Here’s a secret too few families know: if money is tight, your state’s Medicaid program may pay your Medicare premiums for you — and sometimes your deductibles and copays too. These are the Medicare Savings Programs, and every single year I met people who had qualified for ages and never knew. Let’s fix that.
There are three of them, and which one fits depends on your income compared to the Federal Poverty Level (FPL) — in 2026 that’s $15,650 a year for one person (Source: HHS). Here’s what each one does:
QMB — Qualified Medicare Beneficiary. The most generous. If your income is at or below 100% of the poverty level, QMB pays your Part A and Part B premiums and your deductibles, coinsurance, and copays (Source: Medicare.gov). For someone on QMB, a doctor visit can cost almost nothing.
SLMB — Specified Low-Income Medicare Beneficiary. If your income is a bit higher — between 100% and 120% of the poverty level — SLMB pays your Part B premium. That’s $202.90 a month back in your pocket in 2026 (Source: Medicare.gov).
QI — Qualifying Individual. Higher still, between 120% and 135% of the poverty level, QI also pays your Part B premium. One catch: QI has limited funding each year and is first-come, first-served, so apply early in the year (Source: Medicare.gov).
All three also have a savings (asset) limit — in 2026, about $9,660 for one person or $14,470 for a couple. But take heart: not everything counts. Your home and usually one car don’t count against you (Source: Medicare.gov).
And here’s the bonus most people miss: if you qualify for any of these three, you automatically qualify for Extra Help, which slashes your prescription drug costs too. One application can lighten several bills at once.
Ada’s Bottom Line
1. The Medicare Savings Programs use Medicaid to pay your Medicare premiums — and with QMB, your deductibles and copays too.
2. Which one depends on income vs. the poverty level: QMB (at/below 100%), SLMB (100–120%), QI (120–135%). All have an asset limit, but your home and a car usually don’t count.
3. Qualifying also unlocks Extra Help for prescription costs. Don’t assume you earn too much — so many people are wrong about that.
The income and asset rules can be confusing, and some income (like a little from working) is sometimes set aside, so please don’t rule yourself out. To see the programs and help you personally qualify for — with your own numbers — use GoldieCircle’s free Benefits Checker (the “Find Benefits” option in Ask Goldie). For free, unbiased one-on-one Medicare counseling, your local SHIP counselor is a wonderful resource (Source: Medicare.gov). You can also apply through your State Medicaid office.
Ada spent more than 30 years as a SHIP benefits counselor helping seniors and families understand Medicare, Medicaid, and the programs that help pay for them. Confused by a letter, a form, or a bill? Ask Ada.
💡 Have a question for Ada? Use “Questions from readers” just above — Ada answers within the hour. Comments here are for sharing with other members (but Ada reads them too).
Loading comments…