Help Paying Medicare Part B Premium in New York
The Part B Premium Problem
In 2026, the standard Medicare Part B premium is $202.90 per month — $2,434.80 per year. Social Security withholds it before depositing the monthly benefit, so many seniors see their check shrink and feel stuck.
New York has two programs that pay the Part B premium in full: QMB (Qualified Medicare Beneficiary) and QI (Qualifying Individual). Both are part of the state's Medicare Savings Programs, and both eliminate the Part B deduction from the Social Security check.
Who Qualifies in New York
New York's income limits are far more generous than the federal baseline:
QMB — up to $1,856/month for an individual, $2,509 for a couple. QMB pays the Part B premium plus all Medicare deductibles, copays, and coinsurance. If the senior lacks enough work credits for premium-free Part A, QMB pays that too (up to $565/month).
QI — up to $2,494/month individual, $3,375 couple. QI pays the Part B premium only, but that alone saves $2,434.80 per year.
There is no asset test. New York eliminated it in 2008. Bank savings, retirement accounts, and home equity do not count.
How to Apply
File form DOH-4328 with the local agency:
- NYC: through ACCESS HRA or at an HRA Medicaid office
- Upstate/Long Island: at the county Department of Social Services or online through NY State of Health
Attach the Social Security benefit letter (showing gross monthly income), Medicare card, proof of New York residency, and a photo ID. No bank statements needed.
The agency determines whether the applicant qualifies for QMB or QI based on income — you do not need to choose a category.
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What Happens to the Premium After Approval
The Part B premium does not stop immediately. After the local agency approves QMB or QI, the state transmits a buy-in record to CMS, which then notifies Social Security. This takes 60–90 days.
During that window, Social Security continues deducting $202.90/month. Once the buy-in processes, Social Security deposits a lump-sum refund covering every month from the MSP effective date forward. The retroactive payment typically arrives as a direct deposit.
For QI, coverage can also be retroactive up to three months before the application date if the applicant met the income criteria during those months.
Additional Savings That Come With It
Both QMB and QI automatically trigger Extra Help (Low-Income Subsidy) for Part D drug costs. Without filing a separate application, the senior gets:
- $0 Part D premium for benchmark plans (up to $58.82/month)
- $0 Part D deductible
- Copays capped at $5.10 for generics and $12.65 for brand-name drugs
- The Part D late enrollment penalty waived
Between the Part B premium and drug cost reductions, QMB or QI can save a New York senior $4,000–$8,000 per year.
The New York Medicare Savings Programs Guide covers the full application process, income worksheets, and what to do if the premium refund takes longer than expected.
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Download the New York — Medicare Savings Program Eligibility Checklist — a printable guide with checklists, scripts, and action plans you can start using today.