Medicare Savings Program Income Limits for 2026
October 13, 2026
Medicare Savings Programs (MSPs) are Medicaid-administered programs that pay some or all of your Medicare Part A and Part B premiums, deductibles, and coinsurance if your income and savings fall below limits tied to the federal poverty level (FPL), a threshold the U.S. Department of Health and Human Services (HHS) updates every January. For 2026, the four MSP tiers, Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), Qualifying Individual (QI), and Qualified Disabled and Working Individuals (QDWI), still follow the same federal percentage-of-poverty structure, but the exact dollar amounts shift slightly each year and vary by state and household size.
If you're trying to figure out whether you qualify in 2026, the fastest accurate answer comes from your state Medicaid agency or Medicaid.gov, since states finish updating their own 2026 limits at different points in the year. For the full picture of what Medicare costs in 2026, see our 2026 Medicare costs overview. This guide walks through how the four MSP tiers work, what each one pays for, and how to check your state's current numbers before you apply.
Quick Answer
Medicare Savings Program income limits for 2026 are set as a percentage of the federal poverty level: generally up to 100% of FPL for QMB, 120% for SLMB, and 135% for QI, plus a $20 monthly income disregard in most states. QDWI, a smaller program for working people under 65 with disabilities, allows income up to 200% of FPL. Because HHS updates the poverty guidelines each January and states apply the new figures on different timelines, the exact dollar limit for your household size and state can only be confirmed through your state Medicaid office or Medicare.gov, not from a single national number.
The Four Medicare Savings Program Tiers for 2026
Each Medicare Savings Program ties eligibility to a percentage of the federal poverty level, a benchmark set in federal statute that stays consistent even as the dollar figure behind it rises each year.
- Qualified Medicare Beneficiary (QMB): income at or below 100% of FPL. QMB pays your Part A and Part B premiums, deductibles, coinsurance, and copays. Federal Medicaid rules also bar providers from billing QMB enrollees for Medicare cost-sharing on covered services, which effectively functions like a $0 out-of-pocket maximum for Original Medicare, something Original Medicare doesn't otherwise guarantee.
- Specified Low-Income Medicare Beneficiary (SLMB): income above the QMB limit but at or below 120% of FPL. SLMB pays only your Part B premium, covered in our 2026 Medicare Part B premium guide.
- Qualifying Individual (QI): income above the SLMB limit but at or below 135% of FPL. QI also pays the Part B premium, but it draws from a capped annual federal allotment, so approval depends on your state's remaining funding and you must reapply every year.
- Qualified Disabled and Working Individuals (QDWI): income up to 200% of FPL, for people under 65 with a disability who lost premium-free Part A after returning to work, as determined by the Social Security Administration (SSA). QDWI pays only the Part A premium.
Most states subtract a $20 monthly general income disregard before comparing your income to these limits, which raises your practical income ceiling slightly above the percentages above. Resource (asset) limits apply too, and in 2023 the Centers for Medicare & Medicaid Services (CMS) aligned those limits with the resource test used for Part D's Extra Help program, removing a lower, separate asset ceiling that had disqualified some applicants.
Medicare Savings Program Tiers at a Glance
| Feature | Income Limit | What It Pays |
|---|---|---|
| QMB | Up to 100% of FPL | Part A & B premiums, deductibles, coinsurance, copays |
| SLMB | 100% to 120% of FPL | Part B premium only |
| QI | 120% to 135% of FPL | Part B premium only (limited annual funding) |
| QDWI | Up to 200% of FPL | Part A premium only |
Why This Differs From the IRMAA Surcharge
Medicare Savings Programs and the income-related monthly adjustment amount sit at opposite ends of the same income scale. MSPs lower costs for enrollees with limited income, while IRMAA raises Part B and Part D premiums for higher earners based on income reported two years earlier. According to KFF, millions of people with Medicare also qualify for Medicaid or a Medicare Savings Program because their income falls at or near the poverty level, a sign of how many enrollees rely on these programs to afford basic Medicare costs. If your income changed significantly this year, in either direction, it's worth checking both your MSP eligibility and your IRMAA bracket, since the two use different income-counting rules and different data years.
Check Your State's Exact 2026 Limits
Income and resource limits differ by state, and a few states, including Alaska and Hawaii, use higher federal poverty guidelines than the rest of the country. Some states also apply more generous income disregards or set higher resource limits than the federal minimum. Confirm your state's current 2026 Medicare Savings Program limits through your state Medicaid agency or Medicaid.gov before you apply, since a national average can be off by hundreds of dollars a month for your specific state.
Could You Qualify for a Medicare Savings Program in 2026?
- My monthly income is close to or below the federal poverty level for my household size
- I'm enrolled in Medicare Part A, Part B, or both
- I'm having trouble affording my Part B premium, deductible, or coinsurance
- My savings and other countable resources are limited
- I haven't checked my Medicare Savings Program eligibility in the past year
How to Apply for a Medicare Savings Program
Find your state Medicaid office
Medicare Savings Programs are administered by state Medicaid agencies, not Medicare or Social Security, so you apply through your state's Medicaid or human services office.
Gather income and asset documentation
Bring recent pay stubs, Social Security award letters, bank statements, and any other proof of income and resources your state requests.
Submit your application
Most states accept MSP applications online, by mail, or in person, and some let you apply for Medicaid and an MSP at the same time.
Watch for a determination and reapply if required
QI approval is funded year by year, so even approved QI recipients must reapply annually; QMB, SLMB, and QDWI typically renew on your state's regular redetermination schedule.
Get Help Understanding Your Medicare Costs
If you're not sure whether a Medicare Savings Program, Extra Help, or a different plan change fits your situation, get free, plain-language guidance before you decide.
Frequently Asked Questions
Yes. HHS updates the federal poverty guidelines each January, and most states adjust their Medicare Savings Program income limits for the new year within the following weeks or months. Some states apply the updated limits retroactively to January 1.
It depends on the tier. QMB, SLMB, and QI pay Medicare premiums and, for QMB, cost-sharing on Original Medicare, but qualifying for any MSP tier also enrolls you automatically in Part D Extra Help, which lowers your drug plan premium, deductible, and copays. MSPs don't directly pay Medicare Advantage premiums beyond the Part B premium they already cover.
Some states apply additional income disregards beyond the standard $20 general exclusion, so your countable income may be lower than your total income once those are applied. If you're close to the limit, apply anyway and let your state Medicaid agency calculate your countable income rather than assuming you don't qualify.
Medicare Savings Programs apply only once you're enrolled in Medicare, and HSA contribution rules generally stop once Medicare Part A or Part B coverage begins. Existing HSA funds you've already saved typically count toward your state's resource limit, so check with your state Medicaid agency on how your specific account is treated.