Medicare Savings Programs and Extra Help: Lower Your Costs in 2026

Medicare is not free, and for millions of older adults and people with disabilities the premiums, deductibles, and copays add up to a real strain. What many do not realize is that there are federal and state programs specifically designed to lower — and sometimes nearly eliminate — those costs. The key takeaway: if your income and savings are modest, Medicare Savings Programs and Extra Help can save you thousands of dollars a year, yet millions of people who qualify never apply simply because they do not know these programs exist.

This guide explains the four Medicare Savings Programs (QMB, SLMB, QI, and QDWI), the separate Extra Help program that lowers prescription drug costs under Part D, who generally qualifies based on income and assets, what each program pays for, and how to apply. All of the 2026 dollar figures below are federal baselines that CMS and SSA update annually — and many states use higher limits — so treat them as approximate guideposts and confirm the current figures for your state before assuming you do or do not qualify.

Help Is Available — and Widely Underused

The government estimates that a large share of the people eligible for these programs are not enrolled. Part of the reason is that the names are confusing and the programs are administered by different agencies: the Medicare Savings Programs (MSPs) are run through your state Medicaid office, while Extra Help is run by the Social Security Administration. The encouraging news is that they work together. In fact, qualifying for any Medicare Savings Program automatically enrolls you in Extra Help, so a single application can unlock help with both your medical and your drug costs.

If your income is limited, it is almost always worth applying even if you are not sure you qualify. The asset rules exclude many things people assume would count against them, income limits are higher in some states, and there is no penalty for applying and being turned down. The worst outcome of applying is a "no"; the best outcome is hundreds of dollars back in your pocket every month.

The Four Medicare Savings Programs at a Glance

The Medicare Savings Programs are four related programs that help pay Medicare costs for people with limited income and resources. Each has its own income limit and its own set of benefits, but they follow a clear hierarchy — the lower your income, the more help you can get.

• QMB (Qualified Medicare Beneficiary) — the most generous; pays premiums and most cost-sharing.
• SLMB (Specified Low-Income Medicare Beneficiary) — pays your Part B premium.
• QI (Qualifying Individual) — also pays your Part B premium, but funding is limited and first-come, first-served.
• QDWI (Qualified Disabled and Working Individual) — pays the Part A premium for certain working people with disabilities under 65.

QMB: The Most Comprehensive

The Qualified Medicare Beneficiary (QMB) program offers the broadest help. It pays your Part A and Part B premiums and also covers Medicare deductibles, coinsurance, and copayments. Just as important, if you have QMB, providers are not allowed to bill you for Medicare cost-sharing on covered services — a protection known as the QMB balance-billing prohibition. If a doctor or hospital does send you a bill for those amounts, that is improper, and you can point them to your QMB status.

Because QMB pays the Part B premium, enrolling can immediately put roughly $202.90 a month back in your budget in 2026 just from the premium alone, before you count the savings on deductibles and coinsurance. QMB has the lowest income limit of the group, so it is aimed at those with the greatest need, but its benefits are by far the most complete.

SLMB and QI: Help With the Part B Premium

The Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI) programs are narrower: both pay your monthly Part B premium and nothing more. That single benefit is still worth about $202.90 a month in 2026 — roughly $2,435 a year — so it is far from trivial. SLMB has a somewhat higher income limit than QMB, and QI has a higher limit still.

Two important wrinkles set QI apart. First, its funding is capped each year and awarded first-come, first-served, so it pays to apply early in the year and to reapply annually. Second, you generally cannot receive QI if you also qualify for Medicaid. SLMB, by contrast, can be held alongside Medicaid. For most people who are just over the QMB line, SLMB or QI is the practical way to get the Part B premium covered.

QDWI: For Working People With Disabilities

The Qualified Disabled and Working Individual (QDWI) program is the outlier of the four and helps a specific group. It is for people under 65 who have a disability, have returned to work, and lost their premium-free Part A because their earnings rose above the threshold. QDWI pays the Part A premium for these individuals, which can otherwise be a substantial monthly cost.

Because QDWI is meant for working people, its income limit is much higher than the other three programs — often several times the federal poverty level — while its asset limit is comparatively low (commonly around $4,000 for an individual and $6,000 for a couple). If you are a younger Medicare beneficiary who went back to work and got a bill for Part A, QDWI is the program to ask your state Medicaid office about.

2026 Income and Asset Limits

The table below shows approximate 2026 federal monthly income limits for the three main programs. These figures are tied to the federal poverty level and are updated every year; they also typically include a small income disregard (about $20 a month), and several states set higher limits or have eliminated asset tests entirely. Use this as a rough guide, not a final answer.

For QMB, SLMB, and QI, the federal asset (resource) limit in 2026 is roughly $9,950 for an individual and $14,910 for a couple — though, again, some states are more generous or ignore assets altogether. Crucially, many things you own do not count: your primary home, one car, household goods and personal belongings, and a limited amount set aside for burial. Because these thresholds move each year and vary by state, do not disqualify yourself based on a rough guess; let your state Medicaid office make the determination.

Extra Help (Part D Low-Income Subsidy)

Extra Help, also called the Part D Low-Income Subsidy (LIS), is a separate federal program that slashes the cost of prescription drugs. For people who qualify, Extra Help can pay the Part D premium (up to a benchmark amount), eliminate the deductible, and cap copays at low fixed amounts — around $5.10 for generics and $12.65 for brand-name drugs in 2026. It also removes the Part D late-enrollment penalty for the months you qualify, and there is no coverage-gap "donut hole" to worry about.

In recent years the program was simplified so that everyone who qualifies now receives the full subsidy — the old partial-subsidy tier was eliminated. To qualify in 2026, your income generally must be below 150% of the federal poverty level — roughly $23,940 for an individual and $32,460 for a couple — with resource limits of $16,590 for an individual and $33,100 for a couple (rising to $18,090 and $36,100 if you tell Social Security you have set aside money for burial expenses). And remember: if you have Medicaid, SSI, or any Medicare Savings Program, you get Extra Help automatically without a separate application.

How to Apply

Applying is free, and you can pursue both types of help. To apply for Extra Help, contact the Social Security Administration — online at SSA.gov, by phone at 1-800-772-1213, or at a local Social Security office. To apply for a Medicare Savings Program, contact your state Medicaid office; when you apply for an MSP and are approved, you are automatically signed up for Extra Help too, so many people start there.

For free, unbiased help with either application, reach out to your State Health Insurance Assistance Program (SHIP), which offers one-on-one Medicare counseling at no cost. Gather basic documents before you start — proof of income, bank statements, and information about your resources — and do not let uncertainty stop you. Because eligibility rules and dollar limits change every year and differ by state, the surest way to find out whether you qualify is simply to apply.

The Bottom Line

If money is tight, these programs are among the most valuable benefits in all of Medicare. The four Medicare Savings Programs can cover your Part B premium and, with QMB, your deductibles and coinsurance too, while Extra Help can make prescription drugs affordable by wiping out the Part D deductible and capping your copays. Together they can be worth thousands of dollars a year, and qualifying for an MSP hands you Extra Help automatically.

The programs are underused mainly because people assume they earn too much, own too much, or would face too much hassle — assumptions that are often wrong. Apply through your state Medicaid office for an MSP and through Social Security for Extra Help, and lean on your local SHIP counselor for free guidance. Because the 2026 income and asset limits shown here are federal baselines that are indexed annually and vary by state, always confirm the current figures for where you live before deciding you do not qualify.