Medicare and Medicaid help
Last checked: May 2026
Medicare Savings Programs can help pay some Medicare costs for people with limited income. These programs are run by state Medicaid agencies, not by a private plan.
If you help a parent, spouse, relative, or friend with bills, this guide explains the four programs, where to apply, what papers may be needed, and what to do if the first answer is no.
Quick answer
A Medicare Savings Program may help pay a Medicare Part A premium, a Medicare Part B premium, or Medicare cost-sharing. The exact help depends on which program the person gets.
The four Medicare Savings Programs are QMB, SLMB, QI, and QDWI. QMB gives the most help. SLMB and QI usually help with the Part B premium. QDWI is for certain people with disabilities who returned to work and need help paying the Part A premium.
You apply through the state Medicaid agency. Medicare.gov says the state decides which program a person qualifies for, and that a person should still apply even if they do not think they qualify. State rules can be higher or easier than the federal numbers. Start at the official Medicaid.gov state contact page or call the local SHIP program for free Medicare help.
Who this helps
This page is for a caregiver who is trying to lower Medicare costs for someone else.
It may help if the person you care for:
- has Medicare Part A, Part B, or both;
- has a low or modest monthly income;
- has money taken from Social Security for the Part B premium;
- is getting bills for deductibles, coinsurance, or copays;
- needs help paying for prescriptions;
- was told they make too much for full Medicaid, but still struggles with Medicare costs; or
- needs help filling out a state Medicaid application.
This page is not a full Medicaid long-term care guide. If the person may need home care, adult day care, or nursing home care paid by Medicaid, also read our guide to Medicaid HCBS waivers and our guide to the Medicaid look-back period.
What may pay or help
Medicare Savings Programs are Medicaid programs for people who have Medicare. They can help with Medicare costs. They do not replace Medicare.
Medicare.gov states that these programs can help pay Medicare Part A and Part B premiums. Some programs may also pay Part A and Part B deductibles, coinsurance, and copayments for Medicare-covered care.
| Program | Plain-English meaning | What it may pay | Extra Help connection |
|---|---|---|---|
| QMB | Qualified Medicare Beneficiary | Part A premium if owed, Part B premium, and Medicare-covered deductibles, coinsurance, and copays. | QMB also leads to Extra Help for Part D drug costs. |
| SLMB | Specified Low-Income Medicare Beneficiary | Part B premium. The person must have both Part A and Part B. | SLMB also leads to Extra Help for Part D drug costs. |
| QI | Qualifying Individual | Part B premium. The person must have both Part A and Part B. | QI also leads to Extra Help for Part D drug costs. |
| QDWI | Qualified Disabled and Working Individual | Part A premium only, for certain working people with disabilities who lost premium-free Part A after returning to work. | QDWI is different. Ask the state and SHIP if Extra Help should be filed separately. |
What Extra Help means
Extra Help is a Medicare program for Part D drug costs. Medicare.gov says Extra Help can help pay Part D premiums, deductibles, coinsurance, and other drug costs. Medicare.gov also says people who get help from a state paying their Part B premium through a Medicare Savings Program get Extra Help automatically. See Medicare.gov on Extra Help with drug costs.
Important if the person has QMB
CMS says federal law bars Medicare providers and suppliers, including pharmacies, from billing people in QMB for Medicare cost-sharing for Medicare-covered items and services. If a QMB person gets a bill for a Medicare-covered deductible, coinsurance, or copay, do not pay it right away. Call the provider and say the person has QMB. Ask them to bill the correct payer. See the CMS page on QMB billing protections.
If the problem is about whether Medicare covers a service at all, start with our guide to what Medicare covers. If the person is leaving a hospital and care is being cut off too soon, read our guide to hospital discharge rights.
Who may qualify
Most Medicare Savings Programs look at income and resources. But states have room to use easier rules for some groups. Some states do not count certain income. Some states do not use a resource test for some Medicare Savings Programs.
The federal numbers below are the 2026 limits listed by Medicare.gov and Social Security policy. Alaska and Hawaii have higher income limits. Your state may also have higher or easier limits. Do not stop here if the person is close to the line.
| Program | 2026 monthly income limit, individual | 2026 monthly income limit, married couple | 2026 resource limit |
|---|---|---|---|
| QMB | $1,350 | $1,824 | $9,950 individual / $14,910 couple |
| SLMB | $1,616 | $2,184 | $9,950 individual / $14,910 couple |
| QI | $1,816 | $2,455 | $9,950 individual / $14,910 couple |
| QDWI | $5,405 | $7,299 | $4,000 individual / $6,000 couple |
These are federal figures for most states. Social Security says states may raise the effective limits for QMB, SLMB, and QI by not counting certain income or resources. See the Social Security POMS page on Medicare Savings Program income and resource limits.
Three quick checks before you apply
- Does the person have, or qualify for, Medicare Part A?
- Is the person near the income range for one of the programs?
