How Much Does QMB Save in Tennessee? A Full Breakdown of Benefits

The short answer: QMB in Tennessee can save a beneficiary well over $7,000 a year. The longer answer depends on how much Medicare your parent actually uses — because QMB does not just pay the premium. It covers nearly every out-of-pocket Medicare cost.

The 2026 QMB Savings Breakdown

Here is what QMB pays on behalf of the beneficiary each year:

Part B premium: $202.90/month × 12 = $2,434.80/year. This is the guaranteed minimum savings. Every QMB enrollee gets this regardless of how much medical care they use.

Part B annual deductible: $283.00. Without QMB, this is out of pocket before Medicare starts paying 80% of outpatient services.

Part B coinsurance: 20% of every Medicare-approved outpatient charge. A single outpatient surgery billed at $5,000 has a $1,000 coinsurance. Over a year of doctor visits, lab work, and specialist appointments, this easily runs $1,000–$3,000.

Part A hospital deductible: $1,736.00 per benefit period. One hospitalization triggers this. A second admission after 60 consecutive days without inpatient hospital or skilled nursing facility care starts a new benefit period and triggers it again.

Part A daily coinsurance (days 61–90): $434.00/day. A 10-day extended stay costs $4,340 without QMB.

Part A reserve days (days 91–150): $868.00/day. These lifetime reserve days are the final inpatient days Medicare may cover in a benefit period.

Skilled nursing facility coinsurance (days 21–100): $217.00/day. A 30-day SNF stay after a hospitalization carries $6,510 in coinsurance without QMB.

Part A premium (if applicable): Up to $565.00/month ($6,780/year) for someone without 40 work quarters. Tennessee is a Part A buy-in state, so QMB can cover this premium at any time of year without waiting for the General Enrollment Period.

The Real-World Number

For a QMB enrollee who stays healthy and only sees a doctor a few times a year, the savings are roughly $2,700–$3,000 (premium + deductible + modest coinsurance).

For someone managing chronic conditions — diabetes, heart disease, COPD — with regular specialist visits, lab work, and one hospitalization, annual savings easily exceed $5,000–$7,000.

For a senior without premium-free Part A who gets hospitalized, QMB can save over $12,000 in a single year.

QMB vs Extra Help: Different Problems

QMB and Extra Help are not alternatives — they work together. QMB handles Medicare Part A and Part B costs (premiums, deductibles, copays). Extra Help handles Medicare Part D costs (prescription drug premiums, deductibles, copays).

Every QMB enrollee in Tennessee is automatically deemed eligible for Extra Help. That adds another layer of savings: the Part D deductible ($615 in 2026) is eliminated, and copays drop to $12.65 or less for covered drugs.

Combined, a QMB enrollee with Extra Help can save $8,000–$15,000 annually compared to paying full Medicare costs out of pocket.

The Balance Billing Protection Bonus

QMB also carries a legal protection that no other MSP tier provides: providers cannot bill QMB enrollees for Medicare deductibles, coinsurance, or copays. Period. Even if TennCare pays the provider $0 on a crossover claim — which happens frequently because TennCare's Medicaid rates are lower than Medicare rates — the provider must absorb the difference. They cannot send the bill to your parent.

This protection applies to every Medicare-enrolled provider, in-network or out-of-network, under Original Medicare or Medicare Advantage.

Is Your Parent Eligible?

QMB requires gross monthly income at or below $1,350 (individual) or $1,824 (couple), after the $20 unearned income disregard. Countable resources must be at or below $9,950/$14,910. The primary home is excluded if the applicant lives there or intends to return; one car and personal belongings are also excluded.

The Tennessee Medicare Savings Programs & Extra Help Guide includes calculation worksheets to determine exact eligibility across all three MSP tiers and walks through the full application process via TennCare Connect.

See more Tennessee guides →