Oregon Medicare Savings Program for Disabled Under 65

Medicare Savings Programs Are Not Just for Seniors

Most people associate Medicare cost help with retirement. But if you are under 65 and receive Social Security Disability Insurance (SSDI), you qualify for Medicare after a 24-month waiting period — and you face the same $202.90 monthly Part B premium deduction from a disability check that is often far smaller than a retirement benefit.

Oregon's Medicare Savings Programs (QMB, SMB, and SMF) apply to anyone with Medicare entitlement, regardless of age. If you have Medicare Part A and your countable income falls within the Federal Poverty Level thresholds, you can apply. The 2026 limits after Oregon's standard $20 income disregard:

• QMB (100% FPL): $1,350/month single, $1,824/month couple — pays Part A and Part B premiums plus all deductibles and coinsurance
• SMB (120% FPL): $1,616/month single, $2,184/month couple — pays Part B premium
• SMF (135% FPL): $1,816/month single, $2,455/month couple — pays Part B premium (capped allocation)

Oregon eliminated the asset test for all three programs. Your savings, vehicle, and home do not count.

SSDI Recipients and QMB

If you receive SSDI and have completed the 24-month Medicare waiting period, you likely have both Part A and Part B. Your SSDI monthly benefit is counted as gross unearned income before the Part B deduction is taken out.

Here is the critical calculation: if your gross SSDI is $1,345/month, subtracting Oregon's $20 unearned income disregard yields $1,325 in countable income — below the $1,330 QMB threshold. You qualify for QMB, which eliminates the $202.90 Part B premium, the $283 annual deductible, and all Medicare coinsurance.

Some SSDI recipients also receive SSI. In Oregon, people receiving SSI who also have Medicare Part A and Part B are assumed eligible for both OSIPM (full Oregon Health Plan) and QMB without a separate income evaluation. Oregon is a 1634 state.

The EPD Pathway: Employed Persons with Disabilities

Oregon also has an Employed Persons with Disabilities (EPD) Medicaid program. EPD and MSP are separate pathways; a working disabled person who has Medicare may also apply for an MSP.

For MSP eligibility, earned income is subject to the standard $20 general disregard (if it is not already used against unearned income), an additional $65 earned income disregard, and a 50% disregard on the remaining amount.

For example, if you earn $1,400/month gross from part-time work and receive no unearned income: subtract $20 (general disregard) = $1,380, then subtract $65 (earned income disregard) = $1,315, then subtract 50% of $1,315 = $657.50 in countable earned income. That is well below the QMB single threshold of $1,330.

QDWI: The Forgotten Fourth Program

Oregon also administers the Qualified Disabled Working Individual (QDWI) program, coded as QMB-DW. This covers a narrow but important situation: individuals under 65 who previously received SSDI and free Medicare Part A, but lost premium-free Part A because they returned to substantial gainful activity and their SSDI ended.

Without QDWI, these individuals would face Part A premiums of up to $565/month — devastating for someone trying to maintain independence through work. QDWI pays the Part A premium only.

QDWI eligibility in 2026:

• Income below 200% FPL: $2,660/month single, $3,607/month couple
• Resource limit: $4,000 individual, $6,000 couple (QDWI is the one MSP category that still has an asset test in Oregon)
• Not eligible for Medicaid through any other pathway

QDWI is rarely discussed because the eligible population is small, but if you are in this situation, it is the only program that prevents a $565/month premium from destroying the financial benefit of returning to work.

Applying With a Disability

The application process is the same as for any MSP — through the ONE Oregon portal at one.oregon.gov, by calling 800-699-9075, or at your local APD or Area Agency on Aging office. If your disability makes it difficult to complete the application yourself, a family member or advocate can file on your behalf using Form MSC 0231 (Authorized Representative form).

One timing note: if you are under 65 and your Medicare eligibility requires a disability determination that is not yet established with Social Security, ODHS has up to 90 calendar days (instead of the standard 45) to process your MSP application.

The Oregon Medicare Savings Programs & Extra Help Guide includes income calculation worksheets that account for earned income disregards, making it straightforward to determine your eligibility whether you are on SSDI alone, working through EPD, or navigating the QDWI pathway.

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