Arizona QMB vs SLMB vs QI: Which Medicare Savings Program Do You Qualify For?

Arizona runs three Medicare Savings Programs, each at a different income level with different benefits. Compare gross monthly income with the limits below; they already account for the $20 unearned income disregard.

The Three Tiers at a Glance

These effective gross-income limits reflect the $20 unearned income disregard. The AHCCCS policy manual shows the corresponding countable-income thresholds before the disregard ($1,330 for QMB single).

QMB: The Most Comprehensive Protection

QMB is the only tier that eliminates Medicare cost-sharing entirely. Beyond paying the Part B premium, Arizona pays Part A and Part B deductibles, coinsurance, and copayments. In 2026, that means:

• Part B annual deductible: $257 — eliminated
• Part A hospital deductible: $1,676 per benefit period — eliminated
• Part A daily coinsurance: $419/day for days 61–90 — eliminated
• 20% outpatient coinsurance on every doctor visit — eliminated

QMB also carries federal balance-billing protection. Doctors, hospitals, and specialists cannot legally collect cost-sharing from QMB patients, even when AHCCCS pays $0 on the crossover claim. This protection applies across all settings, including Medicare Advantage networks.

SLMB and QI: Premium Help Only

SLMB and QI both do the same thing — pay the Part B premium ($202.90/month in 2026). The difference is the income band and funding source.

SLMB is funded as a standard Medicaid entitlement. QI is funded through a capped annual federal block grant and requires that the beneficiary not be receiving full Medicaid benefits through another program. In practice, Arizona has never exhausted its QI allocation.

Neither SLMB nor QI provides balance-billing protection or cost-sharing coverage. Beneficiaries in these tiers still owe standard Medicare deductibles, coinsurance, and copayments.

How Income Determines the Tier

AHCCCS uses gross Social Security — the amount before Part B premiums, taxes, or voluntary deductions are taken out. Check the SSA benefit verification letter for the gross figure.

For a single person with $1,300/month gross Social Security:

• Gross monthly income: $1,300
• QMB limit: $1,350
• Result: qualifies for QMB

For a single person with $1,590/month gross Social Security:

• Gross monthly income: $1,590
• Exceeds QMB ($1,350) but within SLMB ($1,616)
• Result: qualifies for SLMB

For married couples, both spouses' income counts regardless of whether one or both have Medicare. A non-Medicare spouse's pension or earnings go into the household total.

Moving Between Tiers

When income changes — a COLA increase, a pension adjustment, or starting/stopping work — AHCCCS recalculates eligibility and may shift coverage up or down. Moving from QMB to SLMB means losing cost-sharing protection while keeping the premium payment. Moving from SLMB to QI means no change in benefits (both pay the Part B premium).

Report income changes within 10 calendar days. AHCCCS updates the tier assignment and sends a notice. If a tier change is incorrect, file an appeal within 30 calendar days from the notice date; filing within 10 calendar days of the notice date requests Aid Paid Pending, which keeps existing benefits active while the appeal is pending.

The Arizona Medicare Savings Programs & Extra Help Guide includes the income calculation worksheet, tier comparison charts, and the transition checklist for moving between programs.

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