Every month, $202.90 comes out of most Social Security checks for Medicare Part B. That is more than $2,400 a year, and for a great many people on a modest check it is the single largest bill after rent.
For some of them it does not have to be. Every state runs Medicare Savings Programs, paid for with the same Medicare and Medicaid dollars you funded through a working life, that pick up the Part B premium and, at the lowest income tier, Medicare's deductibles and copays as well. And a large share of the people who qualify have never applied. Researchers writing in Health Affairs found that only about two in three people eligible for the fullest program were enrolled in 2022.
Open Enrollment starts October 15. This is the week to find out whether you are one of them.
The three programs and the 2026 limits
These are the federal limits for 2026, from Medicare's own page. "Resources" means savings and investments; your home, one car and most household belongings do not count.
| Program | What it pays | Monthly income, single | Monthly income, couple | Resources, single / couple |
|---|---|---|---|---|
| QMB (Qualified Medicare Beneficiary) | Part B premium plus Medicare deductibles, coinsurance and copays | $1,350 | $1,824 | $9,950 / $14,910 |
| SLMB (Specified Low-Income Medicare Beneficiary) | Part B premium | $1,616 | $2,184 | $9,950 / $14,910 |
| QI (Qualifying Individual) | Part B premium | $1,816 | $2,455 | $9,950 / $14,910 |
Limits are slightly higher in Alaska and Hawaii. QI must be renewed every year and is first come, first served, so apply early in the year.
Why you should apply even if you think you are over
Medicare's own page says it plainly: "Even if you don't think you qualify, you should still apply." There are three reasons.
- Your state may not count your savings at all. About a dozen states and D.C. have dropped the resource test entirely, including New York, Massachusetts, Connecticut, Arizona, Alabama, Louisiana, Oregon and Vermont, according to KFF's 2026 state tables.
- Your state may use a higher income limit. Several states go well beyond the federal line for the fullest program: D.C. up to three times the poverty level, Connecticut about twice, Maine and Massachusetts close to twice.
- Some income is not counted. States ignore certain amounts when they add up your income, which is why the limits above are a little higher than the federal poverty line.
What you get beyond the premium
- Extra Help with prescriptions, automatically. Anyone in one of these programs is enrolled in Extra Help, which in 2026 caps what you pay at $12.65 for each drug your plan covers and can cover the Part D premium on many plans.
- With QMB, no Medicare bills. Doctors and hospitals that take Medicare are not allowed to bill a QMB member for Medicare's deductibles, coinsurance or copays. Show both your Medicare card and your Medicaid or QMB card each time.
- The money shows up in your check. When the state starts paying the Part B premium, Social Security stops deducting it, and your deposit goes up by $202.90 a month.
Who is most likely to be missing out
Look at the income column again. A widow collecting $1,600 a month with $8,000 in the bank is inside the SLMB limit and would keep more than $2,400 a year she is paying now. A single retiree at $1,800 is inside the QI limit. The people who miss these programs are rarely the poorest, who are usually already on Medicaid. They are the ones in between: a modest check, a little saved, and no idea the program exists.
We think that is the point worth making plainly. This is not charity. It is part of the Medicare program you paid into for forty years, and leaving it unclaimed only means your own premium dollars go unreturned.
How to apply
- Call your state Medicaid office, or apply online through your state's benefits site. Medicare Savings Programs are run by the states, not by Social Security.
- Have your papers ready: your Medicare card, your Social Security benefit letter, your last two or three bank statements, and any pension or annuity statement.
- Get free help from your State Health Insurance Assistance Program at 1-877-839-2675. Counselors do these applications every day.
- Do it now, alongside Open Enrollment, October 15 to December 7. Once you have Extra Help, which comes with any of these programs, you can also change drug plans during the year, not only in the fall.
- Tell a parent or a neighbor. If someone you know lives on one Social Security check and pays their own Part B premium, this is the ten-minute phone call that could put more than $200 a month back in it.
Limits are the federal 2026 amounts published by Medicare. Your state may use higher limits or no resource limit; your state Medicaid office makes the final decision.
This story first appeared at Senior Daily Benefits, our sister publication on Social Security, Medicare and the money you earned.
Sources
- Medicare.gov, Medicare Savings Programs (2026 income and resource limits)
- Centers for Medicare & Medicaid Services, 2026 Medicare Parts A and B premiums and deductibles
- KFF State Health Facts, Eligibility for Medicare Savings Programs for Qualified Medicare Beneficiaries, 2026
- Health Affairs, Qualified Medicare Beneficiary Program: enrollment trends and characteristics of low-income beneficiaries (2025)
- Justice in Aging, Final rule to streamline enrollment in Medicare Savings Programs
- Medicare.gov, Help with drug costs (Extra Help)
Mamdani Writes an Antisemitism Plan, and the City's Jewish Groups Say It Misses the Point
Retirees On SS Are Due A Large Surprise This Week
Hegseth Hands the Next War to Musk, Luckey and Gingrich, and Gives Them 120 Days
These 27+ Coolest Gifts For Christmas
Trump Says the Three Justices He Picked 'Voted Against Me Too Often'
Homeowners: See How Much Equity You Could Borrow Without Refinancing
0 Comments
Be the first to comment.