North Dakota Medicare Savings Program Income Limits 2026
2026 Income Limits by Program Tier
North Dakota's Medicare Savings Program income ceilings for 2026, after applying the standard $20 unearned income disregard:
| Program | Single | Couple |
|---|---|---|
| QMB (≤100% FPL) | $1,350/month | $1,824/month |
| SLMB (101–120% FPL) | $1,350.01–$1,616 | $1,824.01–$2,184 |
| QI (121–135% FPL) | $1,616.01–$1,816 | $2,184.01–$2,455 |
Resource limits are identical across all three tiers: $9,950 for a single person, $14,910 for a couple.
Why Gross Income Matters (Not the Direct Deposit)
This trips up most families. North Dakota HHS counts gross Social Security — the full monthly benefit before Part B premiums, tax withholding, or any other deductions come out.
If your parent's bank shows a $1,147 direct deposit, their countable income isn't $1,147. It's the gross amount on their Social Security benefit statement — which could be $1,350 or higher before the $202.90 Part B deduction and any tax withholding.
Check the annual benefit letter from SSA or the monthly benefit statement for the gross figure.
The $20 Disregard That Changes Everything
North Dakota subtracts a $20 general income disregard from total unearned income before comparing it to the limits. This sounds small, but it's the difference between qualifying and not for many families.
A senior receiving $1,365/month in gross Social Security looks over the $1,350 QMB ceiling. But after the $20 disregard: $1,365 − $20 = $1,345. That's under $1,350, and they qualify for QMB — the most comprehensive tier that covers premiums, deductibles, and all cost-sharing.
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Earned Income Gets Additional Deductions
If your parent still works, the calculation is more generous. After applying any remaining portion of the $20 general disregard, North Dakota deducts $65 from gross earnings, then disregards half of whatever's left.
A senior with $1,200 in Social Security and $400 in part-time earnings: the $20 comes off the Social Security first ($1,180), then the $65 off earnings ($335), then half the remainder ($167.50). Total countable: $1,180 + $167.50 = $1,347.50 — under QMB.
What About Pensions and VA Benefits?
Private pensions, civil service annuities, and VA disability payments all count as gross unearned income. VA Aid and Attendance allowances and certain medical reimbursements are excluded.
Irregular or infrequent income under $20/month (unearned) or $10/month (earned) is also disregarded.
The COLA Disregard for Existing Enrollees
North Dakota protects current QI recipients from losing coverage during the annual Social Security cost-of-living adjustment. Under state policy, the January COLA increase is disregarded during January, February, and March, giving time for updated federal poverty guidelines to take effect on April 1.
The North Dakota Medicare Savings Programs & Extra Help Guide includes an income calculation worksheet that walks through every disregard and deduction step by step, so you can confirm eligibility before filing.
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