Medicare Savings Programs: the 2026 limits for QMB, SLMB and QI

The 2026 limits in one table

Program	What it pays	Individual: monthly income / resources	Married couple: monthly income / resources
QMB, Qualified Medicare Beneficiary	Part A premiums if you pay them; Part B premiums; Part A and Part B deductibles, coinsurance and copayments for covered services	$1,350 / $9,950	$1,824 / $14,910
SLMB, Specified Low-Income Medicare Beneficiary	Part B premiums only; requires both Part A and Part B	$1,616 / $9,950	$2,184 / $14,910
QI, Qualifying Individual	Part B premiums only; requires both Part A and Part B	$1,816 / $9,950	$2,455 / $14,910
QDWI, Qualified Disabled and Working Individual	Part A premiums only, for people with a disability who work and lost premium-free Part A	$5,405 / $4,000	$7,299 / $6,000

These figures are from Medicare.gov's Medicare Savings Programs page, read October 23, 2026. They are federal figures. Medicare.gov adds that income limits are slightly higher in Alaska and Hawaii, that some states do not count certain types or amounts of income or resources, and that you may qualify in other states even if your income or resources are above the federal limits. You apply through your state, not through Medicare.

Where the numbers come from

The monthly limits are not arbitrary. They follow from the HHS poverty guideline, which for 2026 is $15,960 a year for one person in the 48 contiguous states and the District of Columbia, plus $5,680 for each additional person. A household of two is therefore $21,640. Divided by twelve, those are $1,330 and about $1,803 a month. Each program takes a percentage of that, and the published figures also add a $20 general income disregard. The result reconciles with every QMB, SLMB and QI cell in the table above. QDWI is built differently: CMS's dual-eligibility document describes the QDWI income limit as not above 200 percent of the poverty level, which does not reproduce Medicare.gov's $5,405 and $7,299, so this page does not derive them. Use the published figures.

Program	Share of the poverty guideline	One person: share of $1,330, plus $20	Two people: share of $1,803.33, plus $20	Published
QMB	100%	$1,330.00 + $20 = $1,350.00	$1,803.33 + $20 = $1,823.33	$1,350 and $1,824
SLMB	120%	$1,596.00 + $20 = $1,616.00	$2,164.00 + $20 = $2,184.00	$1,616 and $2,184
QI	135%	$1,795.50 + $20 = $1,815.50	$2,434.50 + $20 = $2,454.50	$1,816 and $2,455

The published figures round the cents up. Two things follow. First, the limits are tied to the poverty guideline, so they change when HHS publishes a new guideline, and a chart from another year will be off by a few dollars at least. Second, a source that reports $1,330 for the QMB individual limit, as the KFF state table does, is reporting the poverty-guideline figure without the $20 disregard. The two numbers describe the same rule from different starting points, and the Medicare.gov number is the one to compare your income against.

What each program is worth in dollars

The 2026 Part B standard premium is $202.90 a month, and the Part B deductible is $283, according to the CMS 2026 fact sheet. The Part A inpatient deductible is $1,736 per benefit period. Those three figures put a price on each program.

Item (2026)	Amount	Paid by QMB	Paid by SLMB or QI
Part B premium, 12 months at $202.90	$2,434.80	Yes	Yes
Part B deductible	$283.00	Yes	No
20% Part B coinsurance on approved services	20% of the approved amount	Yes	No
Part A deductible per benefit period	$1,736.00	Yes	No

As an invented example, a person whose Part B-approved services for the year total $5,000 owes the $283 deductible and 20 percent of the remaining $4,717, which is $943.40, for $1,226.40 in Part B cost sharing. Add the $2,434.80 premium and the Part B bill for the year is $3,661.20. A QMB enrollee has that whole amount paid. An SLMB or QI enrollee has the $2,434.80 premium paid and still owes the $1,226.40. Add one hospital admission and the Part A deductible of $1,736 is also covered for QMB. These are arithmetic on published rates and an invented spending level, not a forecast of anyone's year.

In every case the program pays the standard Part B premium instead of you. The Medicare.gov page does not address refunds of premiums already paid or any retroactive start date, so this page states no rule on either; ask the state office when you apply.

