Medicare Savings Programs and Extra Help: Who Qualifies and How to Apply
If your parent lives on a modest income, their state may pay the $202.90 monthly Part B premium and more. Here are the 2026 limits and how to apply.
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Medicare Savings Programs are state programs that pay some or all of your parent's Medicare costs. All three main ones (QMB, SLMB and QI) pay the Part B premium, $202.90 a month in 2026, and QMB also covers deductibles and copays. In 2026, one person with income up to $1,816 a month and $9,950 or less in savings may qualify; a home and car don't count. Qualifying also brings Extra Help with drug costs.
We're not insurance or benefits advisers. The limits below change every year, and some states use more generous rules than the federal numbers. For free, unbiased help, your parent can call their State Health Insurance Assistance Program (SHIP) at 877-839-2675 or their state Medicaid office.
Your mom keeps her budget on the back of an envelope: Social Security in, rent and groceries out, and $202.90 a month for Medicare Part B. She has never asked anyone for help, and she isn't about to start. But if her income is modest, her state may pay that premium for her, and possibly her copays and her prescriptions too. She'd never go looking for it. A lot of people don't: more than one in three people who qualify for these programs still aren't enrolled. Here's what they pay, who qualifies in 2026, and how to apply without making her feel like she's asking for a handout.
What these programs pay
Medicare isn't free. In 2026, the standard Part B premium is $202.90 a month, or about $2,435 a year, and the Part B deductible is $283, according to Medicare's 2026 costs. After that, your parent usually pays 20% of each covered service. For someone living on Social Security alone, that adds up fast.
A Medicare Savings Program is run by your parent's state and pays part of that bill. There are three your parent is likely to qualify for:
- QMB (Qualified Medicare Beneficiary). The most generous. It pays the Part B premium, the Part A premium if your parent pays one, and Part B deductibles, coinsurance and copays. Doctors and hospitals that take Medicare aren't allowed to bill a QMB member for Medicare-covered services.
- SLMB (Specified Low-Income Medicare Beneficiary). Pays the Part B premium.
- QI (Qualifying Individual). Also pays the Part B premium, for people with slightly higher income. Your parent has to reapply every year, and states approve QI on a first-come, first-served basis.
- A bonus with all three: anyone in a Medicare Savings Program gets Extra Help with prescription costs automatically. For the rest of 2026, that caps each covered drug at $5.10 for a generic and $12.65 for a brand name, according to Social Security's Extra Help rules.
The 2026 income and asset limits
These are the federal monthly income and resource limits for 2026 from Medicare. Limits are slightly higher in Alaska and Hawaii.
- QMB: income up to $1,350 a month for one person ($1,824 for a married couple); resources up to $9,950 ($14,910 for a couple).
- SLMB: income up to $1,616 a month ($2,184 for a couple); same resource limits.
- QI: income up to $1,816 a month ($2,455 for a couple); same resource limits.
What counts, and why you should apply anyway
Resources means money in checking, savings and retirement accounts, plus stocks and bonds. States don't count your parent's home, one car, a burial plot, up to $1,500 set aside for burial, furniture or other household and personal items. So a parent with a paid-off house and $8,000 in the bank can still qualify.
The federal numbers are a floor, not a ceiling. Some states don't count certain kinds or amounts of income or resources, and as of 2023, 18 states and Washington, D.C., used income and asset limits more generous than the federal minimum, according to a May 2026 brief from West Health, based on Urban Institute analysis. Medicare's own advice is blunt: "Even if you don't think you qualify, you should still apply."
The approval notice, the QI renewal, the Extra Help letter from Social Security: your parent can read it to Tiina, or share a photo, and hear what it says in plain words, as many times as they need. She talks through the next step, and they decide.
Extra Help with prescription costs
Extra Help is the drug-cost side of this. It helps pay Part D premiums, deductibles and copays, and while your parent has it they don't owe a Part D late enrollment penalty. Your parent gets it automatically if they have full Medicaid, a Medicare Savings Program or Supplemental Security Income.
If not, they can apply on their own. The 2026 limits are yearly income up to $23,940 and resources up to $18,090 for one person ($32,460 and $36,100 for a married couple). With Extra Help, the plan premium and deductible are $0. Through December 2026, each covered drug costs no more than $5.10 for a generic or $12.65 for a brand name. Medicare has already posted the 2027 amounts: $5.80 and $14.40, and $0 for every covered drug once total drug costs reach $2,400 that year.
