Help Paying for Medicare: Do You Qualify to Owe Less (or $0)?
If your income is limited, a Medicare Savings Program can pay your premiums, and with QMB your deductibles and copays too, so you owe close to nothing for covered care. Add Extra Help for prescriptions. Check what you may qualify for, using the 2026 limits, and how to apply.
Do you qualify for help paying for Medicare?
A few questions, nothing saved. This is a guide using the 2026 federal limits, not an official decision.
1. Who are we checking for?
Include Social Security, pensions, and work. A rough number is fine.
3. Are your savings and other resources below about $9,950?
Do not count your home, one car, or household goods.
The programs and the 2026 income limits
Medicare Savings Programs are run by your state. The resource (asset) limit for all three is $9,950 for an individual and $14,910 for a couple, and it does not count your home or one car. Limits are slightly higher in Alaska and Hawaii, and some states use higher limits, so apply even if you think you are a little over.
| Program | Helps pay | Income (individual) | Income (couple) |
|---|---|---|---|
| QMB | Part A & B premiums, plus deductibles, coinsurance, and copays (you owe close to $0) | up to $1,350/mo | up to $1,824/mo |
| SLMB | Your Part B premium | up to $1,616/mo | up to $2,184/mo |
| QI | Your Part B premium (reapply yearly, first-come) | up to $1,816/mo | up to $2,455/mo |
Source: Medicare.gov, 2026 Medicare Savings Program limits. All three also come with Extra Help for prescription drugs.
Extra Help (prescription drugs)
Lowers what you pay for Medicare drugs, no more than $12.65 per covered drug in 2026. You get it automatically with QMB, SLMB, or QI. If your income is a bit higher (up to about 150% of the poverty level), you can still apply on your own through Social Security, and its resource limits are more generous.
If you have QMB, you should not be billed
Federal law bars Medicare providers from billing QMB members for covered services, including deductibles, coinsurance, and copays. Getting billed anyway is common. Show your QMB or Medicaid card, and if a bill still comes, here is how to fight it.
How to apply
- Savings Programs (QMB/SLMB/QI): apply through your state Medicaid office. Your state decides which program you qualify for.
- Extra Help: apply through Social Security or call 1-800-772-1213. If you get an MSP or Medicaid, you get it automatically.
- Free, unbiased help: your State Health Insurance Assistance Program (SHIP) walks you through it at no cost, and does not sell plans.
- Apply even if you think you are over. Medicare itself says to apply anyway, since states may use higher limits or not count certain income and resources.
Got a Medicare bill you should not have?
Applying is free, and SHIP can help. Where CareRoute helps is the bill: if you are in a Savings Program (especially QMB) and got billed for covered care anyway, or any Medicare bill looks wrong, send it to us. We review and dispute it. Free to submit, you only pay if we save you money.
Send us the billFree to submit. You only pay if we save you money.
Frequently asked questions
What is a Medicare Savings Program?
A Medicare Savings Program (MSP) is help from your state that pays some or all of your Medicare costs. There are three main levels. QMB is the most generous: it pays your Part A and Part B premiums and your deductibles, coinsurance, and copays, so you owe close to nothing for Medicare-covered care. SLMB and QI pay your Part B premium (about $185 a month in 2025). All three also automatically get Extra Help for prescription drugs. You apply through your state Medicaid office.
What are the income limits for help paying for Medicare in 2026?
For 2026, the monthly income limits are: QMB up to $1,350 for an individual or $1,824 for a married couple; SLMB up to $1,616 or $2,184; and QI up to $1,816 or $2,455. The resource (asset) limit for all three is $9,950 for an individual and $14,910 for a couple, and it does not count your home or one car. These are federal limits, slightly higher in Alaska and Hawaii, and some states use higher limits or ignore certain income, so apply even if you think you are a little over.
If I have QMB, why am I still getting bills?
You should not be. If you are in the QMB program, federal law prohibits Medicare providers from billing you for Medicare-covered services, including deductibles, coinsurance, and copays. Getting billed anyway is called improper or "balance" billing, and it is common. Show your QMB or Medicaid card, and if a bill still comes, it can be fought. We can help you dispute a bill you should not have received.
What is Extra Help?
Extra Help (also called the Part D Low-Income Subsidy) lowers what you pay for Medicare prescription drugs. In 2026, people who qualify pay no more than $12.65 for each covered drug. If you get QMB, SLMB, or QI, you get Extra Help automatically. If your income is a bit higher (up to about 150% of the poverty level), you can still apply for Extra Help on its own through Social Security, and its resource limits are higher than the Savings Programs.
How do I apply, and does CareRoute charge for this?
You apply for a Medicare Savings Program through your state Medicaid office, and for Extra Help through Social Security (ssa.gov) or by calling 1-800-772-1213. Both are free, and your State Health Insurance Assistance Program (SHIP) offers free, unbiased help. CareRoute does not charge you to apply for anything. We earn money only on Bill Defense, where we review and negotiate a medical bill you already have, and only if we save you money, for example a bill a QMB member should never have received.
Related
Sources & references
A general note: the 2026 limits here hold for most people, but states can use higher limits or count income and resources differently, and figures update each year. Treat this as a strong starting point, not an official decision, and apply through your state or Social Security, or ask a free SHIP counselor, to confirm. This is general information, not legal or financial advice. Last updated: August 2026.