Medicare Savings Programs Income Limits 2026: All Four Tiers Explained

2026 Federal Income Limits at a Glance

Medicare Savings Programs use four income tiers, each set as a percentage of the Federal Poverty Level (FPL). All limits include the standard $20 monthly unearned income disregard — meaning your parent's gross income can be $20/month higher than the threshold and still qualify.

QMB, SLMB, and QI trigger automatic enrollment in Extra Help (Part D Low-Income Subsidy), which covers prescription drug premiums, eliminates the Part D deductible, and caps copays at $5.10 for generics and $12.65 for brand-name drugs.

2026 Asset Limits

The federal asset limits for QMB, SLMB, and QI are identical:

• Individual: $9,950
• Couple: $14,910

QDWI uses lower limits: $4,000 (individual) and $6,000 (couple).

What doesn't count as an asset: the primary home (where the applicant or spouse lives), one vehicle, household goods, personal effects, and up to $1,500 per person designated for burial expenses. Life insurance policies with a face value under $1,500 are also excluded.

Social Security retroactive payments — including lump sums from the Social Security Fairness Act — are excluded from countable resources for nine months after the month of receipt under 20 CFR § 416.1233. After nine months, unspent funds count toward the asset limit.

States With No Asset Test

Eleven states and the District of Columbia (12 jurisdictions) have abolished the asset test entirely for QMB, SLMB, and QI: Alabama, Arizona, Connecticut, Delaware, District of Columbia, Louisiana, Maine, Mississippi, New Mexico, New York, Oregon, and Vermont.

If your parent lives in one of these states, only their countable monthly income matters. Bank balances, investments, and savings are irrelevant to the eligibility determination.

States With Higher Income Limits

Several states set their own income thresholds above the federal baseline:

• Connecticut: QMB up to $2,752/month (single), $3,719 (couple)
• District of Columbia: QMB up to $4,010 (single), $5,430 (couple)
• Indiana: QMB up to $2,015 (single), $2,725 (couple)
• Mississippi: Uses a $50 monthly unearned income disregard instead of $20, raising effective QMB limits to $1,380 (single), $1,854 (couple)

A parent who exceeds the federal limits might still qualify under their state's rules. Always check with the state Medicaid agency before concluding ineligibility.

California's Reinstated Asset Limit

California eliminated its Medi-Cal asset test in January 2025, then reinstated it on January 1, 2026, due to budget pressures. The current limits are $130,000 for an individual and $195,000 for a couple — far higher than the federal baseline.

Under current state statute, these limits are scheduled to drop sharply to $21,000 (individual) and $31,000 (couple) on July 1, 2027. California caregivers need to plan around this pending change during the 2026 and 2027 renewal cycles.

How Countable Income Works

MSPs use the SSI income methodology, not the MAGI method used by marketplace insurance. Key rules:

• $20 monthly unearned income disregard — applied once to Social Security, pension, or investment income
• $65 monthly earned income disregard plus 50% of remaining earnings (if the applicant works)
• In-kind support may count depending on state rules

This means the published income limits are effectively $20/month lower than the real qualification threshold. A parent receiving $1,370/month in Social Security ($20 over the QMB chart limit) still qualifies after the disregard.

How to Screen Your Parent

Start with gross monthly income (Social Security benefit letter is the primary source), subtract $20, and compare against the table above. Then total countable assets (bank accounts, investments, non-excluded property) and compare against the asset limits — unless your parent lives in a no-asset-test state.

The Medicare Savings Programs toolkit includes an eligibility screening worksheet that walks through the income and asset calculations for all four tiers, including state-specific variations.

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