Medicare Savings Programs: QMB, SLMB, QI and QDWI explained
Medicare Savings Programs are state-run programs that help people with limited income and resources pay Medicare premiums and, for QMB, cost-sharing. Each state decides which program you qualify for.
Figures on this page use US rates checked October 27, 2026. Check the dated sources because rates and eligibility rules change, and state rules differ.
Medicare Savings Programs help people with limited income and resources pay Medicare premiums and, in one program, deductibles and coinsurance. They are run by your state. They do not pay for long-term care, but they can free up money by lowering your Medicare costs.
Carevo does not check eligibility. Your state Medicaid agency does.
The four programs
Medicare.gov describes four programs:
| Program | What it pays | Notes |
|---|---|---|
| Qualified Medicare Beneficiary (QMB) | Part A premium if you do not have premium-free Part A, Part B premium, and Part B deductible, coinsurance and copayments | Providers cannot bill you for covered costs. You may owe a small Medicaid copayment |
| Specified Low-Income Medicare Beneficiary (SLMB) | Part B premium | You need both Part A and Part B |
| Qualifying Individual (QI) | Part B premium | You need both Parts A and B, must reapply each year, and approvals are first-come, first-served with priority for prior-year recipients. For people who do not qualify for other Medicaid |
| Qualified Disabled and Working Individual (QDWI) | Part A premium | For people with a disability who are working and lost premium-free Part A after returning to work |
People with QMB, SLMB or QI also get Extra Help with prescription drug costs.
What these costs are
For 2026, the Part B premium is $202.90 a month or more depending on income, and the Part B deductible is $283 a year. Original Medicare has no yearly cap on what you pay out of pocket unless you add supplemental coverage. A Savings Program lowers some of these costs. See what Medicare pays for.
Who qualifies
Eligibility depends mainly on monthly income and resources. The limits change each year. Medicaid.gov says the programs use SSI methods to count income and resources, and gives the federal income limits as a share of the federal poverty level: 100% for QMB, 120% for SLMB, 135% for QI and 200% for QDWI, each plus a small SSI income disregard. Limits are higher in Alaska and Hawaii.
For the current dollar amounts of income and resource limits, use the Medicare.gov Medicare Savings Programs page. We do not repeat them here because they change every year.
States can differ. Medicare.gov says each state decides which program or programs you qualify for, and that some states do not count certain income or resources, so you may qualify even if you are over the federal limits. Medicare.gov recommends applying even if you think you will not qualify.
Which program fits which cost
The four programs divide up the Medicare costs between them.
- If the cost you worry about is the Part B premium, SLMB and QI pay it, and QMB pays it too.
- If the cost is deductibles, coinsurance and copayments for Medicare-covered services, only QMB pays them. Providers cannot bill a QMB enrollee for those covered costs.
- If the cost is a Part A premium because you do not have premium-free Part A, QMB or QDWI can pay it, depending on your situation.
You do not choose between them. Your state decides which program you qualify for, and it will tell you which one it has enrolled you in.
What these programs do not do
They do not pay for long-term care. Medicare.gov says Medicare does not pay for long-term care, also called custodial care, and that you pay all costs for non-covered services. Medicaid may cover long-term care if you meet your state's rules. For that, see Medicaid and long-term care, VA benefits and private pay.
How to apply
You apply through your state, not through Medicare. Contact your State Medical Assistance (Medicaid) office. QI applicants must reapply every year.
Ask the state office which documents it needs before you apply.
How this fits with Medicaid
Medicaid.gov says Medicaid can help people who also have Medicare with premiums and out-of-pocket costs, and lists Medicare Savings Programs as one way. Medicare pays first, and Medicaid covers the rest up to the state's payment limit. Long-term care coverage uses a different set of rules. See Medicaid and long-term care and the Medicare vs Medicaid comparison.
Next steps
If you need care now, browse home care, home health care and nursing homes, or tell us what you need.
Looking for care?
Tell us your ZIP code and the type of care, and we will show providers that serve your area.
Common questions
What are Medicare Savings Programs?
They are four state-run programs that help people with limited income and resources pay Medicare costs: Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), Qualifying Individual (QI) and Qualified Disabled and Working Individual (QDWI). Each pays a different mix of premiums and out-of-pocket costs.
What does QMB pay for?
Medicare.gov says QMB is the broadest program. It pays Part A premiums if you do not have premium-free Part A, Part B premiums, and Part B deductibles, coinsurance and copayments for Medicare-covered services. Providers cannot bill you for those covered costs, though you may owe a small Medicaid copayment.
What is the income limit for Medicare Savings Programs?
Limits change every year and are higher in Alaska and Hawaii. Medicaid.gov expresses the federal income limits as a share of the federal poverty level: 100% for QMB, 120% for SLMB, 135% for QI and 200% for QDWI, each plus a small SSI income disregard. Check the Medicare.gov page for the current dollar amounts, and your state for its own rules.
Can I qualify if my income is over the limit?
Possibly. Medicare.gov says some states do not count certain types or amounts of income or resources, so you may qualify even if you are over the federal limits. It recommends applying anyway.
How do I apply?
You apply through your state, not Medicare. Contact your state Medicaid agency. QI is first-come, first-served in each year, and you must reapply every year.
Do these programs help with the cost of drugs?
Medicare.gov says people with QMB, SLMB or QI also get Extra Help with prescription drug costs.
Do these programs pay for home care or nursing homes?
No. They help with Medicare premiums and cost-sharing. Medicare does not pay for long-term custodial care. See our Medicare and Medicaid pages for what pays for long-term care.
Sources
- Medicare.gov: Medicare Savings Programs accessed October 27, 2026
- Medicaid.gov: Seniors and Medicare and Medicaid enrollees accessed October 27, 2026
- Medicare.gov: Medicare costs accessed October 27, 2026
- Medicare.gov: Long-term care accessed October 27, 2026
Review status: Carevo checked this page against the primary sources listed above. It has not been professionally reviewed by a registered nurse, licensed social worker, benefits counselor or attorney. See our editorial standards.
This page is general information, not financial, legal or medical advice. Rules and services vary by state and by individual circumstances. Use the official sources and decision-maker named on the page. Carevo is a connection platform, not a care provider.