What You Pay for Medicare Part B if Your Income Is Low
Medicare Part B is not free for anyone, but if your income is low enough, the government pays most or all of your premium through a program called Medicaid or through a Medicare savings program. The amount you pay depends on your exact income and which state you live in — there is no single cutoff that applies everywhere.
If you may have access to for both Medicare and Medicaid (called "dual may be able to access"), Medicaid typically covers your Part B premium, your deductible, and your copays. If you do not may have access to for full Medicaid but your income is still low, you may may have access to for a Medicare Savings Program, which pays your premium and sometimes your deductible and copays. The income limits for these programs are higher than the limit for full Medicaid.
The key difference: you must be enrolled in Medicare Part B first. These programs do not pay the premium if you have not signed up. If you missed the important date to join Part B, you may face a permanent penalty on your premium.
Key Takeaways
- Medicare Part B always has a monthly premium, but Medicaid or a Medicare Savings Program can pay it for you if your income qualifies.
- Income limits vary by state and change each year, so you must check with your state's Medicaid office or call 1-800-MEDICARE to find your local limit.
- You must already be enrolled in Medicare Part B for these programs to help pay your costs.
- If you think you may have access to, contact your state Medicaid office or a local Area Agency on Aging, which can tell you in one call whether you meet the income and resource limits.
How Income Limits Work and Why They Differ by State
The federal government sets a base income limit for Medicare Savings Programs, but each state can set its own limit higher. This means a person with the same income might may have access to in one state and not in another. For 2024, the federal minimum for the lowest-tier program (called QMB, or may have access to Medicare Beneficiary) is roughly 100% of the federal poverty level, but many states have raised this to 120% or 150%.
Your state also counts "resources" — savings, investments, and property — not just income. The resource limit is usually around $7,500 for an individual and $11,250 for a couple, but again, your state may set a different number. A house you live in does not count toward the resource limit, but a second property does.
Because these numbers change every year and vary by location, the only way to know whether you may have access to is to contact your state Medicaid office directly or call 1-800-MEDICARE and ask them to check your income against your state's current limits. They can tell you on the phone whether you may have access to and what to do next.
The Three Medicare Savings Programs and What Each Covers
There are three tiers of Medicare Savings Programs, each covering different costs. Your state may not offer all three, and you can only be in one at a time.
| Program Name | Income Limit (Federal Minimum) | What It Pays |
|---|---|---|
| QMB (may have access to Medicare Beneficiary) | 100% of federal poverty level | Part B premium, deductible, and copays |
| SLMB (Specified Low-Income Medicare Beneficiary) | 120% of federal poverty level | Part B premium only |
| QI (may have access to Individual) | 135% of federal poverty level | Part B premium only |
If you may have access to for QMB, you are in the best position — the program covers your premium, your annual deductible, and your copays for doctor visits and hospital stays. If your income is slightly higher, SLMB or QI will at least cover your premium, which is the largest monthly cost. For 2024, the standard Part B premium is $164.90 per month, though some people with higher incomes pay more.
How to Check if You may have access to and What to Do Next
Start by calling 1-800-MEDICARE (1-800-633-4227). Tell them you want to know if you may have access to for a Medicare Savings Program in your state. They will ask for your income and resources and can tell you on the phone whether you meet the limits. If you do, they will give you the phone number for your state Medicaid office or tell you how the process works online.
You can also contact your state Medicaid office directly. Search online for "[your state] Medicaid" or call your local Area Agency on Aging, which can connect you to the right office. Have your Social Security number, income information (pay stubs, tax return, or benefit statements), and resource information (bank statements, investment statements) ready when you call.
The process itself is usually short — often just a form with your income and resources. Processing time varies by state, but most decisions come back within two to four weeks. Once you are approved, Medicaid or the Medicare Savings Program will pay your Part B premium directly to Medicare, so you will not see a bill.
Full Medicaid and How It Differs from Medicare Savings Programs
If your income is very low, you may may have access to for full Medicaid instead of just a Medicare Savings Program. Medicaid is a joint federal and state program that covers hospital and doctor visits, not just Medicare premiums. In some states, Medicaid also covers dental, vision, and hearing aids — benefits Medicare does not cover.
The income limit for full Medicaid varies widely by state. Some states use 100% of the federal poverty level; others use 138% or higher. If you may have access to for full Medicaid, you are automatically in the QMB Medicare Savings Program as well, so Medicaid covers both your Medicare costs and other medical costs.
To learn about you may have access to for Medicaid in your state, contact your state Medicaid office or call 1-800-MEDICARE. The same process often covers both Medicaid and Medicare Savings Programs, so you do not need to explore twice.
What Happens if Your Income Changes
If you are approved for a Medicare Savings Program or Medicaid, you must report changes in your income or resources. If your income goes up, you may lose coverage, but you will usually get a notice before that happens. If your income goes down, you may move to a higher tier of coverage — for example, from SLMB to QMB — which means more of your costs are covered.
Most programs require you to recertify your income once a year. Your state Medicaid office will send you a form or notice telling you when and how to recertify. If you do not respond, your coverage may end, so keep an eye out for mail from Medicaid or your state health department.
If your circumstances change — you get a job, receive an inheritance, or have a drop in income — call your state Medicaid office right away. They can tell you whether the change affects your coverage and what you need to do.
Frequently Asked Questions
What if I missed the important date to sign up for Medicare Part B?
If you missed the important date and did not have a valid reason (called "good cause"), you will pay a permanent 10% penalty on your Part B premium for as long as you have Medicare. A Medicare Savings Program can still help pay your premium, but the penalty stays. Contact 1-800-MEDICARE to discuss your situation — some people do may have access to for a late enrollment without penalty.
Can I have Medicare Part B and Medicaid at the same time?
Yes. If you may have access to for both, Medicaid pays your Medicare costs and also covers services Medicare does not, like long-term care, dental, and vision in many states. You are considered "dual may be able to access," and your state Medicaid office handles both programs together.
Do I have to be a U.S. citizen to may have access to for a Medicare Savings Program?
You must be a U.S. citizen or a may have access to non-citizen who has lived in the United States for at least five years. Lawful permanent residents (green card holders) usually may have access to if they meet the income and resource limits. Call 1-800-MEDICARE to confirm your immigration status does not disqualify you.
What if my state did not expand Medicaid?
Some states have not expanded Medicaid, which means the income limit for full Medicaid is very low — sometimes as low as 50% of the federal poverty level. You may still may have access to for a Medicare Savings Program, which has higher income limits. Call your state Medicaid office or 1-800-MEDICARE to find out what programs are available in your state.
How much will a Medicare Savings Program actually save me each month?
If you may have access to for QMB, you save at least $164.90 per month (the 2024 Part B premium), plus your deductible and copays. If you may have access to for SLMB or QI, you save at least the premium amount. The exact savings depend on how much medical care you use and your state's copay amounts. Call your state Medicaid office to ask what your costs would be under each program.