Missouri Medicare Savings Program Income Limits 2026

2026 Income Ceilings by Program Tier

Missouri's Family Support Division (FSD) uses federal poverty guidelines plus a standard $20 monthly unearned income disregard to set eligibility thresholds. Here are the current limits:

These are countable income figures — your gross income minus the $20 disregard.

How FSD Calculates Your Income

FSD starts with your gross Social Security benefit, not what lands in your bank account. If $185 for Part B premiums and $50 for tax withholding are deducted from a $1,400 monthly benefit, your bank sees $1,165 — but FSD counts $1,400 as gross.

From that gross, FSD subtracts the standard $20 monthly unearned income disregard, giving a countable income of $1,380. That's above QMB's $1,255 ceiling but below SLMB's $1,506 limit — so this person would qualify for SLMB but not QMB.

Earned income gets a more generous treatment: a $65 flat disregard plus a 50% deduction on remaining wages. VA benefits count as unearned income, though Aid and Attendance allocations and combat-related compensation have specific exemptions.

Asset Limits and What Counts

All four programs except QDWI share the same resource thresholds: $9,660 for an individual, $14,470 for a couple. QDWI has a lower limit of $4,000 individual / $6,000 couple.

Excluded from counting:

• Primary home (regardless of value)
• One vehicle used for transportation (regardless of value)
• Burial plots and spaces for applicant and family
• Up to $1,500 per person in designated burial funds
• Irrevocable prepaid burial contracts
• Term life insurance with no cash value
• Whole life insurance if total face value is $1,500 or less per individual
• Retirement accounts (IRAs, 401(k)s) in periodic payout status

Counted as resources:

• Bank accounts (checking, savings, CDs)
• Additional vehicles at equity value
• Whole life insurance cash surrender value if face value exceeds $1,500
• Retirement accounts not in payout status
• Investment accounts, stocks, bonds

Joint bank accounts carry a legal presumption that 100% belongs to the applicant. If a joint holder contributed their own funds, you need bank records to prove the split.

Married Couple Rules

When both spouses live together and only one has Medicare, FSD uses the couple income and asset limits. Both incomes are combined and compared against the couple ceiling ($1,703 for QMB, $2,044 for SLMB).

If spouses are legally separated or live apart, FSD treats the Medicare applicant as an individual and uses the single-person limits. Only income personally received by, or legally transferred to, the applicant counts.

When one spouse enters a nursing facility, the rules shift to institutional Medicaid. Spousal impoverishment protections kick in — the community spouse keeps a Community Spouse Resource Allowance (CSRA) and a Minimum Monthly Maintenance Needs Allowance (MMMNA), sheltering assets and income from the institutionalized spouse's spend-down while preserving MSP eligibility.

The January–March COLA Gap

Social Security's annual COLA hits in January, but updated federal poverty guidelines don't flow into FSD's eligibility software until April 1. To prevent people from losing coverage during that window, FSD subtracts the dollar amount of the January COLA increase from countable income when evaluating MSP eligibility between January and March.

If a COLA bumped your monthly benefit by $35, FSD ignores that $35 during Q1. Once the new poverty guidelines take effect in April, the higher income is measured against the higher limits.

What If You're Slightly Over the Limit?

Being above QMB's income ceiling doesn't mean you're out of options. You might qualify for SLMB (120% FPL) or QI-1 (135% FPL), which still cover the Part B premium. And MSP eligibility rules are more generous on assets than full MO HealthNet Medicaid, which uses a $5,000 individual / $10,000 couple limit with medical spend-down.

For worked examples with real numbers, an eligibility worksheet, and an asset inventory checklist, the Missouri Medicare Savings guide covers every step of the financial calculation FSD runs on your application.

See more Missouri guides →