Medicare Savings Programs help pay your premiums, deductibles, and copays if your income and resources fall below certain limits

Medicare Savings Programs (also called may have access to Medicare Beneficiary programs, or QMB) are state-run programs that pay some or all of your Medicare costs when your income is low enough. Each state sets its own income and resource limits, so the threshold that matters is the one in your state, not a national number. You do not have to be on Medicaid to join — these are separate programs run by your state's Medicaid office.

The three main programs are QMB (which covers your Part B premium, deductible, and copays), SLMB (which covers your Part B premium only), and QI (which covers your Part B premium if you do not meet SLMB income limits). A fourth program, QDWI, exists in some states for people who lost coverage because of work. Your state may use different names for these, but the structure is the same.

Key Takeaways

  • Income limits vary by state and change each year, so you must check your state's specific threshold rather than assuming a national figure applies to you.
  • Your countable resources (savings, investments, property other than your home) must also fall below your state's limit, typically $7,500 to $11,500 for an individual.
  • You must already be enrolled in Medicare Part B to join a Medicare Savings Program.
  • Your state's Medicaid office handles enrollment, and the process usually takes two to four weeks once you submit your documents.
  • If you are approved, the program pays your state's Medicare costs directly to Medicare, so you see the benefit when ready on your next bill.

Income limits that change each year by state

Your monthly income must fall below a percentage of the federal poverty level. For QMB, the limit is usually 100 percent of the federal poverty level. For SLMB, it is usually 120 percent. For QI, it is usually 135 percent. In 2024, the federal poverty level for a single person was $1,145 per month, which means QMB income limits ranged from roughly $1,145 to $1,546 depending on the program and your state.

These numbers change every January, and your state may set its own limits within federal guidelines. Some states are more generous than others. You need to contact your state's Medicaid office or use the Medicare Savings Program locator on Medicare.gov to find your state's current limits. Do not rely on last year's numbers or on limits from another state.

Income includes Social Security, pensions, wages, interest, and dividends. Some income does not count — for example, the first $65 of monthly earnings and certain in-kind support. Your state's Medicaid office can tell you which types of income they count.

Resource limits that vary by program and state

Your countable resources are your savings, investments, stocks, bonds, and property other than your home and one car. The resource limit for QMB is often $7,500 for an individual and $11,250 for a couple, though some states set it higher. SLMB and QI may have the same limits or slightly different ones. Your home and one vehicle do not count toward the limit.

Life insurance, burial plots, and prepaid burial accounts usually do not count. Some states exclude a certain amount of burial funds. Again, your state sets the final rules. If you are close to the limit, ask your state's Medicaid office which specific assets they count — the answer can make the difference between approval and denial.

You must already be enrolled in Medicare Part B

Medicare Savings Programs only pay costs for Medicare Part B (doctor visits and outpatient care). You must have Part B active before you can join. If you are not yet on Medicare, you need to enroll in Part B first through Social Security or Medicare.gov.

If you missed your initial enrollment window and did not sign up for Part B when you first became may be able to access, you may face a permanent penalty on your Part B premium. A Medicare Savings Program cannot undo that penalty, but it can still pay your premium once you are enrolled. The program does not cover Part A (hospital) or Part D (prescription drugs), though some states offer separate programs for those costs.

How to find your state's program and current limits

Start at Medicare.gov/savings or call 1-800-MEDICARE (1-800-633-4227). Both will direct you to your state's Medicaid office and tell you the current income and resource limits. You can also call your state's Medicaid office directly — the number is on your state's Medicaid website.

When you contact your state, have your Social Security number, Medicare number, and recent pay stubs or benefit statements ready. Ask them to confirm whether you meet the income and resource limits for your state before you spend time gathering documents. Some states let you do this over the phone; others require you to submit a form first.

What documents you will need to submit

Most states ask for proof of income (recent pay stubs, tax return, or benefit statement), proof of resources (bank statements, investment statements), proof of citizenship or legal residency, and your Medicare card. Some states also ask for a signed process form. The exact list depends on your state and your situation.

Your state's Medicaid office will tell you which documents they need before you explore. Gather them in advance so you can submit everything at once — incomplete applications take longer to process. If you do not have a document (for example, if you have no bank account), ask your state whether you can provide an alternative or a signed statement instead.

Timeline from submission to approval

Most states aim to process Medicare Savings Program requests within 30 days of receiving a complete process. In practice, this often takes two to four weeks. If your process is incomplete, your state will contact you to ask for the missing documents, which can add another week or two.

Once you are approved, your state sends the approval to Medicare, and Medicare updates your account. You should see the benefit on your next Medicare bill — usually within one to two billing cycles. You do not need to do anything else once you are approved; the program pays directly to Medicare on your behalf.

What happens if your income or resources change

You must report changes in income or resources to your state's Medicaid office. If your income rises above the limit, you will lose coverage. If it falls back below the limit later, you can rejoin. Some states allow you to report changes online; others require a phone call or a new form.

Your approval is usually good for one year. Your state will send you a renewal notice before it expires. If you do not respond to the renewal notice, your coverage will end. Keep your contact information current with your state's Medicaid office so you do not miss renewal notices.

Frequently Asked Questions

Do I have to be on Medicaid to join a Medicare Savings Program?

No. Medicare Savings Programs are separate from Medicaid. You can join a Medicare Savings Program even if you do not meet your state's Medicaid income limits. However, some states combine the process, so you may be asked about Medicaid at the same time.

What if my income is just slightly above the limit?

If you are over the limit, you do not meet the income requirement for that program. However, you may meet the limit for a different program — for example, if you are over QMB but under SLMB. Ask your state's Medicaid office to check all three programs. Some states also have small income disregards or allow certain deductions that can lower your countable income.

Can I join if I am still working?

Yes, as long as your total income (wages plus any other income) falls below your state's limit. The first $65 of your monthly earnings usually does not count toward the limit, which can help if you work part-time.

What if I was denied — can I appeal?

Yes. Your state's Medicaid office will send you a denial letter that explains why you were denied and how to appeal. You usually have 30 days to request a hearing. Contact your state's Medicaid office to ask about the appeal process in your state.

Does a Medicare Savings Program cover my prescriptions?

No. Medicare Savings Programs cover Part B costs only (doctor visits, outpatient care, and related copays). They do not cover Part D (prescription drugs). Some states offer a separate program called the State Pharmaceutical information Program (SPAP) for prescription help — ask your state's Medicaid office whether you meet the limits for that program as well.