NH QMB vs SLMB vs SLMB135: Which Medicare Savings Tier Fits?
Three Tiers, Different Coverage
New Hampshire runs three main Medicare Savings Program tiers, each named after its federal counterpart but with one labeling quirk that trips people up. Here's what each one actually pays:
QMB (Qualified Medicare Beneficiary) is the most generous. It covers:
- Part B monthly premium ($202.90 in 2026)
- Part A monthly premium, if you pay one
- Part A hospital deductible ($1,736 per benefit period)
- Part B annual deductible ($283)
- All Medicare coinsurance and copays
SLMB (Specified Low-Income Medicare Beneficiary) covers:
- Part B monthly premium ($202.90)
- Part B late enrollment penalties, if any
SLMB135 covers:
- Part B monthly premium ($202.90)
That last one is where New Hampshire's naming causes confusion. The federal government calls this tier "QI" or "Qualifying Individual." New Hampshire DHHS labels it SLMB135 because the income ceiling is 135% of the Federal Poverty Level. If you see "QI" on a federal website and "SLMB135" on a state form, they're the same thing.
Income Limits Side by Side (2026)
| Tier | Single | Couple | What It Pays |
|---|---|---|---|
| QMB | ≤ $1,350/mo | ≤ $1,824/mo | Premiums + all cost-sharing |
| SLMB | $1,351–$1,616/mo | $1,825–$2,184/mo | Part B premium only |
| SLMB135 | $1,617–$1,816/mo | $2,185–$2,455/mo | Part B premium only |
All three share the same asset limit: $9,950 for an individual, $14,910 for a couple. The income figures above include the standard $20 general disregard.
A Fourth Tier Most People Miss
QDWI (Qualified Disabled Working Individual) exists for people under 65 who lost premium-free Part A when they returned to work and exceeded the Social Security disability income limit. QDWI pays their Part A premium — up to $565 a month. The income limit is much higher ($5,405 single), but the asset limit is lower ($4,000).
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How to Tell Which Tier Applies
Start with countable monthly income. Take gross Social Security (before any deductions) and subtract $20. That's the countable figure for most applicants. Compare it to the table above.
If your parent's income falls at or below the QMB limit, apply for QMB — DHHS will approve the highest tier they qualify for. If income is too high for QMB but under $1,616, the approval comes through as SLMB. Between $1,617 and $1,816, it's SLMB135.
You don't pick a tier on the application. DHHS Form 800 and NH EASY ask for financial information, and the caseworker determines which level fits. If income changes later — say, after a COLA increase pushes someone from QMB to SLMB — DHHS adjusts the tier at renewal without requiring a new application.
Extra Help Comes With All Three
Approval for QMB, SLMB, or SLMB135 automatically qualifies your parent for Full Extra Help with Part D prescription drug costs. No separate application needed. That means $0 deductible on prescriptions and copays as low as $1.60 for generics.
One Key Difference: When Coverage Starts
QMB coverage starts prospectively — the first day of the month after DHHS approves the application. No retroactive help with past premiums.
SLMB and SLMB135 can be applied retroactively for up to three calendar months before the application month, as long as the person was eligible during those months. SLMB135 retroactivity can't cross into a prior calendar year.
That timing difference matters. If your parent has been paying $202.90 a month out of pocket for several months, SLMB or SLMB135 approval can recoup up to $608.70 in retroactive premium reimbursement.
Our New Hampshire Medicare Savings Programs & Extra Help Guide breaks down each tier with worked income examples and a decision flowchart, so you can figure out the right fit before the application goes in.
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