Medicare Part B premium help

What are the Medicare Savings Programs?

Four federal programs, created in 42 U.S.C. § 1396a(a)(10)(E), pay Medicare costs for people with limited income and resources. Social Security's operations manual describes them plainly: "The Medicare Savings Programs (MSPs) are mandatory Medicaid eligibility groups that assist low-income Medicare beneficiaries with some or all of their Parts A and B premiums and cost-sharing. State Medicaid agencies determine whether or not an individual is eligible for Medicaid coverage, including the MSPs." Every state must offer them.

Source: 42 U.S.C. § 1396a(a)(10)(E) and § 1396d(p)(3); Medicare.gov Medicare Savings Programs page.

QMB, SLMB, and QI all cover the Part B premium in full; QMB goes further and covers cost-sharing too. QDWI is the outlier. It touches Part A only and serves a specific group described below. The next several sections take the programs one at a time.

Will Medicaid pay my Medicare Part B premium?

Yes, if your income and resources fit within your state's limits, through a Medicare Savings Program. The mechanism matters for where you apply: these programs are not merely administered alongside Medicaid, they are Medicaid eligibility groups. Your state's Medicaid agency takes the application, applies the rules, and, on approval, starts paying the premium on your behalf. Medicare.gov puts the routing in one line: "These programs are run by your state. Contact your state to apply."

The premium at stake is the standard 2026 Part B premium of $202.90 per month, itemized on the 2026 Medicare Part B premium page. For someone living on a Social Security check of $1,300 a month, that premium consumes more than 15 percent of income. The programs exist for exactly that arithmetic.

Who qualifies in 2026? The income and resource limits

The 2026 federal limits below are effective February 26, 2026, from SSA POMS HI 00815.023. They are monthly figures, and each already includes the $20 general income disregard, so compare them against your countable monthly income as your state calculates it, not against an annual total. Multiplying by 12 produces a number no agency publishes, which is why this page stays monthly.

Source: SSA POMS HI 00815.023 (TN 64, effective 02/26/2026), corroborated by Medicare.gov. FPL is the federal poverty level. All income limits include the $20 monthly SSI general income exclusion; the QDWI figures also incorporate earned-income disregards, so its limit is not a plain 200 percent of poverty. CMS rounds monthly limits up to the nearest dollar. Limits track the poverty guidelines and reset early each year; this table is refreshed when POMS reissues.

Spelled out: a single person qualifies for QMB in 2026 with countable monthly income up to $1,350, for SLMB up to $1,616, and for QI up to $1,816. A couple's ceilings are $1,824, $2,184, and $2,455. Resources, meaning assets like bank accounts and investments as your state counts them, must stay at or below $9,950 for one person or $14,910 for two in all three programs.

These are floors, not the final word. Federal law lets states disregard additional income and resources for QMB, SLMB, and QI, so a state can be looser than this table but never tighter. POMS notes that "Some states have used this authority to effectively eliminate resources tests when determining eligibility for these MSP eligibility groups." The same manual tells SSA's own staff: "Even if the individual's income or resources appear somewhat higher than the state limits, encourage them to apply for the MSPs." Medicare.gov repeats the advice to the public: "You may still qualify for these programs in your state even if your income or resources are higher than the federal limits listed." Looking slightly over the line is not a reason to skip the application.

What does the QMB program cover?

Start with the protection, because it is the part nobody leads with. A person enrolled in QMB cannot legally be billed for Medicare cost-sharing. Medicare.gov states it without qualification: "Medicare providers aren't allowed to bill you for services and items Medicare covers, including deductibles, coinsurance, and copayments." The statute behind that sentence, 42 U.S.C. § 1396a(n)(3)(B), says the beneficiary "shall not have any legal liability to make payment" to the provider for those amounts. A provider who bills a QMB enrollee for a Medicare deductible is breaking federal law, not offering a payment plan.

The coverage itself is defined in 42 U.S.C. § 1396d(p)(3): Part A premiums for those who owe them, Part B premiums, deductibles, coinsurance, and the 20 percent share Medicare normally leaves to the patient. Most people get Part A premium-free, so for a typical enrollee QMB means the $202.90 Part B premium plus essentially all Medicare out-of-pocket costs. You may still get a bill for a small Medicaid copayment where your state charges one.

Timing is the fine print. QMB coverage begins after the month your state makes the determination and is not retroactive. SLMB and QI assistance, by contrast, can reach back up to three months before the application. States administer these start dates, so your state confirms the exact ones.

What do SLMB and QI pay for?

Both pay one bill: the Part B premium. Neither touches deductibles or coinsurance. Both require you to have Part A and Part B, and both use the same resource limits as QMB with higher income ceilings, $1,616 single for SLMB and $1,816 for QI in 2026.

QI carries three rules of its own, all from 42 U.S.C. § 1396u-3. You must reapply every year; Medicare.gov: "You must apply every year to stay in the QI Program." Funding comes from a capped annual allocation to each state, and states approve applications first-come, first-served, with priority for people who received QI benefits at the end of the previous year. QI is also reserved for people who qualify for no other Medicaid coverage; eligibility elsewhere in Medicaid closes QI to you, though QMB or SLMB may not be. The first-come rule means applications earlier in a state's funding year face less risk of the allocation running out, and a lapsed renewal surrenders the priority given to existing enrollees.

What is QDWI?

The Qualified Disabled and Working Individual program covers one narrow situation. It is for people with a disability who returned to work, earned enough that their Social Security disability benefits ended, and lost premium-free Part A along with them. Under 42 U.S.C. § 1396d(s), QDWI pays their Part A premium so they can keep hospital coverage while working. That premium is $311 a month in 2026 for people with 30 to 39 quarters of Medicare-covered work, and $565 with fewer than 30 quarters.

