QMB Income Limits 2026: Eligibility, Benefits, and How to Apply

What QMB Actually Covers (and Why the Income Limits Matter)

The Qualified Medicare Beneficiary program is the most comprehensive of the four Medicare Savings Programs, and it's the one most caregivers should apply for first. QMB pays your parent's Part B premium ($202.90/month in 2026), the Part A inpatient hospital deductible ($1,736 per benefit period), the Part B annual deductible ($283), and all Medicare coinsurance and copayments.

That's $2,434.80 in annual Part B premium savings alone — before counting the deductible and coinsurance coverage that has no annual cap under Original Medicare.

QMB enrollment also triggers automatic enrollment in Extra Help (the Part D Low-Income Subsidy), which covers prescription drug premiums, eliminates the Part D deductible, and caps copays at $5.10 for generics and $12.65 for brand-name drugs.

2026 QMB Income and Asset Limits

Federal QMB eligibility requires countable monthly income at or below 100% of the Federal Poverty Level, plus the standard $20 monthly unearned income disregard. For 2026:

• Individual: $1,350/month ($16,200/year)
• Married couple: $1,824/month ($21,888/year)
• Asset limit (individual): $9,950
• Asset limit (couple): $14,910

Assets that don't count: the primary residence, one vehicle, household goods, personal effects, and up to $1,500 set aside for burial expenses.

Alaska and Hawaii use higher poverty guidelines. Alaska QMB limits are $1,683/month (single) and $2,275/month (couple). Hawaii limits are $1,550 (single) and $2,095 (couple).

States That Ignore the Asset Test Entirely

Eleven states and the District of Columbia (12 jurisdictions) have abolished the asset test for QMB, SLMB, and QI programs: Alabama, Arizona, Connecticut, Delaware, District of Columbia, Louisiana, Maine, Mississippi, New Mexico, New York, Oregon, and Vermont. In these jurisdictions, eligibility depends solely on countable income.

Some states also use higher income limits. Connecticut expanded QMB eligibility to $2,752/month for individuals and $3,719 for couples. The District of Columbia raised its QMB threshold to $4,010 for individuals and $5,430 for couples. Indiana increased limits to $2,015 (individual) and $2,725 (couple).

How Countable Income Is Calculated

QMB uses the Supplemental Security Income (SSI) methodology for income counting, not the Modified Adjusted Gross Income (MAGI) method used by marketplace insurance. The key differences:

• $20 monthly unearned income disregard — Social Security, pensions, and investment income each get this deduction applied once to the household
• $65 monthly earned income disregard plus a 50% reduction on the remainder (if the applicant still works)
• In-kind support (free housing, meals from family) may count depending on the state

This means a parent's gross Social Security check can exceed the chart limits by at least $20/month and still qualify.

How to Apply for QMB

The application goes through your parent's state Medicaid agency, not Medicare or Social Security. The process:

1. Gather documents: Medicare card, Social Security card, three months of bank statements, pension/Social Security benefit letters, proof of address (utility bill), and burial fund documentation if applicable
2. Submit the state application: Apply through the state portal — BenefitsCal in California, YourTexasBenefits in Texas, ACCESS Florida, or HRA MyBenefits in New York. Paper applications are also available at county social services offices
3. Wait for the eligibility determination: States must issue a Notice of Action within 45 days
4. Continue paying premiums during processing: The Part B buy-in takes two to three months to activate through the inter-agency COBA system. Stopping payments during this gap terminates Medicare coverage

Once approved, the SSA will issue a retroactive reimbursement for premiums paid during the processing period. QMB coverage is prospective — benefits begin the first day of the month following the eligibility determination.

The Social Security Fairness Act Complication

The Social Security Fairness Act (signed January 5, 2025) repealed the WEP and GPO, permanently eliminating benefit reductions for retired public servants. For many retirees, this meant an average monthly increase of $360. That increase may push a parent's countable income above QMB limits.

If your parent received a Social Security increase due to the Fairness Act and now exceeds the QMB threshold, check whether they still qualify for SLMB (120% FPL, up to $1,616/month) or QI (135% FPL, up to $1,816/month). Both programs cover the Part B premium and trigger Extra Help enrollment.

The Medicare Savings Programs toolkit walks through each tier's limits and includes a screening worksheet that accounts for the post-Fairness Act income changes.

See more United States guides →