Every month, Medicare takes the Part B premium out of your Social Security check, and for many people that bite adds up to well over a thousand dollars a year. If your income is modest, you may not have to pay it. Medicare Savings Programs can cover that premium and, for some people, much more.
Quick answer: Medicare Savings Programs (QMB, SLMB and QI) are state-run programs that help people with limited income and resources pay Medicare costs, mainly the Part B premium. QMB also covers deductibles and copays. Limits vary by state, so apply through your state Medicaid agency, and ask about Extra Help for drug costs at the same time.
What Medicare Savings Programs actually are
Medicare Savings Programs (MSPs) are federal-state programs. Your state pays some or all of your Medicare out-of-pocket costs if your income and savings fall under certain limits. There are four types, and the three you will hear about most are QMB, SLMB and QI.
These are not the same as full Medicaid. You can qualify for an MSP and still not qualify for Medicaid coverage. You apply through your state Medicaid agency (the name varies by state), but you are applying for a separate benefit.
One more thing worth knowing: these programs are underused. Many eligible people never apply because they assume they earn too much or have too many assets. The only way to know is to check.
QMB, SLMB and QI explained
Each program covers a different slice of your costs, and each has a different income ceiling. Here is the plain-English version.
QMB: Qualified Medicare Beneficiary
QMB is the most generous. It generally pays your Part B premium, and it also covers Medicare deductibles, coinsurance and copays for Medicare-covered services. If you also pay a Part A premium, QMB may cover that too.
A big perk: providers generally cannot bill QMB enrollees for Medicare cost-sharing on covered services. If a provider bills you anyway, that is worth questioning, and our guide to medical billing errors shows how.
SLMB: Specified Low-Income Medicare Beneficiary
SLMB pays your Part B premium. It does not cover deductibles or copays. The income limit is a little higher than QMB, so it catches people who just miss the QMB cutoff.
QI: Qualifying Individual
QI also pays your Part B premium, with an income limit a bit higher still. QI has a few quirks: it is typically funded with a limited pot of money, and you generally cannot be on full Medicaid to get it. Ask your state how it handles applications and renewals.
| Program | What it generally covers | Income level |
|---|---|---|
| QMB | Part B premium, deductibles, coinsurance, copays (and Part A premium if you pay one) | Lowest limit of the three |
| SLMB | Part B premium | A bit above QMB |
| QI | Part B premium | A bit above SLMB |
Exact dollar limits change yearly and differ by state, so always confirm them with your state program office or Medicare.gov.
Do not decide you earn too much. Let your state’s office do the math.
How much can you save?
The Part B premium is deducted monthly for most people, and it is a meaningful chunk of a fixed income. Over a year, having it covered typically means saving many hundreds of dollars, and often more than a thousand. The exact amount depends on the current premium and on your own situation.
QMB can save even more, because it also picks up cost-sharing. For someone with frequent doctor visits or specialist care, that can be a major difference. Your actual savings depend on your state and your health care use, and nothing is guaranteed until you are approved.
Money move: If you are approved, ask your state office and Social Security when the Part B deduction will stop and whether you can get money back for months already paid. Write down the date, the person’s name and what they told you.
Income and asset limits: why they vary by state
The federal government sets the baseline, but states have room to adjust. Some states count less of your income or ignore savings entirely, while others use stricter asset tests. That is why your neighbor across a state line might get different answers than you.
Two terms to know:
- Income: This usually includes Social Security, pensions and wages, though some states ignore small amounts. Ask what deductions or disregards apply.
- Assets (or resources): This generally means things like bank accounts and stocks. Many states do not count your primary home or one vehicle, but confirm this with your state.
Do not rule yourself out based on a number you saw online. Limits change each year, and your state may be more generous than you expect.
How to apply, step by step
Applying is usually free and often easier than people expect. Here is the path.
- Find your state office. Search for your state’s Medicaid agency or Medicare Savings Program office. You can also call 211 or use Benefits.gov to find the right place.
- Gather your documents. Typically this includes your Medicare card, Social Security number, proof of income (Social Security award letter, pension statements, pay stubs), and recent bank statements.
- Ask for the right program by name. Say, “I would like to apply for a Medicare Savings Program, including QMB, SLMB and QI.” That way you are screened for all of them.
- Submit your application. Many states allow online, mail, phone or in-person applications. Keep a copy of everything you send.