Five households, sorted

The incomes below are invented, monthly, and counted the way the table counts them. Assume each person has resources under $9,950 and is single unless noted.

Household (invented)	Monthly income	Federal result	Why
Single, Social Security $1,100 plus a $240 pension	$1,340	QMB	At or under $1,350
Single, Social Security $1,500	$1,500	SLMB	Over $1,350, at or under $1,616
Single, Social Security $1,250 plus $450 of other income	$1,700	QI	Over $1,616, at or under $1,816
Married couple, combined $2,300	$2,300	QI, if funds remain	Over the $2,184 SLMB couple limit and at or under the $2,455 QI couple limit
Single, $1,900	$1,900	Not at the federal limit	Over $1,816; check whether your state goes higher

Look at the fourth row: a couple at $2,300 is within QI, not outside the programs, because the couple limits are higher than the single limits. A common error is comparing a household's income with the single-person figure. The fifth row shows where the federal list ends and the state list begins.

States that go higher than the federal figures

KFF's 2026 table of QMB eligibility levels, drawn from its April 2026 report on non-MAGI Medicaid eligibility, shows that most states use the federal level and that several do not. Its figures use the poverty-guideline basis without the $20 disregard, so add $20 to compare them with Medicare.gov. Checked October 23, 2026.

State	QMB monthly income, individual / couple (KFF basis)	Share of poverty guideline	Resource limit
Federal baseline	$1,330 / $1,803	100%	$9,950 / $14,910
District of Columbia	$3,990 / $5,409	300%	None
Connecticut	$2,806 / $3,804	211%	None
Massachusetts	$2,527 / $3,426	190%	None
Maine	$2,461 / $3,336	185%	None
Indiana	$1,995 / $2,705	150%	$9,950 / $14,910
Vermont	$1,995 / $2,705	150%	None
New York	$1,835 / $2,488	138%	None
Alaska	$1,663 / $2,254	100% (adjusted for Alaska)	$9,950 / $14,910
Hawaii	$1,530 / $2,074	100% (adjusted for Hawaii)	$9,950 / $14,910
Washington	$1,463 / $1,983	110%	None

Fourteen places have no resource limit for QMB in KFF's table: the seven above that show "None," and Alabama, Arizona, Delaware, Louisiana, Mississippi, New Mexico and Oregon, which use the federal income level. The table shows QMB only. SLMB and QI limits in those states are also state decisions, and a state can rank differently on each tier. For your state's current limits and rules, use the "Contact your state" link on the Medicare.gov page or your state Medicaid agency's site, and trust a state page dated this year over a chart.

QMB and the bills you get

QMB is the only program here that changes what a provider may bill you. CMS says federal law prohibits Medicare providers and suppliers from billing QMB enrollees for Medicare Part A and Part B deductibles, coinsurance and copayments for Medicare-covered items and services, that a provider who does so violates its Medicare provider agreement, and that providers can pursue the cost sharing from Medicaid instead. CMS's materials say the rule covers Medicare Advantage plans too. Services Medicare does not cover are outside the prohibition.

The practical sequence, if a bill for Medicare cost sharing reaches a QMB enrollee:

1. Show both the Medicare and the Medicaid cards at each visit, which is the step Medicare.gov recommends so the provider's billing system can flag the status.
2. If a bill arrives anyway, tell the provider or the collector that you are in the QMB program, and ask in writing that the account be corrected and any collection halted.
3. If billing continues, CMS directs beneficiaries to 1-800-MEDICARE.
4. If the account has gone to a collector, send the status in writing inside the validation period; the collections guide covers the timing and the content of that letter.

SLMB and QI do not carry that protection, because they pay only the premium. A person in either program still owes the deductible and coinsurance, and the hospital financial assistance guide is the other route for a large balance. The two can work together: an approval letter from the state is documentation of your income and resources that may help support an assistance application.

QI and QDWI have rules the others do not

QI is not guaranteed to everyone who meets the limits. Medicare.gov says states approve QI applications on a first-come, first-served basis, with priority given to people who received QI the year before, that you must reapply every year, and that it is available only to people who do not qualify for other Medicaid coverage or benefits. For a person near the SLMB line, that is a reason to apply early in the year and to keep the approval letter.

