Ohio Medicare Savings Program Income Limits 2026

2026 Monthly Income Limits by Program

Ohio sets Medicare Savings Program income limits based on the Federal Poverty Level guidelines published annually by the Department of Health and Human Services. The published 2026 limits include Ohio's mandatory $20 general unearned income disregard:

QMB (Qualified Medicare Beneficiary) — up to 100% FPL:

• Single: $1,350/month
• Couple: $1,824/month

SLMB (Specified Low-Income Medicare Beneficiary) — 100% to 120% FPL:

• Single: $1,616/month
• Couple: $2,184/month

QI (Qualifying Individual) — 120% to 135% FPL:

• Single: $1,816/month
• Couple: $2,455/month

QDWI (Qualified Disabled Working Individual) — up to 200% FPL:

• Single: $2,660/month
• Couple: $3,595/month

If your countable income is $1,351 as a single person, you don't qualify for QMB — but you almost certainly qualify for SLMB. The programs form a ladder. You don't have to pick the right one; the county JFS caseworker determines your tier based on your income.

How Ohio Counts Your Income

County CDJFS caseworkers count gross monthly income from all sources: Social Security retirement or disability benefits (RSDI), private pensions, civil service annuities, Railroad Retirement, and VA compensation. Wages, salaries, tips, and net self-employment earnings count as earned income.

What doesn't count: VA Aid & Attendance payments, VA Housebound allowances, and VA unreimbursed medical expense payments are excluded. Irregular unearned income under $20/month and irregular earned income under $10/month are also excluded.

The income calculation follows a specific sequence. First, the $20 general disregard is subtracted from unearned income. Then, for earned income, a $65 earned income disregard is applied, followed by subtracting half the remaining earned income. Working disabled applicants under 65 can also deduct Impairment-Related Work Expenses.

The COLA Protection Window

Every January, Social Security cost-of-living adjustments raise your benefit amount. That bump could push your countable income past a program threshold. Ohio protects against this: Social Security COLA increases are disregarded for MPAP eligibility determinations from January 1 through March 31. Updated FPL-based limits take effect April 1, when the new poverty guidelines are incorporated.

This means you won't lose coverage in the first quarter of the year just because the COLA increased your check before the new, higher limits kick in.

What If You're Just Over the Limit

If your parent's income is a few dollars above the QMB cutoff, check whether the caseworker applied the $20 disregard correctly — the published limits already include it, but errors happen, particularly with pension income where gross vs. net figures get confused.

Also verify that only countable income sources are included. A surviving spouse's VA Aid & Attendance benefit, for instance, should be excluded entirely. If the denial stands, you still qualify for the next tier up (SLMB or QI), which at minimum covers the $202.90 monthly Part B premium.

For a detailed income worksheet and the complete verification document checklist, the Ohio Medicare Savings Programs & Extra Help Guide walks through the calculation step by step with worked examples for common Ohio income scenarios.

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