How to Calculate Income for QMB in Nevada: The $20 Disregard Explained

Why Families Self-Reject Based on the Wrong Number

The most common reason eligible Nevadans never apply for QMB: they compare their gross Social Security amount to the published income limit and assume they are over. But DWSS does not use gross income. Nevada applies specific disregards that lower the countable amount — and that math makes the difference for thousands of families near the line.

The $20 General Unearned Income Disregard

Every MSP applicant in Nevada gets $20 subtracted from their monthly unearned income before DWSS compares it to the limit. This is the standard SSI General Income Exclusion applied under MAABD budgeting rules.

For a single applicant, the 2026 QMB income limit is $1,350 per month. But because of the $20 disregard, someone with gross unearned income of up to $1,370 per month can still qualify — DWSS subtracts $20, bringing the countable amount to $1,350.

That $20 sounds small until you realize how many Social Security checks cluster right around the $1,330 to $1,370 range. A $5 Social Security COLA increase that puts someone at $1,355 gross does not knock them out of QMB eligibility.

The Full Income Calculation

DWSS follows SSI budgeting rules in a strict sequence:

Unearned income (Social Security, pensions, VA benefits, annuities): start with the gross amount — before any Medicare Part B premium is withheld — and subtract the $20 disregard. That is your countable unearned income.

Earned income (wages, self-employment): subtract $65 from gross earnings, then divide the remainder by 2. That is your countable earned income.

Total countable income = countable unearned + countable earned.

Here is a worked example: a single Nevadan receives $1,360 per month in gross Social Security and earns $85 per month from part-time work.

• Unearned: $1,360 − $20 = $1,340
• Earned: ($85 − $65) ÷ 2 = $10
• Total countable: $1,340 + $10 = $1,350

That lands exactly at the QMB limit. Eligible.

Without the disregards, the raw total would be $1,445, and this applicant would have assumed they were $95 over the limit. They would have walked away from $2,434 per year in Part B premium savings plus elimination of all Medicare deductibles and coinsurance.

What Counts as Gross Income

DWSS counts gross unearned income before any deductions. That includes Social Security Title II benefits at the gross amount (before Part B premium withholding), Civil Service Retirement System pensions, private annuities, and Veterans Affairs benefits (excluding Aid and Attendance).

A common mistake: looking at the net Social Security deposit in your bank account. If your parent's bank shows $1,157 deposited monthly, that is already net of the $202.90 Part B premium deduction. The gross amount DWSS uses is $1,360 — higher than what lands in the bank, but also the number the $20 disregard gets applied to.

Couples Work the Same Way

For married couples where both live together and one is applying, DWSS combines household income and resources and compares against couple limits. The 2026 QMB couple limit is $1,824 per month (after the $20 disregard). The same $20 disregard applies once per household, not per person.

COLA Timing Protection

Every January, Social Security applies a Cost-of-Living Adjustment that raises benefit amounts. But the new Federal Poverty Level guidelines typically are not published until February or March. To prevent the COLA from disqualifying people before the new, higher FPL limits take effect, Nevada DWSS disregards the COLA amount from January until the state posts the updated poverty guidelines. This is automatic — you do not need to request it.

The Nevada Medicare Savings Programs & Extra Help Guide includes the full income calculation worksheet with examples for single applicants, couples, and applicants who have both earned and unearned income, plus the current resource limits and what assets are excluded.

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