QDWI is a narrow program with a different shape: Part A premiums only, for people with a disability who are working and who lost Social Security disability benefits and premium-free Part A because they returned to work. Its limits are higher on income ($5,405 for an individual) and lower on resources ($4,000), which is the opposite of the other three. Few people need it, and those who do should ask the state about it by name.

How much of a small income the Part B premium takes

The premium is the part of Medicare cost that every enrollee pays regardless of use, which is why all three programs start there. At $202.90 a month, the share of income it takes falls as income rises.

Monthly income (one person)	Part B premium as a share of income	Program that would pay it, federally
$1,350 (the QMB limit)	15.0%	QMB
$1,616 (the SLMB limit)	12.6%	SLMB
$1,816 (the QI limit)	11.2%	QI
$2,500	8.1%	None at the federal level; check state limits

These shares are the premium alone, before the $283 deductible, 20 percent coinsurance or any plan premium for Part D or a supplement. They explain why the eligibility lines sit where they do and why a household just over a line is still carrying a large fixed cost.

The same programs in CMS's dual-eligibility language

CMS publishes a document, Dual Eligibility Categories (revised February 11, 2026), that names the groups behind these programs and states exactly what each covers. It matters for a bill because the names are the ones a provider's billing system and the state's records use.

• QMB-only. Entitled to Part A, income up to 100 percent of the poverty level, and resources up to three times the SSI limit with inflation adjustments. Medicaid pays Part A premiums if any and Part B premiums. Medicare providers may not bill the person for Part A and Part B cost sharing, and can bill Medicaid instead.
• QMB Plus. QMB eligibility plus full Medicaid benefits under a separate category. Premium and cost-sharing treatment is the same as QMB-only, and the person also receives the full Medicaid benefit package.
• SLMB-only. Income between 100 and 120 percent of the poverty level. Medicaid pays only the Part B premium.
• SLMB Plus. SLMB eligibility plus full Medicaid benefits. For Medicaid-covered services the person pays no more than a nominal Medicaid copay, if one applies.
• QDWI. A person who lost premium-free Part A after returning to work, with income not above 200 percent of the poverty level and resources not above twice the SSI standard. Medicaid pays only Part A premiums.

Three details in that document are worth carrying into any conversation about a bill. First, the same categories apply whether you have Original Medicare or a Medicare Advantage plan. Second, states can set the resource test: CMS notes that income and asset guidelines vary by state and that some states do not count assets. Third, the QMB protection has a footnote: a state may charge a QMB enrollee a nominal Medicaid copay for services that both programs cover. And a provider who may not bill you can still be paid less than the full Medicare cost sharing, because CMS says states may limit their payment to the lesser of the Medicare cost-sharing amount or the difference between the Medicare payment and the Medicaid rate. That affects the provider's willingness to see QMB patients. It does not make you owe the difference.

What QMB takes off a procedure bill: four examples from this site

This site prices Medicare anchors for 30 outpatient procedures. Each Part B service carries a 20 percent coinsurance, and for hospital outpatient facility charges the national minimum copayment is posted in the CMS addendum. QMB covers these amounts; SLMB and QI do not. The table uses the national unadjusted facility anchors and the Michigan Locality 01 physician anchors from the procedure pages, with the 20 percent computed on each, for a person whose deductible has already been met.

Service (CPT)	Facility layer: patient share	Physician layer: 20% of Medicare anchor	What a QMB enrollee owes for Medicare cost sharing
Diagnostic colonoscopy (45378), hospital outpatient	$190.02 minimum copayment	$34.50 (20% of $172.49)	$0.00
Brain MRI without contrast (70551), hospital outpatient	$48.76 minimum copayment	$13.81 (20% of $69.04 professional)	$0.00
Brain MRI without contrast (70551), imaging center, one global anchor	Not billed separately	$38.53 (20% of $192.65)	$0.00
Cataract surgery (66984), hospital outpatient	$471.57 minimum copayment	$93.56 (20% of $467.80)	$0.00
Cataract surgery (66984), ambulatory surgical center	$251.15 (20% of the $1,255.73 ASC payment)	$93.56 (20% of $467.80)	$0.00
Knee arthroscopy with meniscectomy (29881), hospital outpatient	$668.58 minimum copayment	$107.88 (20% of $539.38)	$0.00

For an SLMB or QI enrollee those same columns are what remains to pay, after the $283 deductible. Look at the cataract rows: the setting changes the facility share from $471.57 to $251.15 while the physician share stays at $93.56, which is the setting effect that the surgery center against hospital outpatient guide works through. The numbers are Medicare anchors for the facility and physician layers. They are not patient prices, anesthesia and other separate layers are not included, and a Medicare Advantage plan may set different cost sharing. For a planned procedure, confirm your price in writing before service, with the facility, surgeon and anesthesia layers each named.

