The QMB Program
● Pays the Medicare Part B premium, which is $202.90 per month;
● Covers the Medicare deductibles — $1,736 per benefit period for hospital care and $283 per year for doctor and medical visits — plus your Medicare coinsurance and copayments, when you use a provider who accepts Medicaid;
● Pays the Medicare Part A premium when certain conditions are met. (If you do not have free Part A, you must apply for Conditional Part A at your local Social Security office between January and March, or in the month before, of, or after your 65th birthday.) QMB coverage starts the month after you have been approved by Medicaid;
● Automatically enrolls you in Extra Help for your prescription drugs — you do not have to apply separately.
QMB Income limits (effective February 2026):
● $1,350.00 per month (gross) for an individual who is single, widowed, divorced, or separated, or
● $1,824.00 per month (gross) for a couple.
Specified Low Income Medicare Beneficiary (SLMB) Program
Under the Specified Low Income Medicare Beneficiary (SLMB) program, Medicaid pays the Medicare Part B premium only, which is $202.90 per month.
You will not receive a Medicaid card for the SLMB Program. Coverage may begin up to three months prior to the application month if you meet the requirements. SLMB also qualifies you automatically for Extra Help.
SLMB Income limits (effective February 2026):
● Above the QMB limit and up to $1,616.00 per month (gross) for an individual who is single, widowed, divorced, or separated,
● Above the QMB limit and up to $2,184.00 per month (gross) for a couple.
Qualified Individual-1 (QI-1) Program
You will not receive a Medicaid card for the QI-1 Program. Coverage may begin up to three months prior to the application month if you meet the requirements. QI-1 also qualifies you automatically for Extra Help.
● $1,526.01–$1,715.00 per month (gross) for individuals who are single, widowed, divorced, or separated,
● $2,064.01–$2,320.00 per month (gross) for a couple.
QI-1 is funded on a limited, first-come, first-served basis each year — apply as early in the year as you can.
QI-1 Income limits (effective February 2026):
● Above the SLMB limit and up to $1,816.00 per month (gross) for an individual who is single, widowed, divorced, or separated,
● Above the SLMB limit and up to $2,455.00 per month (gross) for a couple.
Common Questions:
1. How do I apply for the Medicare Savings Programs?
Complete a Form 211 and mail it to the District Office that serves the county where you live. A listing of the District Offices is on the last page of the application.
2. What happens to the application once it reaches the District Office?
Your application will be assigned to a caseworker who will review the information you provided. You will be contacted by mail or phone if they have any questions. Please follow the instructions listed on page 1 of the application to avoid delays in processing. You will be notified by mail of the status — approval or denial — of your application.
3. How long does it take Social Security to stop taking the Part B premium out of my check?
It will take about two months for Social Security to stop taking the Part B premium out of your check. Once the premium is stopped, you will get a refund of all the premiums taken out of your check for the months you were deemed eligible for a Medicare Savings Program. If your check is direct deposit, your refund will also be direct deposit. If, after two months from the month you were awarded a Medicare Savings Program, Social Security continues to take the Part B premium from your check, please contact the Medicaid Agency’s Buy-In Unit at (334) 242-5268.