- Does the person have limited resources, or live in a state with easier resource rules?
Medicare says the only way to know if the person qualifies is to apply. A caregiver can help gather papers and make calls, but the state may need the Medicare beneficiary or legal representative to sign forms.
Where to start first
Start with the state Medicaid agency. Medicare Savings Programs are run by states. Medicaid.gov says people must contact their state Medicaid agency to apply, check eligibility, check an application, or get help with Medicaid claims.
Step-by-step start
- Go to the official Medicaid.gov state help page.
- Choose the state where the person lives.
- Look for the state Medicaid agency, benefits portal, or local county office.
- Ask for a Medicare Savings Program application. Some states call it MSP, Medicare Buy-In, QMB, SLMB, or QI.
- Ask if the state has a short MSP-only application.
- Ask how to send proof and how to check the application status.
- Keep a copy or screenshot of every form, upload receipt, fax receipt, and letter.
Also call SHIP
SHIP gives free, one-on-one Medicare counseling. The Administration for Community Living says SHIP helps Medicare beneficiaries, families, and caregivers with Medicare decisions and benefits. You can find local SHIP help at SHIPHelp.org or call 877-839-2675.
Do this now if money is tight
Apply through the state Medicaid agency, and also ask SHIP if the person should apply for Extra Help through Social Security. Medicare.gov says a person can apply for Extra Help and Medicare Savings Programs at the same time. Social Security can send Extra Help application information to the state to start an MSP application unless the person says not to.
Short phone script for the first call
Use this when calling the state Medicaid agency, local benefits office, or SHIP.
Hello. I help my [parent/spouse/relative/friend] with Medicare papers. They have Medicare [Part A / Part B / both]. I want to apply for a Medicare Savings Program, also called QMB, SLMB, QI, or QDWI.
Can you tell me the correct application for this state? Is there a shorter MSP-only form? What proof do we need to send? How do we check the status? If the application is denied, how do we ask for a hearing or appeal?
If the office says the person does not qualify, ask for that answer in writing. A phone answer is not the same as a written decision.
What documents may be needed
Each state can ask for different proof. CMS model application instructions list common proof such as income, assets, Medicare, immigration status if needed, and where the person lives.
Gather copies before you apply if you can.
- Medicare card or Medicare number.
- Social Security card or proof of Social Security number, if requested.
- Photo ID, if requested.
- Proof of address, such as a lease, utility bill, or state ID.
- Social Security award letter or benefit statement.
- Pension, Railroad Retirement, VA benefit, annuity, or other income proof.
- Recent pay stubs if the person or spouse works.
- Bank statements, if the state uses a resource test.
- Life insurance policy information, if requested.
- Proof of eligible immigration status for non-citizens, if needed.
- Power of attorney, guardianship, or authorized representative papers if you are signing or speaking for the person.
- Copies of bills, denial letters, or pharmacy cost papers if they show the problem.
Use our caregiver checklists page if you need a simple way to sort papers before calling.
What usually goes wrong
Common problems
- The family stops after looking at one chart. State rules may be easier than the federal chart. Apply if the person is close.
- The person applies for Extra Help but does not follow up with the state. Social Security may send information to the state, but the state may still need papers or a signature.
- The office uses a different name. Ask for MSP, Medicare Buy-In, QMB, SLMB, QI, and QDWI.
- The person misses mail. A request for proof may have a deadline. Check mail often and keep envelopes.
- The caregiver cannot speak for the person. The agency may need an authorized representative form, power of attorney, or the person on the phone.
- QMB bills keep coming. Providers may bill by mistake. Show the Medicare and Medicaid cards and ask the billing office to correct the claim.
- The state says the application is incomplete. Ask exactly what is missing and how to send it. Get a receipt.
- The person has a Medicare Advantage plan. MSP can still matter, but billing and plan rules can be confusing. Ask SHIP to review the plan and bills.
What to do if the first path does not work
A no by phone is not the end. Ask for a written notice. The notice should say why the person was denied and how to ask for a hearing or appeal. State deadlines vary. Do not wait.
If the application is denied
- Read the notice. Look for income, resources, missing proof, residency, or Medicare status.
- Check whether the state counted income or resources correctly.
- Send missing documents right away if the notice asks for them.
- Ask SHIP or a local legal aid office to review the notice.
- File the appeal or hearing request before the deadline on the notice.
- Keep copies of the appeal, proof, fax receipts, upload receipts, and names of people you spoke with.
If the issue is a Medicare service denial, plan denial, or coverage cutoff, that may be a separate Medicare appeal. Read our guide on how to appeal a Medicare denial.
If the person is over the MSP limit now, apply again if income drops, a spouse dies, work hours change, savings are spent down on allowed needs, or the state changes its rules. Medicare.gov says income and resource limits can go up each year.
If QMB bills are still arriving
QMB has special billing protection. A person in QMB should not be billed for Medicare Part A or Part B deductibles, coinsurance, or copayments for Medicare-covered care. CMS says QMB beneficiaries have no legal duty to pay that Medicare cost-sharing.
