Quick answer: Medicare Savings Programs are run by states and help pay Medicare premiums and, for the lowest-income group, deductibles and coinsurance. For 2026, Medicare.gov lists federal monthly income limits from $1,350 (QMB) to $1,816 (QI) for an individual, with a $9,950 resource limit. Extra Help is a federal program for Part D drug costs; its 2026 limits are $23,940 in yearly income and $18,090 in resources for an individual. Anyone who qualifies for a Medicare Savings Program gets Extra Help automatically. Apply for Medicare Savings Programs through your state Medicaid office and for Extra Help through Social Security.
Medicare is not free. Part B alone costs $202.90 a month in 2026 for most people, and deductibles, coinsurance and drug costs come on top. For someone living on a modest Social Security check, those costs can take a large share of income.
Two kinds of help exist for people with limited income and savings: state-run Medicare Savings Programs and the federal Extra Help program for prescription drugs. Many people who would qualify never apply, often because they assume their income is too high or do not know the programs exist. This guide explains each program, the 2026 limits and how to apply. For the wider picture of how Medicare costs work, see our complete guide to Medicare.
Figures below come from Medicare.gov’s Medicare Savings Programs and Help with drug costs pages and the Social Security Administration’s Extra Help page, checked October 2026. Limits change every year, and some states use higher limits than the federal ones. This is general information, not legal or financial advice.
The Two Kinds of Help at a Glance
Before the details, it helps to see how the programs divide the work.
| Program | Run by | Helps pay | Where to apply |
|---|---|---|---|
| Medicare Savings Programs (QMB, SLMB, QI, QDWI) | Your state | Part A and/or Part B premiums; QMB also covers deductibles, coinsurance and copays | State Medicaid office |
| Extra Help (Part D Low-Income Subsidy) | Federal government | Part D premiums, deductibles and drug copays | Social Security, or automatic for some |
The programs connect. According to Medicare.gov’s Help with drug costs page, you get Extra Help automatically if you have full Medicaid, get help from your state paying Part B premiums through a Medicare Savings Program, or receive Supplemental Security Income (SSI). Applying for Extra Help through Social Security also starts a Medicare Savings Program application with your state, unless you tell Social Security not to send your information.
The Four Medicare Savings Programs and Their 2026 Limits
Medicare.gov’s Medicare Savings Programs page describes four programs. Your state decides which one you qualify for when you apply. The income limits below are monthly, and they are slightly higher in Alaska and Hawaii.
Qualified Medicare Beneficiary (QMB) Program
QMB is the most generous program. It helps pay Part A premiums (for people who do not have premium-free Part A) and Part B premiums, deductibles, coinsurance and copayments for services Medicare covers.
| QMB, 2026 | Monthly income limit | Resource limit |
|---|---|---|
| Individual | $1,350 | $9,950 |
| Married couple | $1,824 | $14,910 |
Under QMB, Medicare providers are not allowed to bill you for Medicare-covered services and items, including deductibles, coinsurance and copays. You may still owe a small Medicaid copayment if one applies. Medicare.gov advises showing both your Medicare card and your Medicaid or QMB card each time you get care.
Specified Low-Income Medicare Beneficiary (SLMB) Program
SLMB helps pay Part B premiums only. You must have both Part A and Part B.
| SLMB, 2026 | Monthly income limit | Resource limit |
|---|---|---|
| Individual | $1,616 | $9,950 |
| Married couple | $2,184 | $14,910 |
Qualifying Individual (QI) Program
QI also helps pay Part B premiums, for people with somewhat higher incomes. It works differently from the others in three ways: you must reapply every year, states approve applications first come, first served (with priority for people who had QI the year before), and you cannot get QI if you qualify for any other Medicaid coverage.
| QI, 2026 | Monthly income limit | Resource limit |
|---|---|---|
| Individual | $1,816 | $9,950 |
| Married couple | $2,455 | $14,910 |
Qualified Disabled and Working Individual (QDWI) Program
QDWI helps pay the Part A premium for people under 65 who have a disability, are working, and lost premium-free Part A and Social Security disability benefits because they returned to work.
| QDWI, 2026 | Monthly income limit | Resource limit |
|---|---|---|
| Individual | $5,405 | $4,000 |
| Married couple | $7,299 | $6,000 |
Why You Should Apply Even if You Think You Are Over the Limit
Medicare.gov says plainly that you should apply even if you do not think you qualify. Several reasons support that advice.
