Medicare Savings Programs and Extra Help
Four programs pay the Medicare premiums of people with limited income, and a fifth pays most drug costs. Answer two questions to see where your figures sit against the federal limits for QMB, SLMB, QI and QDWI, plus Part D Extra Help. Those federal numbers are a floor many states exceed, so this is an estimate, never a decision.
Works offline — your inputs never leave this device. How that works
Two questions
That is all this needs. We do not ask for your name, your address, your phone number or your Social Security number, and nothing you type here leaves your own browser.
Married couples living together are measured against the couple's figures, even when only one of you has Medicare.
Social Security, a pension, wages, anything regular. A rough figure is enough — states do not count every dollar, and several disregard some of it entirely.
Where your figure sits
Premium programs your figure is under
2 of 3
QDWI is counted separately — it is a special case, and it has its own card below
Part D Extra Help
Under the limit
$18,000 a year against a limit of $23,940
Most complete help your figure reaches
SLMB
$116 a month below its federal limit
These federal figures are a floor, not a test
The figures on this page are the FEDERAL limits. They are a floor, not a test. In Medicare.gov's own words: "You may still qualify for these programs in your state even if your income or resources are higher than the federal limits listed. Some states don't count certain types or specific amounts of income or resources when deciding who qualifies." Several states use higher income limits, and several disregard assets entirely.
So read the rows below as "worth asking about", never as "no". The one thing that settles it is an application, and it costs nothing to make one.
The four programs
All four are run by your state Medicaid office, and being in any of them brings Extra Help with prescription drugs automatically, without a second application.
QMB — Qualified Medicare Beneficiary Program
Your monthly figure is $150 above the federal income limit — still worth applying
- Federal monthly income limit
- $1,350 a month
- Federal countable resource limit
- $9,950
What it helps pay for
- Part A premiums, if you do not have premium-free Part A
- Part B premiums
- Deductibles, coinsurance and copayments for services and items Medicare covers
SLMB — Specified Low-Income Medicare Beneficiary Program
Your monthly figure is $116 below the federal income limit
- Federal monthly income limit
- $1,616 a month
- Federal countable resource limit
- $9,950
What it helps pay for
- Part B premiums
QI — Qualifying Individual Program
Your monthly figure is $316 below the federal income limit
- Federal monthly income limit
- $1,816 a month
- Federal countable resource limit
- $9,950
What it helps pay for
- Part B premiums
QDWI — Qualified Disabled & Working Individual Program
Your monthly figure is $3,905 below the federal income limit
- Federal monthly income limit
- $5,405 a month
- Federal countable resource limit
- $4,000
What it helps pay for
- Part A premiums only
Savings, and what is not counted
The resource test is where most people talk themselves out of applying, usually because they are counting things that are not counted. Your home, one car, a burial plot and household belongings are outside the test in the federal rules.
Extra Help with prescription drugs
Extra Help is the Part D low-income subsidy, and it goes through a different front door: you apply to Social Security, not to your state. One application can start both — when you apply for Extra Help, Social Security passes the information to your state to open a Medicare Savings Program application unless you tell them not to on the form.
Annual income limit
$23,940
Your figure works out to $18,000 a year
Resource limit
$18,090
Savings and investments, not your home
What Extra Help covers once it is granted
- Drug plan premium
- $0.00
- Drug plan deductible
- $0.00
- Most you pay for a generic
- $5.10
- Most you pay for a brand name
- $12.65
- Covered drugs cost nothing after
- $2,100 of drug spending
Apply to Social Security, not to Medicare — online, by phone on 1-800-772-1213, or at an appointment. Your local State Health Insurance Assistance Program (SHIP) will help you fill in the form for free.
You already have Extra Help, without applying, if you have
- Full-benefit Medicaid coverage
- Help from your state paying your Part B premiums, through any Medicare Savings Program
- Supplemental Security Income (SSI) payments from Social Security
Extra Help is not offered in Puerto Rico, U.S. Virgin Islands, Guam, Northern Mariana Islands, American Samoa. Those territories run their own pharmaceutical assistance instead.
