Help Paying Medicare Part B Premium in North Carolina

The Part B Premium in 2026

The standard Medicare Part B premium is $202.90 per month in 2026, or $2,434.80 per year. For most beneficiaries, it's deducted directly from their Social Security check before the money hits their bank account. On a monthly Social Security benefit of $1,400, that deduction takes a noticeable bite.

North Carolina has three programs that can eliminate that deduction entirely by having the state pay the Part B premium on your parent's behalf.

Three Programs That Cover the Part B Premium

All three operate through the state's Medicare Savings Programs, administered by county Departments of Social Services:

MQB-Q (QMB) — Covers the Part B premium plus all Medicare deductibles, coinsurance, and copays. Income must be at or below $1,330 per month (individual) or $1,804 (couple) after the $20 disregard. Resources at or below $9,950 / $14,910.

MQB-B (SLMB) — Covers the Part B premium only. Income between $1,330.01 and $1,596 per month (individual) or $1,804.01 and $2,164 (couple). Same resource limits as MQB-Q.

MQB-E (QI) — Covers the Part B premium only. Income between $1,596.01 and $1,796 per month (individual) or $2,164.01 and $2,435 (couple). Same resource limits. Funded through a capped federal block grant, so applications are processed first-come, first-served.

At the broadest tier, a single senior earning up to $1,816 per month gross ($1,796 after the $20 disregard) can get their full Part B premium paid. That's roughly the middle of the Social Security benefit distribution.

How the Premium Stops Coming Out of Your Check

Once the county DSS approves your parent for any of these three programs, the state transmits enrollment data to the Social Security Administration through the BENDEX system. SSA then stops deducting the Part B premium from your parent's monthly check.

The process typically takes two to three Social Security payment cycles after the state system updates. During that lag, the premium may still be deducted. If the approval included retroactive months (available for MQB-B and MQB-E, covering up to three calendar months before the application month), SSA reimburses the premiums that were withheld during those months via a separate deposit.

MQB-Q coverage is prospective only — no retroactive premium reimbursement.

The Bonus: Automatic Extra Help for Prescriptions

All three programs automatically trigger Part D Extra Help, which drops prescription copays to $5.10 for generics and $12.65 for brand-name drugs in 2026. No separate application to Social Security is needed. NCDHHS transmits approval data directly to CMS, and the Extra Help benefit kicks in without a second filing.

For a senior paying full Part D costs — which can run hundreds per month depending on their medication list — this automatic benefit often saves more than the Part B premium itself.

How to Apply

The fastest route is through North Carolina's ePASS portal (epass.nc.gov), selecting "Medical Assistance" and indicating Medicare enrollment. You'll also need to complete Appendix D (the income/resources supplement for Aged, Blind, and Disabled coverage).

If you're helping a parent, file Appendix C (DHB-5202C-ia) to be designated as their authorized representative. This lets you file on their behalf, receive county notices, and communicate directly with the caseworker.

County DSS offices must process the application within 45 days.

What If Your Parent Is Slightly Over the Limit?

Don't assume ineligibility based on gross income alone. The $20 general disregard applies before the comparison, and if your parent has any earned income, additional deductions reduce countable income further — a $65 earned income exclusion plus halving the remainder.

The North Carolina Medicare Savings Programs & Extra Help Guide includes the complete income calculation worksheet, so you can run the numbers precisely before deciding whether to apply.

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