Nebraska Medicare Savings Program: QMB, SLMB and QI Explained

A $202.90 monthly deduction from a Social Security check hits hard when the entire check is under $1,400. Nebraska runs three Medicare Savings Programs — QMB, SLMB and QI — that can eliminate that Part B premium and, for QMB enrollees, wipe out deductibles and coinsurance too. Up to 30% of eligible low-income Nebraska seniors and people with disabilities remain unenrolled.

The Three Tiers of Nebraska's Medicare Savings Programs

Nebraska's Department of Health and Human Services (DHHS) administers all three MSP tiers under Title 477 of the Nebraska Administrative Code. Each tier covers a different income range and a different slice of Medicare costs.

QMB (Qualified Medicare Beneficiary) is the most comprehensive. It pays the Medicare Part B premium ($202.90/month in 2026), the Part A premium if you owe one, the Part B annual deductible ($283), and all Medicare coinsurance and copayments. To meet the income limit as a single person, your gross monthly income must be at or below $1,350. For a couple, the limit is $1,824.

SLMB (Specified Low-Income Medicare Beneficiary) covers the Part B premium only. Gross income must fall between $1,351 and $1,616 for an individual, or $1,825 to $2,184 for a couple. SLMB can be applied retroactively up to three months before the month you applied.

QI (Qualifying Individual) also covers only the Part B premium. Gross income falls between $1,617 and $1,816 for one person, or $2,185 to $2,455 for a couple. QI is funded from a capped federal allotment, so applying early in the calendar year matters.

All three tiers share the same 2026 resource limits: $9,950 for an individual and $14,910 for a couple. These are significantly higher than Nebraska's regular Medicaid asset limit of $4,000/$6,000.

How Income Is Counted

Nebraska DHHS uses gross income — not what hits your bank account. If Social Security deducts $202.90 for Part B before depositing your check, DHHS counts the full amount before that deduction. A mandatory $20 general income disregard is then subtracted from gross income to reach countable income. The published limits above already have that disregard built in, so you compare your gross income directly against the threshold without subtracting $20 again.

This matters because a senior with $1,365 in gross Social Security is above the published QMB limit of $1,350. Since the published limit already incorporates the $20 disregard, that income does not meet the QMB income limit; it is below the SLMB limit.

What Happens After Approval

All three MSP tiers automatically qualify you for Extra Help (the Part D Low-Income Subsidy). There is no separate application. Once DHHS approves your MSP, CMS awards Extra Help. For people with MSP-only status, 2026 copays are up to $5.10 for generics and $12.65 for brand-name drugs.

QMB enrollees also gain federal billing protections — providers cannot bill you for Medicare deductibles, coinsurance, or copayments under any circumstances.

Where to Start

Applications go through iServe Nebraska at iserve.nebraska.gov, by mailing Form MLTC-64, or by calling DHHS Medicaid Customer Service at (855) 632-7633. Nebraska SHIIP (1-800-234-7119) offers free, unbiased counseling on Medicare Savings Programs and can walk you through the eligibility math.

If you want a step-by-step roadmap covering the full application process, income worksheets, document checklists, and what to do if you're denied, the Nebraska Medicare Savings Programs & Extra Help Guide lays out the complete workflow.

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