- Respond fast to follow-up requests. If the office asks for more documents, answer quickly. Missed deadlines are a common reason for denials.
- Get free help if you are stuck. Your State Health Insurance Assistance Program (SHIP) offers free, unbiased Medicare counseling and can help with applications.
What to say on the phone
Try this script: “Hi, I am on Medicare and I would like to apply for a Medicare Savings Program. Can you tell me which of QMB, SLMB and QI I might qualify for, what documents you need, and how long approval usually takes?” Then write down names, dates and reference numbers.
For more tips on calls like this, see our guide on how to negotiate bills with scripts, timing and tactics.
How MSPs link to Extra Help
Here is the bonus. In general, if you qualify for a Medicare Savings Program, you are automatically treated as eligible for Extra Help, the federal program that lowers Part D prescription drug costs. That can mean lower premiums, smaller deductibles and reduced copays at the pharmacy.
That makes an MSP a two-for-one: help with Part B premiums and help with drug costs. For details on how that works, see our upcoming guide on Medicare Extra Help and lowering your prescription drug costs.
Even if you are not sure you qualify for an MSP, you can apply for Extra Help directly through Social Security. Their income and resource limits differ from the MSPs, so some people qualify for one and not the other. And once you have lower drug costs, our guide to lowering prescription costs has more ways to squeeze the pharmacy bill.
One application can lower your premium and your pharmacy bill. Ask about both every time.
Common mistakes that cost people benefits
- Assuming you earn too much. Limits vary and some income is not counted.
- Applying for only one program. Ask to be screened for all of them.
- Ignoring renewal notices. MSPs generally require periodic renewal. Missing the paperwork can end your benefit.
- Forgetting about pending bills. If you were billed for Medicare cost-sharing while eligible for QMB, ask about it. Our guide to negotiating medical bills can help.
Other ways to lower medical costs on Medicare
An MSP is a strong foundation, but it is not the only lever. Medicare does not cover everything, and gaps like dental and vision can sting. Our upcoming piece on how to lower dental bills will cover that, and knowing urgent care vs ER cost can keep you from overpaying when something comes up.
If bills are piling up already, these 9 steps for when you cannot pay medical bills are a good place to start. For a broader list of programs, see our hub on help paying bills. If you want to look at your own numbers, try the Bill Savings Finder.
Bill Reduction Institute may earn referral fees from some partners, but we do not run these programs and cannot approve applications. Always confirm current rules with your state Medicaid agency, Social Security or Medicare.
Where to confirm the current rules
Because limits and rules change, check these official sources before you apply:
- Your state Medicaid agency or Medicare Savings Program office
- Medicare.gov for program descriptions
- Social Security for Extra Help applications
- Your State Health Insurance Assistance Program (SHIP) for free counseling
- 211 or Benefits.gov to find local help
For the full picture of medical bill strategies, visit our Medical Bills section.
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Key takeaways
- QMB, SLMB and QI are state-run programs that generally pay the Part B premium; QMB also covers deductibles and copays.
- Income and asset limits vary by state and change yearly, so check with your state office instead of guessing.
- Apply through your state Medicaid agency and ask to be screened for all three programs.
- Qualifying for an MSP generally also gets you Extra Help with Part D drug costs.
- Free SHIP counselors can help you apply and appeal a denial.
- Watch renewal notices so you do not lose your benefit by accident.
Frequently asked questions
Do I have to be on Medicaid to get a Medicare Savings Program?
No. Medicare Savings Programs are run through your state Medicaid agency, but you apply for them separately from full Medicaid. Many people get QMB, SLMB or QI help without qualifying for full Medicaid coverage.
Will a Medicare Savings Program also help with prescription costs?
In general, yes. People who qualify for a Medicare Savings Program are typically enrolled automatically in Extra Help, the federal program that lowers Part D drug costs. Confirm your status with your state program or Social Security.
Can I get help if I own a home or a car?
Usually yes. Asset tests in most states generally do not count your primary home or one vehicle, though rules differ by state. Ask your state program office exactly what counts and what does not.
What if my application is denied?
You have the right to appeal, and the denial notice should explain how and by when. Ask what specific item caused the denial, since errors in income or asset counting are common. Your State Health Insurance Assistance Program (SHIP) offers free counseling to help.
How long does it take to start saving?
It varies by state. Approval can take weeks, and some programs can reduce or refund Part B premiums going back a few months, depending on the program and state rules. Ask your state office how your start date works.