New York QMB and QI Income Limits 2026
QMB in New York: Up to 138% FPL
Qualified Medicare Beneficiary status in New York covers more ground than in most states. The 2026 income limits:
| Household | Gross Monthly Income Limit |
|---|---|
| Individual | $1,856 |
| Couple | $2,509 |
QMB is the full package. It pays:
- The Part B premium ($202.90/month in 2026)
- Premium Part A for those without enough work credits ($311 or $565/month)
- The Part A hospital deductible ($1,736 per benefit period)
- All Part B deductibles, coinsurance, and copays
- Skilled nursing facility coinsurance ($217/day for days 21–100)
QMB also carries federal billing protections. Medicare-participating providers cannot bill a QMB enrollee for any cost-sharing — no deductible bills, no copay invoices. If a provider sends one, federal law prohibits them from collecting.
QI in New York: Up to 186% FPL
Qualifying Individual covers seniors with slightly higher incomes:
| Household | Gross Monthly Income Limit |
|---|---|
| Individual | $2,494 |
| Couple | $3,375 |
QI pays the Part B premium only — the same $202.90/month. It does not cover deductibles, copays, or coinsurance. But $2,434.80 annually is still significant for someone on a fixed income.
One constraint: QI recipients cannot simultaneously receive full Medicaid. If a senior needs both MSP help and full Medicaid, they would need to qualify for QMB instead, which allows dual coverage.
Why There Is No SLMB in New York
If you are searching for SLMB income limits in New York, you will not find current ones. New York eliminated the SLMB category on January 1, 2023. Everyone who would have been SLMB (100–120% FPL) now falls under QMB (up to 138% FPL).
This is an upgrade. SLMB only paid the Part B premium. QMB pays the premium plus all cost-sharing — deductibles, copays, and coinsurance. Former SLMB recipients were automatically reclassified to QMB and gained thousands of dollars in additional coverage without reapplying.
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How to Apply for QMB or QI
Both categories use the same application: form DOH-4328 (Application for Medicare Savings Program). You do not need to specify QMB or QI — the agency determines the correct category based on the income reported.
Submit to:
- NYC residents: ACCESS HRA portal or an HRA Medicaid office
- Upstate/Long Island: County Department of Social Services or NY State of Health
No asset documentation is required. New York has had no MSP asset test since 2008.
Both QMB and QI automatically trigger full Extra Help for Part D drug costs — the pharmacy savings kick in without a separate application to Social Security.
The New York Medicare Savings Programs Guide includes a side-by-side comparison of QMB and QI benefits, the income worksheets, and the timeline from application to first premium refund.
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Download the New York — Medicare Savings Program Eligibility Checklist — a printable guide with checklists, scripts, and action plans you can start using today.