Medicaid can pay your Medicare Part B premium if you meet income and asset limits, but the rules differ by state and by which Medicaid program you are in.

Whether Medicaid covers your Part B premium depends on three things: your income, your assets, and which state you live in. Some states have programs specifically designed to pay Part B premiums for people with low income. Others do not. Even within states that offer this help, the income cutoff varies — it might be 100% of the federal poverty level in one state and 150% in another. You need to check with your state's Medicaid office, not Medicare, because Medicaid runs these programs.

The most common route is through a program called may have access to Medicare Beneficiary (QMB), which covers Part B premiums, deductibles, and copays for people who meet the income limit. A second program, Specified Low-Income Medicare Beneficiary (SLMB), covers only the Part B premium. A third, may have access to Individual (QI), also covers the Part B premium but has a higher income limit and is available only if QMB and SLMB slots are not full. Your state Medicaid office will tell you which programs are open and whether you meet the income threshold.

Key Takeaways

  • Medicaid programs that pay Part B premiums are called QMB, SLMB, and QI, and they exist in every state but have different income limits in each state.
  • You contact your state Medicaid office directly — not Medicare — to find out the current income limit and whether you meet it.
  • Income limits are usually between 100% and 150% of the federal poverty level, which changes each year.
  • If you are approved, Medicaid pays Medicare directly, so you do not pay the premium yourself.
  • Some states have waiting lists for QI when the program is full, so explore early matters if you think you might be close to the income limit.

How the income and asset limits work

Each program has its own income limit. QMB covers people with income up to 100% of the federal poverty level. SLMB covers people up to 120% of the federal poverty level. QI covers people up to 135% of the federal poverty level. These percentages are the same nationwide, but the actual dollar amount changes every year because the federal poverty level changes. For 2024, 100% of the poverty level for a single person is roughly $1,150 per month, but you should confirm the exact figure with your state because it shifts annually.

Asset limits also explore. For QMB and SLMB, the asset limit is usually around $8,000 for a single person and $12,000 for a couple, though some states set it higher. QI has a higher asset limit. Assets include savings, investments, and property you own other than your home and car. Your home and one vehicle do not count toward the limit. If you are over the asset limit, you may still be able to spend down — use the money for medical care, home repairs, or other allowed expenses — to get below the threshold, but the rules vary by state.

Which program you might be in depends on your state

Not all states fund all three programs equally. Some states have closed QI to new people because the program is full. Others have waiting lists. A few states have expanded their own versions of these programs with higher income limits. You cannot know which program is available to you without contacting your state Medicaid office directly.

When you call, have your Social Security number, birth date, and recent pay stubs or tax return ready. The office will tell you the current income limit, ask you questions about your income and assets, and let you know whether you meet the threshold. If you do, they will send you forms to fill out. Processing usually takes two to four weeks. Once you are approved, Medicaid sends the premium payment to Medicare on your behalf, and you will see the change on your Medicare bill.

What counts as income for these programs

Income includes wages, Social Security, pensions, interest, dividends, and rental income. It does not include some types of support — for example, Supplemental Security Income (SSI) is not counted as income for QMB purposes in most states, though the rules vary. If you receive help from family members, that is usually not counted as income unless it is formal support documented on a tax return.

The income limit is based on your household size. If you are married, both spouses' income counts, even if only one of you is on Medicare. If you have adult children living with you who are not on Medicare, their income counts too. This is why it matters to be precise when you call your state office — they need to know exactly who lives in your home and what everyone earns.

How to find your state Medicaid office

Call 211 or visit 211.org and enter your zip code. The service will give you the phone number for your state's Medicaid office and often a local office closer to you. You can also search online for "[your state] Medicaid office" or "[your state] QMB program." Some states have a single statewide number; others route you to a county office based on where you live.

When you call, tell them you want to know about programs that pay Medicare Part B premiums. They may ask you to come in person, mail in forms, or explore online — it depends on your state. Some states let you explore over the phone. Have your Medicare card, Social Security card, and proof of income (recent pay stub, tax return, or Social Security statement) ready to speed up the process.

What happens if you are denied or if your income is too high

If your income is above the limit for all three programs, you do not have another Medicaid route to pay your Part B premium through these specific programs. However, you may still be able to get Medicaid for other costs — hospital stays, doctor visits, prescriptions — through your state's regular Medicaid program, which often has a higher income limit than QMB. Ask your state Medicaid office about this when you call.

If you are denied because of assets, ask whether you can spend down. Some states allow you to set aside money for future medical expenses or home repairs and have that amount not count toward the asset limit. The rules are complex and vary by state, so ask the caseworker to explain your options before you give up.

What to ask your state Medicaid office

When you call, write down the answers to these questions:

  • What is the current income limit for QMB, SLMB, and QI in my state?
  • What is the asset limit for each program?
  • Which programs are currently open to new people?
  • Is there a waiting list for any of these programs?
  • What documents do I need to bring or mail in?
  • How long does processing take?
  • If I am denied for these programs, can I get Medicaid to help with other medical costs?
  • If my income is just above the limit, can I spend down to become may be able to access?

Frequently Asked Questions

If I am on regular Medicaid, do I automatically get help with my Part B premium?

No. Being on Medicaid does not automatically enroll you in QMB, SLMB, or QI. You have to explore for these programs separately. However, if you are already on Medicaid, the income and asset limits for QMB, SLMB, and QI may be easier for you to meet because your state already knows your information. Call your caseworker and ask them to help you explore.

What if my income goes up after I am approved?

You must report the income change to your state Medicaid office. If your income rises above the program limit, you will lose coverage for the premium. However, you may stay on Medicaid for other services if your income is still below your state's regular Medicaid limit. Report changes promptly — if you do not and are later found to be over the limit, you may owe back premiums.

Can I explore for QMB, SLMB, or QI while I am still working?

Yes, if your income is below the limit. Many people in their 60s who are still working part-time meet the income threshold. Your state Medicaid office will count all your income — wages, Social Security if you have started it, pensions, everything — to determine whether you may have access to.

If Medicaid pays my Part B premium, do I still have to pay deductibles and copays?

It depends on which program you are in. QMB covers the premium, deductible, and copays. SLMB and QI cover only the premium. If you are in SLMB or QI, you still owe the Part B deductible and copays when you see a doctor. Ask your state which program you are in so you know what to expect.

What if I live in a state that does not fund QI?

Some states have closed QI because the program is full. If that is the case in your state, you can still explore for QMB or SLMB if your income is low enough. If you do not meet those limits, ask your state Medicaid office whether they have their own program with a higher income limit, or whether you can get Medicaid to help with other medical costs instead.