Medicare Savings Programs and Extra Help: 2026 Limits, How to Apply

Yes. A Medicare Savings Program (MSP) from your state pays your Part B premium, $202.90 a month in 2026, and its fullest level, QMB, also pays your Medicare deductibles, coinsurance and copays. Extra Help, Medicare's drug-cost program, pays your drug plan premium, sets your drug deductible at $0 and holds each covered prescription to $12.65 or less this year. Start with one filing today: apply for Extra Help at ssa.gov/extrahelp, and Social Security sends your answers to your state to open your MSP application.

The four Medicare Savings Programs and their 2026 limits

One application covers all four; the state places you by income and savings. The 2026 federal limits:

SLMB and QI require both Part A and Part B. QI is only for people with no other Medicaid coverage; you reapply yearly, and states approve it first come, first served, with priority for last year's members. Medicare raises these limits every year; the 2027 figures are still unpublished.

States with higher limits or no asset test

Federal law lets states count income and savings more generously, raising the limits or dropping the asset test. Three 2026 examples:

• New York: no resource test; QMB covers income up to $1,856 a month for one person ($2,509 for a couple), and QI up to $2,494.
• Massachusetts: no asset limit since March 1, 2024; QMB reaches 190% of the federal poverty level and SLMB/QI 225%.
• Connecticut: no asset limit for any MSP.

California runs its MSPs through Medi-Cal; see our California Medicare Savings Programs guide.

QMB billing protection

With QMB, the state pays your Medicare deductibles, coinsurance and copays for covered care, and federal law bars every Original Medicare and Medicare Advantage provider from billing you for them, including providers outside Medicaid, even when Medicaid pays the provider nothing. The one charge allowed is a small Medicaid copay where your state has one; your Extra Help drug copays still apply at the pharmacy.

Carry both cards, Medicare plus Medicaid or QMB, to each appointment.

Extra Help: 2026 limits and 2027 costs

For 2026, you qualify for Extra Help with yearly income below $23,940 for one person ($32,460 for a married couple living together) and resources below $18,090 ($36,100). Earnings from work, dependents living with you, or an Alaska or Hawaii address raise the income limit.

Resources are bank accounts, stocks, bonds, mutual funds, IRAs, cash and real estate other than your home; your car, burial plot and life insurance stay out. The $18,090 limit assumes you tell Social Security some savings are for burial; otherwise it is $16,590 ($33,100 for a couple).

Extra Help pays the whole premium of a basic drug plan priced at or under your region's low-income benchmark, and that same amount toward a pricier plan; you pay the difference. Compare plans at Medicare.gov/plan-compare. While you have Extra Help, you owe no Part D late enrollment penalty.

Extra Help lasts through December 31 even if your income changes, and renews unless Medicare or Social Security mails you a notice. Return any review form (SSA-1026, usually sent at the end of August) within 30 days, or Extra Help stops the following year.

Who gets Extra Help without applying

You get Extra Help automatically with full Medicaid, QMB, SLMB, QI or SSI (our SSI vs. SSDI guide covers SSI), and Medicare mails a purple letter that replaces the application. Without a drug plan, Medicare enrolls you in one (a yellow or green letter gives the start date) and lets you switch. Until a plan starts, Medicare's LI NET program (1-800-783-1307, TTY 711) covers your prescriptions and can pay you back for covered drugs you bought after you qualified, so keep the receipts.

What to do today

1. Write down your numbers: monthly income from every source, and the balance of each bank account, stock, bond, mutual fund and IRA, for you and a spouse you live with.
2. File for Extra Help online, by phone at 1-800-772-1213 (TTY 1-800-325-0778, weekdays 8 a.m. to 7 p.m.), or at a Social Security office. If you plan to use some savings for your funeral, say so: that puts your resource limit at $18,090. On the paper form, SSA-1020, leave question 15 blank: Social Security then sends your answers to your state to start an MSP application.
3. Call your state Medicaid office, found on Medicaid.gov's state contact page or through 1-800-MEDICARE (1-800-633-4227). Say: "I have Medicare and want to apply for the Medicare Savings Programs. Please screen me for QMB, SLMB, QI and full Medicaid, and tell me what proof to send and where." Have your Medicare card, photo ID, proof of address, this year's Social Security benefit letter, other income proof and recent bank statements ready, and note the date you applied. You can get an MSP without full Medicaid, and the state must decide within 45 days, or 90 if you apply based on disability.
4. Keep paying Medicare until the approval letter arrives.

Where it splits

• If your income or savings sit above the federal limits: apply anyway. Your state may count more generously, and Extra Help allows $16,590 in savings for one person against $9,950 for an MSP, so file both.
• If you already have full Medicaid or SSI: Extra Help is already yours; if your drug plan misses a prescription, use the monthly switch below.
• If an employer or union plan covers your drugs: check with its benefits administrator before you take Part D; joining can end that coverage for your dependents too.

After approval

• Part B premium: the deduction from your Social Security payment stops, or Medicare stops billing you. Your MSP pays the 2027 Part B premium, whatever CMS sets.
• Back months: SLMB and QI can pay your Part B premium for up to 3 months before the month you apply (QI only within the same calendar year), and Social Security refunds what it deducted. Full Medicaid reaches back 3 months too. For applications filed from January 1, 2027, federal law cuts all of these to 2 months, so apply before December 31. QMB starts the month after the state approves you, or in some states the month after you met every requirement, and covers no earlier months.
• Drug plan changes: with Extra Help or Medicaid, once each calendar month you can join or switch to a stand-alone drug plan, or leave Medicare Advantage for Original Medicare plus a stand-alone drug plan; the change starts the first of the next month. A plan that flags you by letter as at risk under its drug management program closes that option. If you learn you will lose Extra Help next year, you get 3 full months from the date you lose it or the date of the notice, whichever is later, to change plans.
• Your estate: Medicaid estate recovery excludes the Medicare cost sharing an MSP paid for you.

Your leverage

• A provider bills you while you have QMB: tell the office or debt collector you are in QMB and ask for a refund of anything you paid, which is your right. If bills keep coming, 1-800-MEDICARE confirms your QMB status and asks the provider to stop billing and refund you; in Medicare Advantage, call your plan too. If a collector keeps calling, complain to the Consumer Financial Protection Bureau at consumerfinance.gov/complaint or 1-855-411-2372.
• The state denies your MSP or lets 45 days pass: request a fair hearing; a denial notice gives the deadline, at most 90 days from its mailing date.
• Social Security turns down Extra Help: a pre-decisional notice gives you 10 days to call 1-800-772-1213 or visit an office with corrected figures. After a final denial, appeal within 60 days on form SSA-1021.

Call legal aid if a collector sues you over a QMB bill or your hearing turns on how the state valued a house, trust or retirement account.

What to say about a QMB bill

"My name is [name], Medicare number [number]. I am in the Qualified Medicare Beneficiary program, effective [month and year]. Your bill dated [date] charges me $[amount] in Medicare deductible, coinsurance or copay for a Medicare-covered service on [date of service]. Federal law bars Medicare providers from billing QMB members for Medicare cost sharing. Please cancel the charge, stop any collection, refund the $[amount] I paid, and bill [state] Medicaid for the cost sharing instead. Please confirm in writing."

Today

1. File for Extra Help at ssa.gov/extrahelp.
2. Call your state Medicaid office and apply for every Medicare Savings Program.
3. If you have a drug plan, price your drugs on Medicare Plan Finder before December 7 (see our open enrollment checklist).

Social Security mails its Extra Help decision, the state Medicaid office answers on the MSP within 45 days, and once the state's payment starts, your Social Security deposit rises by the Part B premium.