The short answer
The Medicare Savings Programs, run by state Medicaid agencies, pay the Part B premium - $202.90 a month in 2026 - and in the most generous tier the deductibles and coinsurance too. Extra Help, run by Social Security, lowers Part D drug costs. The federal income limits start at $1,350 a month for one person and reach $1,816, and savings of up to $9,950 are allowed.
Four programmes, one purpose
The Qualified Medicare Beneficiary programme, QMB, is the broadest: it pays the Part A and Part B premiums and the deductibles, coinsurance and copayments Medicare would otherwise leave to you. Providers are not allowed to bill a QMB enrollee for Medicare-covered services. The Specified Low-Income Medicare Beneficiary programme, SLMB, and the Qualifying Individual programme, QI, pay the Part B premium only.
The fourth, Qualified Disabled and Working Individuals, is narrow: it pays the Part A premium for people under 65 who lost premium-free Part A by returning to work. For most people the question is which of the first three they fit, and income decides it.
The income and resource limits
For 2026 the federal monthly income limits are $1,350 for an individual and $1,824 for a couple for QMB, $1,616 and $2,184 for SLMB, and $1,816 and $2,455 for QI. Resources - savings, investments, a second property - must be no more than $9,950 for an individual or $14,910 for a couple. The home you live in, one car and household goods do not count.
Those are floors, not ceilings. States may count income and resources more generously, and several do not count resources at all, so a state's figure can be well above the federal one. The limits are also higher in Alaska and Hawaii. Anyone near these figures should apply rather than rule themselves out.
Extra Help with prescription drugs
Extra Help, also called the Part D Low-Income Subsidy, pays the Part D premium up to a benchmark amount, removes the deductible and caps what you pay at the pharmacy: in 2026 no covered drug costs more than $12.65. Income must be below 150% of the federal poverty guidelines, and resources below $16,590 for an individual or $33,100 for a couple, including $1,500 each set aside for burial.
You apply for Extra Help through Social Security, online or by phone, and the application takes about as long as a tax form. Anyone enrolled in a Medicare Savings Program, full Medicaid or SSI qualifies automatically and does not need to apply.
Why many people who qualify never apply
The Medicare Savings Programs are run by state Medicaid offices, which surprises many retirees who have never used Medicaid and assume it is not for them. The application goes to Medicaid, but a Savings Program is not full Medicaid coverage, and a QMB, SLMB or QI enrollee keeps ordinary Medicare with the same doctors.
Estate recovery is the other worry that keeps people away. Since 2010 federal law has exempted Medicare Savings Program payments from Medicaid estate recovery, so the premiums and cost-sharing a state pays under these programmes are not claimed back from your estate. A state may still recover the cost of other Medicaid services, which is a separate question worth asking if you also receive full Medicaid.
Applying, and what happens next
Apply for a Medicare Savings Program through your state Medicaid agency, and for Extra Help through Social Security. An Extra Help application also sends your information to the state to start a Savings Program application unless you ask Social Security not to, so one application can open both doors.
Once you are enrolled in a Savings Program the state pays the Part B premium directly, the deduction disappears from your Social Security payment, and any Part B late enrollment penalty is no longer charged. It can take a few months for the deduction to stop, and premiums taken in the meantime are usually refunded.
What our calculator works out
Our Medicare calculator shows what you would pay for Part B based on your income, including any income-related surcharge. If the result is the standard premium and your income is modest, that is the amount a Medicare Savings Program could take over.
What this does not tell you
This article describes the federal limits. Your state Medicaid agency decides Savings Program eligibility using its own counting rules, and Social Security decides Extra Help.
The calculator does not screen for a Medicare Savings Program or Extra Help, and it does not model Part D, Medicare Advantage or Medigap costs.
Official sources
What you can do next
Add up your monthly income before deductions and your countable savings, and compare them with the limits above - remembering that your state's may be higher. If you are anywhere near them, apply for Extra Help first: it takes minutes and starts the state application for you.