States can be more generous
Medicare.gov notes that you may qualify in your state even if your income or resources are higher than the federal limits, because some states do not count certain types or amounts of income or resources. A few states have no resource test at all for some programs. The only way to know is to apply or ask your State Health Insurance Assistance Program (SHIP).
Not all income counts
Program rules exclude some income when deciding eligibility, and Medicare.gov publishes details on what counts toward income and resource limits. The numbers on your Social Security statement may not be the number the state uses.
Not all assets count
Resources generally include money in checking and savings accounts, stocks and bonds. Medicare.gov explains that your home, one car, a burial plot, household goods and certain burial funds up to a set amount are generally not counted. People with a paid-off house and a small savings account often fall under the limit.
Extra Help: Lower Drug Costs Through Part D
Extra Help, also called the Part D Low-Income Subsidy, lowers the cost of Medicare drug coverage. It pays toward Part D premiums, deductibles and copays.
Who qualifies
For 2026, Medicare.gov lists these limits:
| Extra Help, 2026 | Yearly income limit | Resource limit |
|---|---|---|
| Individual | $23,940 | $18,090 |
| Married couple | $32,460 | $36,100 |
As with Medicare Savings Programs, the limits may go up each year, and different limits apply in Alaska and Hawaii. Extra Help is not available in Puerto Rico or the U.S. territories, which have their own programs through their Medicaid offices.
What you pay with Extra Help
People in a Medicare Savings Program pay no more than $12.65 for each covered drug in 2026, according to Medicare.gov. For 2027, Medicare.gov lists these amounts for people with Extra Help:
- Plan premium: $0 on qualifying plans.
- Plan deductible: $0.
- Up to $5.80 for each generic drug and up to $14.40 for each brand-name drug at a participating pharmacy.
- Once total drug costs, including payments made on your behalf, reach $2,400, you pay nothing for covered drugs for the rest of the year.
People with full Medicaid who are also in QMB pay no more than $4.90 per covered drug in 2027.
No Part D penalty
You also do not pay a Part D late enrollment penalty while you get Extra Help. That matters for anyone who went without drug coverage after first becoming eligible. Our explainer on how Part D formularies and tiers work covers the rest of the drug benefit.
Help stays through December
If you qualify, you keep Extra Help through December 31 even if your income changes mid-year. If you still meet the limits for the next year, it continues; Medicare or Social Security only sends a notice if you no longer qualify or your plan is changing.
How to Apply
The two programs have different front doors, but one application can start both.
Medicare Savings Programs
Contact your state Medicaid office. Many states accept applications online, by mail or in person, and some have a short form just for Medicare Savings Programs. Have these ready:
- Your Medicare card and Social Security number.
- Proof of income, such as a Social Security benefit letter, pension statements and pay stubs.
- Bank statements and statements for any investments or retirement accounts.
- Proof of address and identity.
Extra Help
The Social Security Administration’s Extra Help page lets you apply online at any time, before or after you join a Part D plan. You can also call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) to apply by phone. Social Security suggests gathering bank statements and tax returns, IRA or 401(k) balances, and statements for pensions, veterans benefits, annuities and Railroad Retirement benefits for you and your spouse.
What happens next
If you qualify for Extra Help and are not in a drug plan, Medicare enrolls you in one automatically so you can use the savings, and you can pick a different plan if you prefer. Medicare.gov also notes that people with Medicaid or Extra Help may be able to change drug coverage more often than other people, rather than waiting for the fall open enrollment period.
Free help applying
SHIP counselors can help you complete applications at no cost. Find your local office at SHIPhelp.org or by calling 1-800-MEDICARE (1-800-633-4227).
How These Programs Interact With Other Medicare Costs
Qualifying for help can change other parts of your Medicare picture.
