Idaho Medicare Savings Program Income Limits 2026

2026 Limits at a Glance

Every January, the federal poverty level adjusts and Idaho's Medicare Savings Program thresholds shift with it. Here are the 2026 monthly income and resource limits DHW uses to determine eligibility:

Single applicants:

• QMB: $1,350/month income, $9,950 resources
• SLMB: $1,616/month income, $9,950 resources
• QI: $1,816/month income, $9,950 resources
• QDWI: $5,405/month income, $4,000 resources

Married couples (both applying or living together):

• QMB: $1,824/month income, $14,910 resources
• SLMB: $2,184/month income, $14,910 resources
• QI: $2,455/month income, $14,910 resources
• QDWI: $7,299/month income, $6,000 resources

These figures include the $20 monthly general income disregard already built into the posted limits. Idaho follows the federal baseline without any state-level income expansion.

What Each Tier Covers

QMB at 100% of the federal poverty level is the most valuable. It pays the Part B premium ($202.90/month in 2026), the Part A premium if your parent doesn't have premium-free Part A, and all Medicare deductibles and coinsurance — including the $1,736 Part A hospital deductible and the $283 Part B annual deductible. Providers cannot bill QMB enrollees for any of these costs.

SLMB at 120% FPL and QI at 135% FPL both cover the Part B premium only. The practical difference: SLMB is funded through the regular Medicaid budget with no annual cap, while QI uses a capped federal allotment.

QDWI at 400% FPL serves a narrow group — disabled workers under 65 who lost premium-free Part A after returning to work. It covers only the Part A premium.

QMB, SLMB, and QI automatically qualify the enrollee for Extra Help, cutting Part D prescription costs to $5.10 for generics and $12.65 for brand-name drugs.

How QMB, SLMB, and QI Compare

A parent with $1,300 gross monthly Social Security fits comfortably under QMB. At $1,500, they qualify for SLMB. At $1,600, they clear QMB but land in SLMB. At $1,700, SLMB is out but QI covers the Part B premium. At $1,900, they exceed all MSP income limits.

The resource limit — $9,950 for singles, $14,910 for couples — is the same across QMB, SLMB, and QI. Only QDWI uses a lower threshold ($4,000/$6,000).

This tiered structure means a parent who seems "over the limit" for QMB may still qualify for SLMB or QI. Always check all three tiers before concluding that no help is available.

The $20 Disregard That Changes the Math

DHW subtracts $20 from gross monthly unearned income before comparing it to the limit. This sounds small, but it's the difference between qualifying and not for anyone within $20 of a threshold. A senior with $1,370 gross Social Security has countable income of $1,350 — exactly at the QMB ceiling.

Earned income gets a larger break: the first $65 is excluded, then half the remainder. A parent earning $500 per month from part-time work has only $217.50 counted.

The Social Security Fairness Act Wrinkle

The Social Security Fairness Act repealed the Windfall Elimination Provision and Government Pension Offset in January 2025, retroactive to January 2024. Idaho public retirees — teachers, state workers, municipal employees — who were previously penalized saw their Social Security benefits increase. That higher gross income may have pushed some above the QMB or SLMB line and into a different tier. Running the numbers with current gross Social Security is essential.

Next Steps

If your parent's income falls near any of these thresholds, the Idaho Medicare Savings Programs & Extra Help Guide includes a gross-to-net income worksheet that walks through the exact calculation DHW uses, including disregards, earned income exclusions, and spousal deeming rules. Getting the math right before applying avoids delays from incorrect income reporting.

See more Idaho guides →