This is not a decision, and we cannot make one
Nothing on this page decides anything. Only your state Medicaid office — and, for Extra Help, Social Security can, and the only way to find out is to apply. People who are over a published limit are approved every day, because states count income and savings differently from the way a household counts them.
Applying costs nothing, and nobody may charge you a fee to file an initial application for these benefits. If someone offers to do it for a fee, for a share of any back payment, or as part of buying an insurance policy or an annuity, that is the moment to stop and call your free state counseling program instead. An elder-law attorney charging for advice about property or a transfer is a different thing, and a legitimate one.
What the source says about these limits
These are the standing notes stored with the figures, so they travel with the numbers rather than living in page copy someone can forget to update.
- Nothing here is a determination. Only your state Medicaid office can decide a Medicare Savings Program application, and only Social Security can decide Extra Help. If you are anywhere near these numbers — or even over them — apply. Take-up of these programs is low mostly because people screen themselves out.
- Two different front doors, and this is what trips people up. Extra Help (the Part D subsidy) is applied for through Social Security. The four Medicare Savings Programs are applied for through your state Medicaid office. One application can start both: when you apply for Extra Help, Social Security sends the information to your state to begin a Medicare Savings Program application unless you tell them not to on the form.
- Getting a Medicare Savings Program is worth more than the premium it pays. Anyone enrolled in any of the four programs automatically gets Extra Help with prescription drugs as well, without a separate application.
- Income limits are slightly higher in Alaska and Hawaii, because the federal poverty guidelines these limits are built on are higher there. The Alaska and Hawaii poverty guidelines are included in this pack; the exact Medicare Savings Program limits for those two states are set by the state and are not published on the federal page.
- Your State Health Insurance Assistance Program (SHIP) gives free, unbiased, one-to-one help with these applications. They are not selling anything. Nobody should ever charge you a fee to apply for a Medicare Savings Program or for Extra Help.
- The resource limits do not count your home, one car, a burial plot, up to $1,500 set aside for burial expenses, furniture, or other household and personal items. They do count money in checking, savings and retirement accounts, stocks and bonds.
- SSA's own booklet "Understanding the Extra Help With Your Medicare Prescription Drug Plan" (publication 05-10508, January 2026 edition) still prints the previous year's Extra Help income limits of $23,475 for one person and $31,725 for a married couple, because it went to press against the 2025 poverty guidelines. The figures in this pack are the ones Medicare.gov publishes for 2026, and they line up exactly with 150% of the 2026 HHS poverty guidelines. If a Social Security representative quotes you the lower number, that is why — and it is another reason to apply rather than to assume.
Where to apply
- Social Security — Extra Help with Medicare drug costs ↗
The Extra Help application, online or on 1-800-772-1213. There is never a fee.
- Medicare.gov — Medicare Savings Programs ↗
The federal page these figures are transcribed from, with the route into your own state Medicaid office, which is the body that decides.
- BenefitsCheckUp, from the National Council on Aging ↗
A free nonprofit screener that goes wider than ours — food, energy and housing help as well as these five. It asks for a ZIP code; ours deliberately asks for nothing.
Who to ask next
We publish figures and explain how they work. We do not decide anything, and nobody who does is on this website. These are the people who can, and the first four cost nothing.
- Eldercare Locator — 1-800-677-1116 ↗Free
Run by the federal Administration for Community Living. Give them a ZIP code and they connect you to the area agency on aging that covers it, which is the office that knows what exists locally.
- Your State Health Insurance Assistance Program ↗Free
One-to-one counseling on Medicare, Medicare Savings Programs and Extra Help, from someone paid by a federal grant rather than by commission. The local name differs by state — HICAP in California, SHINE in Florida, SHIBA in Washington.