Part B penalty relief
Medicare.gov’s late enrollment penalty page says you generally will not pay a Part B late enrollment penalty if you enroll in a Medicare Savings Program. For someone who delayed Part B and now faces a lifetime surcharge, that can be significant.
Part B enrollment outside the usual windows
Some states let people who qualify for a Medicare Savings Program enroll in Part B outside the normal enrollment periods. Ask your state Medicaid office or SHIP whether this applies to you.
Income-related premiums
At the other end of the scale, higher earners pay extra for Part B and Part D through IRMAA. These programs and IRMAA never overlap, but both depend on income reporting, so keep your information current with Social Security. Our guide to Medicare premiums and IRMAA explains the higher-income side.
Temporary drug coverage
Medicare’s Limited Income Newly Eligible Transition (LI NET) program gives temporary Part D coverage to people who qualify for Extra Help or Medicaid but are not yet in a drug plan. Medicare.gov says you may be able to get money back for covered drugs you paid for after you qualified; call LI NET at 1-800-783-1307.
Common Mistakes That Cost People Help
Small errors keep many eligible people from getting help, or cause them to lose it.
- Not applying because of the federal number. State rules can be more generous, and some income and assets do not count.
- Forgetting to renew QI. The Qualifying Individual program requires a new application every year.
- Paying bills you do not owe. If you are in QMB and a provider bills you for Medicare cost-sharing, Medicare.gov explains you are protected. Show your QMB proof and call 1-800-MEDICARE if billing continues.
- Missing mail from the state or Social Security. Renewal forms and requests for information have deadlines. Update your address with both.
- Assuming a pharmacy charge is right. If you have Extra Help and think you are paying the wrong amount, Medicare.gov says to contact your drug plan first, then 1-800-MEDICARE.
- Skipping Part D because drugs are cheap now. With Extra Help, many plans cost nothing, and enrolling avoids a future penalty.
Quick Self-Check
Answer these to decide whether to apply now:
- Is your monthly income near or below about $1,800 as a single person, or about $2,450 as a couple? Apply for a Medicare Savings Program.
- Is your yearly income below about $24,000 single or $32,500 married, with savings under about $18,000 or $36,000? Apply for Extra Help.
- Do you receive SSI or full Medicaid? You should already have Extra Help; check your mail or call 1-800-MEDICARE.
- Are you unsure? Apply anyway, or call SHIP for a free screening.
If you are new to Medicare, our plain-English overview of Medicare Parts A, B, C and D explains which costs these programs are helping with.
Frequently Asked Questions
What is the difference between a Medicare Savings Program and Extra Help?
Medicare Savings Programs are state programs that help pay Part A and Part B costs, mainly premiums. Extra Help is a federal program that lowers Part D prescription drug costs. If you qualify for a Medicare Savings Program, you automatically get Extra Help.
What are the 2026 income limits for QMB?
Medicare.gov lists $1,350 a month for an individual and $1,824 for a married couple, with resource limits of $9,950 and $14,910. Some states use higher limits.
Does my house count as a resource?
Generally no. Medicare.gov explains that your home, one car, a burial plot and household goods are not counted. Bank accounts, stocks and bonds usually are.
How do I apply for Extra Help?
Apply online through Social Security, or call 1-800-772-1213. You can apply at any time of year.
Will I pay a Part D penalty if I get Extra Help?
No. Medicare.gov says you do not pay the Part D late enrollment penalty while you receive Extra Help.
Do I have to reapply every year?
For QI, yes. For other Medicare Savings Programs, your state will tell you its renewal schedule. Extra Help continues automatically if you still qualify; you only get a notice if something changes.
Sources
- Medicare.gov, Medicare Savings Programs (2026 income and resource limits for QMB, SLMB, QI and QDWI).
- Medicare.gov, Help with drug costs (Extra Help 2026 limits, 2027 copays, LI NET).
- Medicare.gov, Avoid late enrollment penalties.
- Social Security Administration, Apply for Medicare Part D Extra Help.
- CMS, 2026 Medicare Parts A and B premiums and deductibles fact sheet.