QDWI does nothing for the Part B premium, and its income figures in the table above are not comparable to the other rows: they embed earned-income disregards on top of the $20, which is why a working person can qualify at $5,405 a month. It is also the one program with no automatic drug-cost help, covered two sections down.

How do I apply for a Medicare Savings Program?

Through your state Medicaid agency. That is the answer for every state, and it is also the answer to "what is the limit in my state," since states may layer their own disregards over the federal floor. Medicare.gov's Medicare Savings Programs page routes you to your state's contact, and the State Health Insurance Assistance Program (shiphelp.org) offers free one-on-one counseling for the application itself. Neither charges anything.

A second door exists, and few people know it is the same door. Filing the Social Security application for Extra Help with drug costs, form SSA-1020, starts an MSP application automatically. POMS HI 00815.025: "An Application for Extra Help with Medicare Prescription Drug Plan Costs (SSA-1020) starts the application process for the Medicare Savings Programs (MSP) unless the beneficiary objects. SSA transmits data from the Extra Help application decision to the appropriate state Medicaid agency to begin the MSP process." One form, two programs.

Approval changes the premium's payer, not your coverage. The state "buys in," taking over the premium; for people paying by Social Security deduction the withholding stops, and for people billed directly the premium bill goes away. CMS's buy-in manual describes the result: enrollees "see a notable increase in their monthly payments." For 2026 that increase is the full $202.90 a month.

Do these programs help with drug costs too?

Enrollment in QMB, SLMB, or QI automatically qualifies you for the full Part D low-income subsidy, called Extra Help, under 42 CFR § 423.773(c)(1). No second application, no second income test. QDWI is not on that deeming list, so it carries no automatic drug benefit.

Extra Help caps what you pay at the pharmacy. Medicare.gov: "You'll pay no more than $12.65 in 2026 for each drug covered by your Medicare drug plan." Once deemed, the status runs through the end of the calendar year, or through the following year as well if you are deemed between July and December. Drug coverage carries its own income-based surcharge at the top of the income scale, described on the Part D IRMAA page; Extra Help and that surcharge sit at opposite ends of the same premium system.

What is the Medicare Part B giveback?

The giveback is a Medicare Advantage plan feature, not a government assistance program, and it has no income test. It comes from 42 CFR § 422.266(b)(3): when an MA plan bids below its county benchmark, it keeps 50, 65, or 70 percent of the savings depending on its star rating, and it may credit some or all of that rebate "toward reduction of the Medicare Part B premium." Social Security's manual calls the feature the Medicare Advantage Reduction, or MARD, and notes that "The amount of the reduction may vary among plans."

Medicare.gov keeps its description to one careful sentence: some plans "will help pay all or part of your Part B premium, but this isn't available in all areas." That is the full verified claim. Where a giveback plan exists, nothing new arrives in the mail and no money changes direction: whatever already collects your premium simply collects less of it. The CMS manual is explicit that the reduction "cannot be paid to the beneficiary."

How big is the giveback really?

Smaller than the advertising, in most places. CMS documented this itself in an April 2023 rule (88 FR 22120). In 2021, national advertisements told beneficiaries they "could get up to $144 back" on their Social Security checks. CMS then looked at where such plans existed: during 2021 and 2022, the only states or territories with reductions of $140 or more were California, Florida, and Puerto Rico, and beneficiaries in more than 60 percent of states could reach at most a $99 reduction in 2022. CMS's conclusion, in its own words, was that advertising the top figure nationally is "potentially misleading."

This page publishes no maximum giveback figure and no count of giveback plans, because no primary source supports a stable number for either. Whether any plan in your county offers a reduction, and how much, is a question for the Medicare Plan Finder at medicare.gov or a SHIP counselor. And the framing matters more than the amount: a giveback plan is still a Medicare Advantage plan, with its own provider network, drug formulary, and cost-sharing. Choosing one is a coverage decision. The premium reduction is a line item inside that decision, never a reason to skip reading the rest of the plan.

Does the giveback lower IRMAA or a late enrollment penalty?

No. The regulation reaches only the standard premium: the rebate credit applies to the Part B premium "determined without regard to" the subsections of the law that create the late enrollment penalty and the income-related surcharge. A Part B giveback cannot offset an IRMAA surcharge, cannot reduce a late enrollment penalty, and cannot be paid out as cash. Someone paying $284.10 a month because of a first-tier IRMAA surcharge keeps paying the full $81.20 surcharge inside a giveback plan; only the standard $202.90 portion can shrink. No advertisement says this. The regulation does.

What if my income is too high for any of this?

This site spends its other pages on the opposite problem: people who pay more than $202.90 because their income is high. The same premium has a dial at each end. IRMAA raises it, starting above $109,000 in 2024 MAGI for a single filer, and the Medicare Savings Programs lower it or erase it. The two systems share nothing but the bill they adjust.

Sources: CMS 2026 premium tables; 42 U.S.C. § 1396d(p)(1); SSA POMS HI 00815.023.

The income definitions do not even rhyme. IRMAA reads adjusted gross income plus tax-exempt interest off a return filed two years ago, a figure assembled on the how to calculate MAGI for IRMAA page, while an MSP application counts this month's income under Supplemental Security Income rules. The full surcharge schedule sits in the 2026 IRMAA brackets.

If you landed here because your premium jumped, not because it is unaffordable, you are probably an IRMAA case. Type your 2024 MAGI and filing status into the IRMAA calculator to see which tier produced the new bill. And if the income behind that surcharge has since dropped after retirement or another life event, Form SSA-44 asks Social Security to use your lower current income; the IRMAA appeal paths page covers the rest of the correction routes.