The standard Medicare Part B premium is $202.90 a month in 2026, which works out to more than $2,400 a year taken straight out of most retirees’ Social Security checks. For millions of people on modest fixed incomes, a state program will pay that premium in full, and many who qualify have never applied.
They are called Medicare Savings Programs, four of them, run by state Medicaid offices with federal rules. Depending on your income, they can cover the Part B premium alone or nearly all of your Medicare cost sharing. Here is what each program does, the 2026 limits, and why it is worth applying even if your numbers look slightly too high.
Four programs, one application
You do not have to figure out which program fits. You apply once through your state, and the state sorts you into whichever program your income and resources support, as Medicare.gov explains. The four tiers, from most generous to most targeted:
Qualified Medicare Beneficiary (QMB). Pays the Part B premium, the Part A premium for people who do not get it free, and Medicare deductibles, coinsurance, and copayments on covered services. Providers who take Medicare are not allowed to bill QMB enrollees for those amounts at all. The 2026 federal limits are monthly income of $1,350 for an individual or $1,824 for a couple, with resources of $9,950 and $14,910 respectively.
Specified Low-Income Medicare Beneficiary (SLMB). Pays the Part B premium only, for incomes up to $1,616 single or $2,184 for a couple in 2026, with the same resource limits as QMB.
Qualifying Individual (QI). Also pays the Part B premium only, one income step higher: up to $1,816 single or $2,455 for a couple. QI money is first come, first served, and you must reapply every year, with priority for people who had it the year before.
Qualified Disabled and Working Individual (QDWI). A narrower program that pays the Part A premium for certain working people with disabilities who lost premium-free Part A by returning to work. Its 2026 income limits are higher, $5,405 single and $7,299 for a couple, with lower resource limits of $4,000 and $6,000.
What counts, and why higher earners should still apply
The dollar figures above are the federal floor, not a wall. States are allowed to disregard certain income and assets, and some do so aggressively; a handful have dropped the asset test altogether or set higher income cutoffs. Limits also run slightly higher in Alaska and Hawaii. Medicare.gov’s advice is blunt: even if you do not think you qualify, apply anyway and let the state do the math.
Resources generally mean money in checking, savings, and investment accounts, while the home you live in, one car, household goods, and a burial plot typically do not count. Because the counting rules are the trickiest part, a wrong guess at the kitchen table is common, usually in the pessimistic direction.
The drug-cost bonus that comes with it
Enrolling in QMB, SLMB, or QI automatically qualifies you for Extra Help, the federal program that lowers Medicare drug plan costs. In 2026, people with Extra Help pay no more than $12.65 for each drug their plan covers, and the program also wipes out drug-plan premiums and deductibles for most enrollees. For someone taking several brand-name prescriptions, this piece alone can be worth more than the premium help.
What the savings look like in real dollars
Take a single retiree with $1,500 a month in Social Security and little else. That income clears QMB’s limit but fits SLMB, so the state picks up the $202.90 Part B premium. Her Social Security check rises by that amount because the premium is no longer withheld, an effective raise of about 13 percent, plus the automatic Extra Help on prescriptions.
A couple living on $1,700 a month lands under the QMB limits. Beyond the premium, QMB pays Medicare’s cost sharing, which in 2026 includes the $283 Part B deductible and the 20 percent coinsurance Original Medicare normally leaves to the patient. For someone facing a knee replacement or regular specialist care, that protection is the difference between treatment and debt.
How to apply
Applications go through your state Medicaid agency, not Social Security and not your Medicare plan. You can find your state’s contact through the state menu at Medicaid.gov. Expect to provide proof of income, such as your Social Security award letter, and recent bank statements for the resource test.
If you want a person to walk you through it, every state runs a State Health Insurance Assistance Program, or SHIP, offering free unbiased counseling from trained volunteers; find yours at shiphelp.org. SHIP counselors handle Medicare Savings Program applications all day and know each state’s quirks, including which income disregards apply.
One caution about timing on QI: because its funding is capped and allocated first come, first served, applying earlier in the year is better than later. And keep the award letter once you are approved. If you are in QMB and a provider bills you for a Medicare deductible or coinsurance anyway, that billing is improper, and showing your QMB status, or calling 1-800-MEDICARE, is the way to get it corrected.
None of this help arrives automatically. The programs have existed for decades, the 2026 limits are set, and the application is the only step between a qualifying retiree and roughly $2,400 a year. If your income is anywhere near the numbers above, or a parent’s is, the hour it takes to apply is among the best-paid hours of the year.
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