifying for QMB, SLMB, or QI automatically qualifies you for Medicare Part D Extra Help, also called the Low Income Subsidy. Extra Help reduces your Part D premium, eliminates or reduces the Part D deductible, and lowers your drug copays significantly. In 2025, Extra Help beneficiaries pay no more than $4.60 for generic drugs and $11.20 for brand-name drugs per fill. For people who take multiple medications, this benefit alone can be worth hundreds or thousands of dollars per year.
Annual reapplication requirements
QMB and SLMB are typically renewed automatically if your income remains stable. QI requires you to reapply each year because enrollment is capped. States contact you near renewal time, but it is worth proactively confirming your status each year, particularly if your income or asset situation has changed. Income changes can affect eligibility in either direction.
Frequently asked questions