New York Medicare Savings Program Income Limits 2026
2026 Income Limits for QMB and QI in New York
New York's Medicare Savings Program income thresholds are significantly higher than the federal baseline. After the state expanded eligibility in January 2023, the limits now stand at:
| Program | Individual | Couple |
|---|---|---|
| QMB (138% FPL) | $1,856/month | $2,509/month |
| QI (186% FPL) | $2,494/month | $3,375/month |
These figures include the standard $20 monthly unearned income disregard that the state builds into published tables. Gross Social Security income is counted before the Part B premium deduction — the full benefit amount, not what hits the bank account.
For comparison, the federal QMB limit is just $1,350/month (100% FPL). New York's expanded threshold means roughly 500,000 additional seniors could qualify compared to the federal floor.
New York Has No Asset Test
This is the single most misunderstood rule. National sources — including Medicare.gov — cite a federal asset limit of $9,950 for individuals and $14,910 for couples. But New York eliminated the MSP asset test in 2008 under state option authority.
Bank accounts, certificates of deposit, retirement savings, investment portfolios, home equity, vehicles — none of it counts for MSP in New York. Only income matters. A senior with $200,000 in savings and $1,800 in monthly income still qualifies for QMB.
This applies only to the Medicare Savings Program. Full non-MAGI Medicaid in New York does retain an asset limit ($33,038 individual / $44,796 couple in 2026), and institutional long-term-care Medicaid may involve a 60-month look-back. Families often confuse the two, which is why many assume they are ineligible when they are not.
What the 2023 Expansion Changed
Before January 1, 2023, New York followed the standard three-tier structure: QMB up to 100% FPL, SLMB from 100–120% FPL, and QI from 120–135% FPL. The 2023 expansion:
- Raised QMB eligibility from 100% to 138% FPL
- Eliminated the SLMB category entirely — everyone formerly in SLMB now gets full QMB coverage
- Extended QI from 135% to 186% FPL
The upgrade from SLMB to QMB matters because QMB pays all Medicare deductibles, copays, and coinsurance — not just the Part B premium. That is thousands of dollars in additional annual protection.
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Income Disregards That Can Help
If gross income is close to the limit, certain deductions apply:
- $20 monthly unearned income disregard — already built into the published thresholds
- Health insurance premiums — Medigap, dental, and vision premiums paid by the applicant may be deducted from countable income
- Earned income formula — working seniors get a $65 disregard plus 50% of remaining earnings excluded
A senior whose gross Social Security is $1,870/month — technically over the QMB limit — might qualify after deducting a $150/month Medigap premium brings countable income to $1,720.
For the full income calculation worksheet and application steps, the New York Medicare Savings Programs Guide walks through the math line by line.
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