- Medicaid.gov — eligibility policy ↗Free
The federal rules Medicaid long-term care sits inside. Your own state agency administers them and is the only body that can decide your case.
- VA — find an accredited representative ↗Free
VA's own search for accredited Veterans Service Organization representatives, attorneys and claims agents. VSO representatives help with pension and Aid and Attendance claims at no charge.
- National Academy of Elder Law Attorneys ↗Directory is free; the attorney is not
Where to find a lawyer who does this work full time, if a transfer, a trust, a house or a second marriage is involved. Attorneys charge; asking one before you move money is usually cheaper than asking one afterwards.
Our own who to ask page sorts these by situation, and the paying for care hub holds the rest of this wing.
Verified 2026-08-02 against Medicare.gov, Medicare Savings Programs — 2026 monthly income and resource limits; Extra Help limits from Medicare.gov drug-cost help; poverty guidelines from HHS ASPE (effective 2026-01-01)
Estimate only — not financial, tax, legal, or insurance advice. Only CMS can determine your actual amounts.
Official source: Medicare.gov — Medicare Savings Programs ↗
🎓 Understand this tool
What it is
Shows where your monthly income and your savings sit against the federal figures for the four Medicare Savings Programs and for Part D Extra Help. Those five programs pay Medicare premiums, and in one case deductibles and copayments as well, for people with limited income.
How it works
It compares the two figures you enter against the limits Medicare.gov publishes for the current year, program by program, for one person and for a married couple. No scoring, no weighting and no eligibility model: a comparison against a published number is the only honest thing a website can do here, because the rules that actually decide are written state by state.
Getting the most from it
- Say whether you are applying on your own or as a married couple. Couples living together are measured against the couple figures even when only one of you has Medicare.
- Enter roughly what comes in each month before deductions. A rough figure is enough.
- Read the four programs. Being above a limit is a reason to ask, not a reason to stop.
- Open the savings panel if you want the resource comparison as well.
- Take the program names to your state Medicaid office, and Extra Help to Social Security.
Reading your result
Under a limit means the federal figure would not stand in your way. Above a limit means very little on its own: states set their own limits above the federal ones, apply their own disregards, and several do not count savings at all. The number of programs your figure sits under is a rough measure of how strong the case is, not a result.
What it can't tell you
These are the federal figures, and they are a floor rather than a test. This page cannot see how your state counts income, what it disregards, or whether it applies a resource test at all. It knows nothing about your household beyond the two numbers you typed. Only your state Medicaid office can decide a savings-program application, and only Social Security can decide Extra Help. Take-up of these programs is low mainly because people rule themselves out.
Frequently asked questions
The federal figures for 2026 are on this page, program by program, for one person and for a married couple. Read them as a floor rather than as a test: Medicare.gov states plainly that you may still qualify in your state with income or resources above them, because states count income differently and several disregard savings entirely.
Related calculators
Funding Screener
Seven questions, none of them about who you are, and the answer is a list of offices rather than a verdict: Medicare Savings Programs, Medicaid long-term care, VA pension, your free state counselors, the area agency on aging, and an elder-law attorney if property is involved. Each one names who decides and what to bring. Estimate only, never a determination.
Part B Premium
The standard Medicare Part B premium and annual deductible for 2026, taken straight from the CMS notice that set them, with every year back to 2016 so you can see how fast this line item has actually risen. Higher earners pay more through IRMAA; this page shows the base figure everyone starts from.
Total Cost Estimator
Nobody publishes one number for what a year of Medicare costs a household, because the pieces live in separate documents. This estimator adds them: the Part B premium, any IRMAA surcharge, deductibles, and the drug or supplement premium you supply. Original Medicare and Advantage are shown as two shapes of cost, without a verdict.
Look-Back
Medicaid examines a five-year window before an application, looking for gifts and property transfers, and one found there creates a penalty period that starts only once the money has already run out. Here is how that works, how fast a spend-down happens, and a printable worksheet. Not legal advice — your state agency decides.
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