Oklahoma Medicare Savings Program Income Limits

2026 Income Limits by Program Tier

OKDHS publishes these limits annually in Appendix C-1. These are countable-income standards; the $20 monthly general income disregard is applied under each program's rules:

These thresholds cover four different levels of help. QMB pays everything — Part A premium, Part B premium, deductibles, coinsurance, copays. SLMB and QI-1 pay only the Part B premium ($202.90/month in 2026). QDWI covers the Part A premium for working disabled individuals.

How OKDHS Actually Counts Your Income

The limits above look straightforward, but the calculation method determines whether you qualify or fall just over the line. OKDHS follows OAC 317:35-5-42, and two mechanical rules matter:

The $20 general unearned income disregard. OKDHS subtracts $20 from your total unearned income before comparing it against the limit. This is per household, not per person. If your gross Social Security is $1,365, your countable income is $1,345 — below the QMB limit.

For QDWI, the $20 general disregard is applied to either earned or unearned income, not both.

The BENDEX cent-drop. When OKDHS verifies your Social Security benefits through the federal BENDEX electronic interface, cents are dropped to the next lower whole dollar. A gross benefit of $1,349.80 becomes $1,349 in the system. This isn't rounding — cents are always dropped, never rounded up. That matters for people sitting right at the threshold.

Combined, these two rules can push someone who looks over-income back under. A senior with gross Social Security of $1,369.90 becomes $1,369 after the cent-drop, then $1,349 after the $20 disregard — exactly at the QMB individual limit.

What Counts as Income (and What Doesn't)

Counted: Gross Social Security (RSDI), pensions, annuities, VA service-connected disability payments, interest and dividend income.

Not counted: In-kind support and maintenance (food or shelter someone gives you), VA Aid & Attendance payments, and income from adult children living in the household. That last one surprises people — if a parent lives with an adult child earning $4,500/month, only the parent's own income counts for MSP eligibility.

Earned income gets a bigger break. If you're still working, OKDHS applies a $65 earned income exclusion plus a 50% disregard on the remaining gross earned income, on top of the $20 general disregard.

Spousal Income Rules

When both spouses live together, their income is combined under spousal deeming rules in OAC 317:35-5-42. But when spouses have been separated for more than 30 consecutive days — whether through legal separation or just living apart — deeming stops. Only the applicant's own income and assets are evaluated.

This matters for seniors in situations where an estranged spouse's pension would push joint income over the limit. If they've been living apart for more than 30 days, that pension drops out of the calculation entirely.

What Happens When Income Changes Mid-Year

Social Security cost-of-living adjustments (COLA) hit every January, bumping gross income. But the Federal Poverty Guidelines don't update until late January or February. Oklahoma bridges this gap with a mandatory COLA Disregard: the dollar amount of the January increase is excluded from countable income until the state eligibility system catches up to the new poverty thresholds.

If OKDHS terminates your MSP in January because the COLA pushed your income over the old threshold, that's an error. Request a fair hearing and cite 42 CFR § 435.135.

The Oklahoma Medicare Savings Programs & Extra Help Guide includes income worksheets that walk through the full calculation — cent-drop, disregards, spousal deeming — with worked examples for every MSP tier.

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