People with Extra Help can also change their drug coverage once a month, instead of waiting for open enrollment like everyone else.
How to apply
For a Medicare Savings Program, apply through your parent's state Medicaid office. Medicaid's state directory lists each state's agency with phone numbers and links. Have your parent's Medicare card, their Social Security benefit letter or other proof of income, and recent bank statements ready.
For Extra Help, your parent can apply online with Social Security or call 1-800-772-1213 on a weekday. Here's a shortcut worth knowing: when your parent applies for Extra Help, Social Security sends their information to the state to start a Medicare Savings Program application too, unless they say not to. One application, two chances.
If the forms feel like too much, a SHIP counselor will walk through them with your parent for free, and the free BenefitsCheckUp screener can check for these and other benefits in a few minutes. Nobody legitimate charges to apply. If someone calls offering to sign your parent up for a fee, it's a scam; here are the tells of a Medicare scam call.
One note: if what you're really after is Medicaid paying you to care for your parent, that's a different program, covered on the paid caregiver page of your Survival Guide.
Why so many people who qualify never apply
Participation has improved, but more than one in three eligible people still aren't enrolled, according to the May 2026 West Health brief. People 65 and older were 18.3% less likely to be enrolled than younger people with Medicare. The researchers point to limited awareness of the programs, confusion about who's eligible, trouble with technology, and worry about scams. People with savings near the limit were also less likely to enroll, which the researchers suggest may reflect confusion about who qualifies.
For a parent, there's often pride on top of that. It helps to say plainly what this is: not charity, but a standard part of how Medicare and Medicaid work together, and something every state Medicaid program is required to offer. Lead with the number: "This could save you $202.90 every month." Then offer to sit with them while they call, so the hardest part isn't done alone.
After your parent is approved
Your parent will get a notice in the mail. With QMB, they should show both their Medicare card and their Medicaid or QMB card every time they get care. If they have Original Medicare, the Medicare Summary Notice also shows they're in QMB, and it's worth learning to read; here's what an EOB or Summary Notice means.
With Extra Help, Medicare will enroll your parent in a drug plan if they don't have one. If a pharmacy charges the wrong amount, call the drug plan first, then 1-800-MEDICARE (1-800-633-4227). And if your parent is in QI, put a reminder on the calendar to reapply next year.
Mom opens the Medicare mail again, because someone will explain it.
The $202.90 premium stops coming out of her check, and the envelopes keep coming: the Summary Notice, the drug plan letter, the QI reminder next fall. She reads each one to Tiina, hears it in plain words, and decides what to do, with nothing reported back to the family.
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Methodology & editorial policy
Reviewed and updated October 31, 2026 by the Tiina Editorial Team. Facts, programs and prices in this guide come from the sources listed below.
About composite scenarios. The opening scene is a composite.
About Tiina. Tiina is a voice-first AI companion for older adults: an app for iPhone and iPad that your parent opens whenever they want someone to talk to, day or night.
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Sources. 10 references: Medicare.gov, Social Security Administration, Medicaid.gov, West Health Policy Center and Aurrera Health Group, SHIP Technical Assistance Center, National Council on Aging, MACPAC.View all
- Medicare.gov. Medicare Savings Programs. medicare.gov
- Medicare.gov. Help with drug costs (Extra Help). medicare.gov
- Medicare.gov. Medicare costs 2026. medicare.gov
- Social Security Administration. Apply for Extra Help with Medicare Prescription Drug Plan Costs. secure.ssa.gov
- Medicaid.gov. Where can people get help with Medicaid and CHIP?. medicaid.gov
- West Health Policy Center and Aurrera Health Group. Rising MSP Participation Signals Progress, but Significant Enrollment Gaps Remain (May 2026). a-us.storyblok.com
- SHIP Technical Assistance Center. Get Medicare help from your local SHIP. shiphelp.org
- National Council on Aging. BenefitsCheckUp. benefitscheckup.org
- MACPAC. Medicare Savings Programs: New Estimates Continue to Show Many Eligible Individuals Not Enrolled. macpac.gov
- Social Security Administration. POMS HI 03001.005: Medicare Part D Extra Help (Low-Income Subsidy). secure.ssa.gov