Try this order:
- Call the provider billing office.
- Say the person has QMB and ask them to update the account.
- Give the Medicare number and Medicaid or QMB card information if safe to do so.
- Ask for a corrected bill showing a zero Medicare cost-sharing balance, if that is right.
- If collections start, ask SHIP, the state Medicaid agency, or legal aid for help.
Do not ignore bills. But do not assume a QMB bill is correct.
This is a national starting point, not your state decision
Medicare Savings Program rules depend on the state. The federal program names are the same, but the application, income counting, resource rules, proof rules, and local office names can differ.
Use this article to know what to ask for. Then confirm the details with the state Medicaid agency or SHIP in the state where the Medicare beneficiary lives.
Best first official route
State Medicaid agency or state benefits portal.
Best free help route
Local SHIP counselor through SHIPHelp.org or 877-839-2675.
Best drug-cost route
Ask about Extra Help. If not automatic, apply through Social Security.
Official sources used and what we checked
For this update, we checked official sources for program names, what each program pays, 2026 federal income and resource limits, QMB billing protections, the state Medicaid application route, Extra Help, and SHIP help.
- Medicare.gov: Medicare Savings Programs
- Medicare.gov publication: Get help with your Medicare costs
- Social Security POMS: Medicare Savings Program income and resource limits
- CMS: Qualified Medicare Beneficiary Program Group
- CMS model Medicare Savings Program application instructions
- Medicaid.gov: State Medicaid agency contacts
- Medicare.gov: Extra Help with drug costs
- ACL: State Health Insurance Assistance Program
- SHIPHelp.org: Find local Medicare help
Resumen en espanol
Los Medicare Savings Programs pueden ayudar a pagar algunos costos de Medicare para personas con ingresos limitados. Los programas se llaman QMB, SLMB, QI y QDWI. La ayuda depende del programa.
La solicitud se hace con la agencia estatal de Medicaid. Si la persona recibe QMB, SLMB o QI, tambien puede recibir Extra Help para los costos de medicinas de Medicare Parte D. Llame a Medicaid de su estado o a SHIP para ayuda gratis con Medicare.
About This Guide
CaregiverBenefits.org writes guides for family caregivers who need clear benefit steps. We focus on official rules, real application routes, documents, phone calls, denials, and what to try next.
This guide is a national starting point. Medicare Savings Programs are run by states, so your state Medicaid agency or SHIP should confirm the current rules for the person you care for.
Plain disclaimer
This guide is for general information. It is not legal, tax, medical, or benefits advice. Program rules can change. State Medicaid agencies, Medicare, Social Security, SHIP, or a qualified local adviser should confirm what applies to your situation.
FAQ
What is a Medicare Savings Program?
A Medicare Savings Program is a state-run Medicaid program that helps some people with limited income pay Medicare costs. The help may include Part A premiums, Part B premiums, and in some cases Medicare deductibles, coinsurance, and copays.
What are the four Medicare Savings Programs?
The four programs are QMB, SLMB, QI, and QDWI. QMB helps with the most costs. SLMB and QI usually help pay the Part B premium. QDWI helps certain working people with disabilities pay the Part A premium.
Where do I apply?
Apply through the state Medicaid agency in the state where the Medicare beneficiary lives. You can start at the Medicaid.gov state contact page or ask SHIP for help.
Can a caregiver apply for someone else?
A caregiver can help gather papers, fill out forms, and make calls. The state may need the Medicare beneficiary to sign forms or name the caregiver as an authorized representative. If you have power of attorney or guardianship papers, keep a copy ready.
Does QMB stop Medicare bills?
QMB protects a person from being billed for Medicare Part A and Part B cost-sharing for Medicare-covered items and services. If a bill comes anyway, call the provider and tell them the person has QMB.
Does a Medicare Savings Program include prescription help?
QMB, SLMB, and QI are tied to Extra Help for Medicare Part D drug costs. QDWI is different, so ask SHIP or the state whether a separate Extra Help application is needed.
What if the person is a little over the income limit?
Apply or ask the state before giving up. Some states count income differently or have higher limits. Medicare.gov says a person may qualify in a state even if income or resources are higher than the federal limits.
What if the application is denied?
Ask for the written notice. Read why the state denied it. Send missing proof if that is the issue. Ask SHIP or legal aid for help, and file any appeal or hearing request by the deadline on the notice.
Is this the same as full Medicaid?
No. A Medicare Savings Program can be narrower than full Medicaid. It may only help with Medicare costs. Some people have both full Medicaid and a Medicare Savings Program, but not everyone does.
Does this help with nursing home or home care costs?
Not by itself. Medicare Savings Programs focus on Medicare costs. If the person needs home care, adult day care, or nursing home care paid by Medicaid, ask the state about long-term services and supports or Medicaid waiver programs.