Help with drug costs comes with it

Medicare.gov says QMB, SLMB and QI also include Extra Help with prescription drug costs, with a 2026 cap of $12.65 per covered drug. How the Part D cap and the monthly payment option interact with Extra Help is in the Part D out-of-pocket cap guide, and CMS says that for people who qualify for Extra Help, that program is more advantageous than the payment plan. This page does not rank anyone's drug plan.

Two edge cases from the CMS document

You do not have Part A yet. Some people reach Medicare without premium-free Part A because they lack the work history for it. CMS's dual-eligibility document says that a person without Part A who meets the QMB eligibility guidelines may, depending on the state, have Part B only or Part B and conditional Part A, and that the state may have a process to let the person obtain Part A and QMB coverage at the same time. It adds that many states allow this throughout the year while others limit when you can enroll in Part A. For someone facing a Part A premium, this is the first thing to ask the state about, because QMB pays Part A premiums where there are any.

You take an immunosuppressive drug under Part B. CMS describes a limited Part B immunosuppressive drug benefit, and says people who have only that benefit may qualify for the QMB or SLMB eligibility group with coverage limited to the Part B-ID premium or cost sharing. The status is known as QMB-Part B-ID or SLMB-Part B-ID. This page covers prices only and says nothing about that or any other drug, but it is the kind of detail that explains why a state letter can name a category you did not expect. Read the category on any approval letter against the list above.

A final point on timing: the category in your approval letter, not the name of the program you applied to, is what a provider's billing office sees. If the letter says QMB Plus, the QMB billing rule applies to you and you also have Medicaid. If it says SLMB-only, it does not, and your remaining cost sharing is yours to manage through the other tools on this site. Keep the letter with your Medicare card, and read it when it arrives.

Before you apply: write these down

• Your gross monthly income from every source, and the monthly figure for your spouse if you are married, since the couple limits apply.
• Your bank balances and other countable resources, and the date of each statement. Use statements dated close together, so the totals describe one point in time.
• Your Medicare number, your Part A and Part B start dates, and whether you pay a Part A premium.
• Your state Medicaid agency's contact details, from the "Contact your state" link, and the date you applied.
• A copy of everything you send, since a state office cannot decide on a form it does not have.

Medicare.gov says that even if you do not think you qualify, you should still apply. The cost of applying is an hour; for a person who qualifies, not applying means continuing to pay the $2,434.80 a year that the Part B premium comes to in 2026. If you are also working through a bill, the Medicaid retroactive coverage guide covers a different program with its own look-back rule.

Savings program questions people ask

Sources, with the date each was read

Medicare.gov, Medicare Savings Programs, https://www.medicare.gov/basics/costs/help/medicare-savings-programs, read October 23, 2026. HHS ASPE, 2026 Poverty Guidelines, https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines, read October 23, 2026 ($15,960 for one person, $5,680 for each additional person; published in the Federal Register January 15, 2026). KFF, Eligibility for Medicare Savings Programs for Qualified Medicare Beneficiaries (QMBs), 2026 state table, https://www.kff.org/medicare/state-indicator/eligibility-for-medicare-savings-programs-for-qualified-medicare-beneficiaries-qmbs/, read October 23, 2026. CMS, 2026 Medicare Parts A and B premiums and deductibles fact sheet ($202.90, $283, $1,736), read October 23, 2026. CMS, Dual Eligibility Categories (revised 02/11/2026), https://www.cms.gov/files/document/dual-eligible-categories.pdf-0, read October 23, 2026. The $20 disregard is inferred from the reconciliation shown in the table above; confirm with your state. State rules change; use your state's current page.