Florida Medicare Savings Program Income Limits 2026: Eligibility by Program

2026 Income Limits for Each Florida MSP Tier

Florida's Medicare Savings Programs have four tiers with different income ceilings. All figures below reflect 2026 federal poverty level calculations and include the standard $20 monthly unearned income disregard that DCF applies during eligibility determination.

QMB (Qualified Medicare Beneficiary)

• Individual: up to $1,350/month
• Couple: up to $1,824/month
• Covers: Part A and B premiums, deductibles, coinsurance, and copays

SLMB (Specified Low-Income Medicare Beneficiary)

• Individual: $1,350.01–$1,616/month
• Couple: $1,824.01–$2,184/month
• Covers: Part B premium only ($202.90/month in 2026)

QI (Qualifying Individual)

• Individual: $1,616.01–$1,816/month
• Couple: $2,184.01–$2,455/month
• Covers: Part B premium only, funded through a capped federal grant

QDWI (Qualified Disabled and Working Individual)

• Individual: up to $2,683/month
• Couple: up to $3,628/month
• Covers: Part A premium only, for working disabled individuals

Every program shares the same resource limits: $9,950 for an individual, $14,910 for a couple (except QDWI, which uses $4,000/$6,000).

How DCF Counts Income — The Details That Matter

The income figure DCF uses isn't simply the number on your parent's Social Security statement. Florida applies a specific calculation sequence under F.A.C. Rule 65A-1.713 that works in the applicant's favor:

Gross income includes Social Security retirement or disability payments (the amount before the Part B premium deduction, not the net deposit), private pensions, VA pension benefits, annuities, and gross earned wages.

The $20 general unearned income disregard comes off first. Every household gets this — $20 subtracted from total unearned income. So a senior receiving $1,365/month in Social Security has $1,345 in countable income, potentially falling within QMB range.

Earned income disregard applies for working beneficiaries: DCF drops the first $65 of gross monthly earnings, then ignores half of whatever's left. A senior earning $500/month from part-time work would have $217.50 counted ($500 − $65 = $435; half of that is $217.50), before any applicable IRWE deductions.

Impairment-Related Work Expenses (IRWE) are deducted from earned income if your parent has documented out-of-pocket costs required for them to work with a disability.

COLA disregard: annual Social Security cost-of-living increases effective in January are excluded from countable income until the new federal poverty guidelines take effect (typically April 1). If your parent's income just crossed the limit because of a January COLA, the disregard may preserve eligibility through March.

The Income Limits Are Higher Than They Look

Many families glance at the QMB limit of $1,350/month and assume their parent doesn't qualify because their Social Security check is, say, $1,400. But that $1,400 is the amount before the Part B premium deduction — which is the figure DCF uses — and after applying the $20 disregard, countable income drops to $1,380. Still over QMB.

But now check SLMB: with $1,380 in countable income, your parent falls well within the SLMB range (up to $1,616). SLMB still pays the entire $202.90/month Part B premium, returning $2,434.80 per year to their check. And SLMB approval automatically triggers Extra Help, cutting prescription drug costs dramatically.

Families whose parent earns slightly too much for SLMB should check QI, which extends to $1,816/month for individuals.

Resource (Asset) Limits and What's Excluded

The $9,950 individual resource limit ($14,910 for couples) is less restrictive than it sounds once you know what DCF excludes:

Not counted: the home (regardless of market value, no equity cap for MSP), one vehicle (regardless of value), household goods, personal effects, burial plots for the applicant and immediate family, up to $2,500 per person in designated burial funds, irrevocable pre-need burial contracts (no dollar cap), and term life insurance.

Counted: checking and savings balances, CDs, stocks, bonds, mutual funds, brokerage accounts, non-home real estate equity, and life insurance cash surrender value if total whole life face value exceeds $1,500 per person.

Retirement accounts: an IRA or 401(k) is countable if your parent can withdraw a lump sum. If they've placed the account into mandatory periodic payouts, the principal is excluded and only the monthly distribution counts as income.

Jointly held bank accounts with adult children are presumed owned entirely by the applicant. This presumption can be rebutted by showing the child deposited their own funds — but you'll need financial tracing records.

Married Couples: How DCF Handles Spousal Income

When both spouses are on Medicare and live together, DCF evaluates combined income and resources against the couple limits.

When only one spouse is on Medicare, the non-applicant spouse's income goes through spousal deeming — DCF allocates a portion to cover the non-applicant's basic needs before counting the rest toward the applicant's eligibility.

If spouses live apart in separate residences for more than one month, DCF evaluates the applicant as a single individual using the lower single-person limits.

A parent in a nursing home or assisted living applying only for MSP is evaluated under single standards — the institutional spousal impoverishment rules (like the Community Spouse Resource Allowance) don't apply to MSP.

For detailed worksheets that walk through the full income calculation and asset classification, the Florida Medicare Savings Programs & Extra Help Guide includes a step-by-step eligibility assessment.

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