Yes, Medicaid can pay your Medicare premiums if you meet income and asset limits

If you have both Medicaid and Medicare — a situation called "dual may be able to access" — Medicaid may pay some or all of your Medicare premiums, deductibles, and copayments. Whether it does depends on which Medicaid program you're in and your income level. The main programs that cover Medicare costs are called may have access to Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and may have access to Individual (QI). Each has different income thresholds and covers different parts of your Medicare bills.

The income limits change each year and vary by state. In 2024, QMB covers people with income up to about 100% of the federal poverty level, SLMB covers up to about 120%, and QI covers up to about 135% — but your state Medicaid office sets the exact number for your area. You'll also need to have limited assets, usually under $8,000 for an individual or $12,000 for a couple, though this varies by state and program.

Key Takeaways

  • Medicaid programs called QMB, SLMB, and QI specifically pay Medicare premiums and cost-sharing for people with low income.
  • Income limits are set by your state and change yearly, so you may become covered in one year and lose coverage in another if your income changes.
  • You must contact your state Medicaid office to find out whether you meet the income and asset limits for your state right now.
  • Once approved, Medicaid sends the premium payment directly to Medicare, so you don't pay it yourself.

The three Medicaid programs that pay Medicare costs

QMB (may have access to Medicare Beneficiary) covers the most. It pays your Part B premium (currently $174.70 per month for most people in 2024), your Part A deductible, and your copayments and coinsurance for hospital and doctor visits. You must have income at or below 100% of the federal poverty level — in 2024, that's about $1,385 per month for a single person, though your state may use a slightly different figure.

SLMB (Specified Low-Income Medicare Beneficiary) pays only your Part B premium. Your income can be higher than QMB — up to about 120% of poverty level, or roughly $1,662 per month for one person in 2024. This program helps people who can't afford the Part B premium but have slightly more income than QMB allows.

QI (may have access to Individual) also pays your Part B premium, but for people with income up to about 135% of poverty level — roughly $1,868 per month for one person in 2024. QI has a waiting list in some states and may have a limited budget, so you might be told to reapply later if funds run out.

All three programs have asset limits. Most states set the limit at $8,000 for an individual or $12,000 for a married couple, but some states use different numbers. Assets usually include savings accounts, stocks, and bonds — but not your home or car.

How to learn about your state covers you

Contact your state Medicaid office directly. You can find the phone number by calling 1-800-MEDICARE (1-800-633-4227) and asking for your state's Medicaid office, or by visiting your state's Medicaid website. When you call, have your Social Security number, income information from the last month or two, and a list of your assets ready.

Tell them you want to know whether you meet the income and asset limits for QMB, SLMB, or QI in your state. They will tell you the exact income threshold for your household size and whether you may have access to right now. If you don't may have access to this year, ask when you can reapply — income limits reset each year on January 1st in most states, so you may become covered later.

Some states also use a different program called Medicare Savings Program (MSP) as an umbrella term for all three. If your state calls it MSP instead of listing the three programs separately, that's the same thing — just ask about all three levels of coverage.

What happens after you're approved

Once your state Medicaid office approves you, Medicaid sends your Medicare premium directly to Medicare. You won't see a bill for your Part B premium anymore — Medicare will receive the payment from Medicaid instead. The same applies to any deductibles and copayments Medicaid covers under your program.

You'll receive a notice in the mail confirming your coverage and which program you're in. Keep this notice. If you see a bill for something Medicaid should be paying, call your state Medicaid office with your notice number.

Your coverage is usually good for one year. Before it expires, your state will contact you to renew. If your income or assets change during the year, report it to Medicaid right away — if your income goes up, you might lose coverage, but if it goes down, you might move to a higher-paying program like QMB.

Income changes and what to report

If your income increases during the year, you may lose Medicaid coverage for Medicare premiums. Most states allow a small increase without affecting your coverage — usually 10% above the limit — but check with your state office about their rules. If you lose coverage, you can reapply on January 1st when the new income limits take effect.

If your income decreases, report it to Medicaid. You might move from QI to SLMB, or from SLMB to QMB, which means Medicaid will cover more of your costs. Don't wait for your renewal notice — call your state office as soon as your income drops.

Major life changes like retirement, a job loss, or a spouse's death can affect your income. Let Medicaid know within 30 days so they can update your coverage if needed.

What these programs do and don't cover

QMB covers your Part A deductible (the amount you pay before Medicare starts paying for a hospital stay), your Part B premium, and your copayments and coinsurance for Part A and Part B services. It does not cover Part D (prescription drugs) premiums or copayments — you'll need separate help for that, such as the Low-Income Subsidy program.

SLMB and QI cover only your Part B premium. They do not cover deductibles, copayments, or coinsurance. If you're in SLMB or QI and you need help with other costs, you may be able to get Medicaid coverage for those separately, depending on your state.

None of these programs cover Part D copayments. If you need help paying for prescription drugs, ask your state Medicaid office about the Low-Income Subsidy (LIS) program, which is separate from the Medicare premium programs.

Frequently Asked Questions

What's the difference between QMB and SLMB?

QMB covers more — it pays your Part B premium plus deductibles and copayments — but has a lower income limit (about 100% of poverty). SLMB pays only your Part B premium but allows higher income (about 120% of poverty). If you meet QMB's income limit, you'll be put in QMB automatically because it covers more.

Can I have Medicaid and Medicare at the same time?

Yes. You can have both. If you have both, you're called "dual may be able to access." Medicare is your primary insurance, and Medicaid helps pay the costs Medicare doesn't cover — including premiums, deductibles, and copayments if you're in one of the programs described here.

What if I'm on Medicare but don't have Medicaid yet?

You can explore for Medicaid through your state Medicaid office. You don't need to have Medicaid first to learn about you meet the income limits for the Medicare premium programs. Call your state office and ask about QMB, SLMB, or QI — they'll tell you if you may have access to.

Do I have to reapply every year?

Yes. Your state will send you a renewal notice before your coverage expires, usually around the same time each year. You'll need to confirm your income and assets again. Income limits also reset on January 1st, so you might become covered or lose coverage when the new year starts.

What if I live in a state that hasn't expanded Medicaid?

The Medicare premium programs (QMB, SLMB, QI) are separate from regular Medicaid expansion. All states run these programs for Medicare beneficiaries with low income, regardless of whether they expanded Medicaid. Contact your state Medicaid office to find out your income limit.