The Four MSP Categories
Qualified Medicare Beneficiary (QMB): Income at or below 100% FPL ($1,255/month individual in 2026). Pays: Part A and Part B premiums, deductibles, coinsurance, and copays. Providers are legally prohibited from billing QMB enrollees for any Medicare cost-sharing — if billed, you can refuse to pay and report it to 1-800-MEDICARE.
Specified Low-Income Medicare Beneficiary (SLMB): Income 100–120% FPL ($1,507/month individual). Pays: Part B premium only.
Qualifying Individual (QI): Income 120–135% FPL ($1,695/month individual). Pays: Part B premium. QI has limited slots funded annually — apply early in the calendar year.
Qualified Disabled Working Individual (QDWI): For people under 65 with disabilities who are working and no longer receiving SSI. Income up to 200% FPL. Pays: Part A premium.
Income and Asset Limits for 2026
| MSP | Individual Monthly Income | Couple Monthly Income |
|---|---|---|
| QMB | Up to $1,255 | Up to $1,703 |
| SLMB | Up to $1,507 | Up to $2,044 |
| QI | Up to $1,695 | Up to $2,299 |
Asset limits exist but have important exclusions: home, car, household goods, burial plot, and life insurance up to certain values are excluded. The net asset calculation often makes more people eligible than the simplified limits suggest — apply and let your state determine eligibility.
What Each MSP Pays
QMB is the most comprehensive — it pays both Part A and Part B premiums plus all Medicare deductibles and copays. For someone with high Medicare utilization, QMB can save thousands annually. Importantly, any provider who tries to bill a QMB member for Medicare cost-sharing is violating federal law. SLMB and QI pay only the Part B premium — still $174.70/month ($2,096/year) in 2026, a meaningful annual savings for fixed-income households.
How to Apply
Apply through your state Medicaid agency — not through Social Security or Medicare. Search "[your state] Medicare Savings Programs" or call your state Medicaid agency. Documentation: proof of Medicare enrollment, income documentation, and asset information. Processing takes up to 45 days. MSP enrollment is retroactive to the first of the month you applied in most states — premium savings begin from application month even if processing takes weeks.
Automatic Enrollment Through Extra Help
If enrolled in Extra Help (the Part D subsidy), Social Security automatically checks whether you qualify for SLMB or QMB and notifies your state Medicaid agency. You may be automatically enrolled without a separate application. However, this process isn't 100% reliable — if you qualify for an MSP but haven't been enrolled, apply directly through your state Medicaid office.
MSPs and Extra Help Together
MSPs and Extra Help are complementary — MSPs reduce or eliminate Part A/B costs; Extra Help nearly eliminates Part D costs. QMB or SLMB combined with Full Extra Help can reduce annual Medicare costs from thousands of dollars to effectively zero. Apply for both simultaneously. See Extra Help for Prescription Costs for the Extra Help application guide.