Maryland Medicare Savings Program: QMB, SLMB, and QI Explained

What the Medicare Savings Programs Actually Do in Maryland

Maryland runs three Medicare Savings Programs — QMB, SLMB, and QI — through its Department of Human Services local offices. If you qualify, the state pays covered costs directly. The Part B premium can still be withheld for 60 to 90 days while state, CMS, and Social Security records update; SSA then refunds premiums withheld since the MSP effective date.

Here's what each tier covers:

Qualified Medicare Beneficiary (QMB) is the most comprehensive. Maryland pays your Part A premium (if you have one), your Part B premium ($202.90/month in 2026), and all Medicare deductibles, coinsurance, and copayments. Doctors and hospitals cannot bill you for any Medicare cost-sharing — that protection is federal law.

Specified Low-Income Medicare Beneficiary (SLMB) covers your Part B premium only. You still handle deductibles and coinsurance, but that $202.90 monthly premium stops coming out of your Social Security check.

Qualifying Individual (QI) also covers the Part B premium, but it runs on a capped federal grant instead of open-ended funding. Maryland processes QI applications on a first-come basis each calendar year. Existing enrollees get priority at renewal, but new applicants who file late in the year could hit the funding ceiling.

Who Qualifies in Maryland (2026 Numbers)

Maryland uses SSI-style income counting. The published 2026 monthly thresholds already include the standard $20 general disregard, so don't subtract that amount a second time when checking the listed limits:

• QMB (100% FPL): $1,350/month individual, $1,824/month couple
• SLMB (120% FPL): $1,616/month individual, $2,184/month couple
• QI (135% FPL): $1,816/month individual, $2,455/month couple

All three tiers share the same resource limits: $9,950 for an individual, $14,910 for a couple. Your home, one car, household goods, and irrevocable burial contracts don't count toward that number.

If your parent lives with you, your income is never counted toward their eligibility. Maryland only looks at the applicant's income (and their spouse's, if married and living together).

How MSPs Connect to Extra Help and SPDAP

Getting approved for any MSP tier automatically qualifies your parent for Full Extra Help with Part D drug costs. They don't file a separate application — CMS sends a notice confirming the benefit. That means $0 Part D premiums on a benchmark plan, no deductible, and minimal copays at the pharmacy.

The connection works in reverse too. When someone applies for Extra Help through Social Security, SSA transmits that application to Maryland's Medicaid agency for an MSP screening.

Maryland also runs the Senior Prescription Drug Assistance Program (SPDAP), which pays up to $100/month toward Part D premiums for moderate-income seniors. But SPDAP and MSP serve different income brackets — anyone receiving Full Extra Help through an MSP is ineligible for SPDAP.

Why This Matters for Your Parent's Monthly Budget

A senior on Social Security with a $1,200/month benefit loses $202.90 to the Part B premium before they see a dollar. QMB approval puts that money back and eliminates cost-sharing at the doctor's office. SLMB or QI approval restores the $202.90 and, through deemed Extra Help, wipes out pharmacy deductibles and most copays.

The application goes through your local Department of Social Services or the myMDTHINK online portal. Processing takes up to 45 days by federal rule.

If you're helping a parent navigate this process, the Maryland Medicare Savings Programs, Extra Help & SPDAP Guide walks through every step — from checking eligibility to tracking the premium refund after approval.

See more Maryland guides →