How QMB, SLMB, and QI Programs Help Pay Your Medicare Costs

What These Three Programs Do

QMB, SLMB, and QI are state-run programs that pay some or all of your Medicare premiums, deductibles, and copayments if your income is low enough. They are not Medicare itself — they are separate programs run by your state that work alongside Medicare to reduce what you owe out of pocket.

The three programs have different income limits and cover different costs. QMB covers the most; SLMB and QI cover less. Which one you can join depends on your income and assets, and your state runs the enrollment process. You do not apply to Medicare for these programs — you apply to your state.

These programs exist because Medicare has premiums, deductibles, and copayments that add up quickly for people on fixed incomes. If you are already on Medicare and your income has dropped, or if you are turning 65 and your income is low, one of these three programs may reduce what you pay each month.

Key Takeaways

• QMB pays your Part B premium, Part A premium (if you have one), deductibles, and copayments; SLMB pays your Part B premium only; QI pays part of your Part B premium.
• Income limits vary by state and change each year, but QMB's limit is roughly double SLMB's, and QI's is slightly higher than SLMB's.
• You apply through your state Medicaid office or your state's health insurance program, not through Medicare or Social Security.
• Once you are enrolled, the program pays providers directly — you do not pay and then get reimbursed.
• If your income changes or you move to a different state, you must report it and may need to reapply.

QMB: The Most Comprehensive Coverage

QMB stands for may have access to Medicare Beneficiary. If you are enrolled in QMB, the program pays your Medicare Part B premium, your Part A premium (if you are not yet 65 or did not work long enough to get free Part A), your Part A deductible, your Part B deductible, and your copayments for most services. Essentially, QMB removes most of your out-of-pocket costs for Medicare-covered care.

QMB has the highest income limit of the three programs. The exact limit depends on your state and changes each year, but it is roughly 100% of the federal poverty level. For 2024, that means a single person's income must be under approximately $1,550 per month, though your state may set it slightly higher or lower. Your state will tell you the exact number when you contact them.

QMB also has an asset limit. You can own a home and a car without it counting against you, but cash, savings accounts, stocks, and bonds do count. The asset limit is usually around $8,000 for a single person and $12,000 for a couple, though this varies by state.

SLMB: Part B Premium Coverage Only

SLMB stands for Specified Low-Income Medicare Beneficiary. If you are enrolled in SLMB, the program pays your Medicare Part B premium only — not your deductibles or copayments. This means your monthly premium goes away, but you still pay out of pocket when you use Medicare services.

SLMB has a lower income limit than QMB. It is roughly 120% to 135% of the federal poverty level, depending on your state. For 2024, that is approximately $1,860 to $2,090 per month for a single person. Like QMB, SLMB has an asset limit, usually around $8,000 for a single person.

SLMB makes sense if your income is too high for QMB but low enough for SLMB, and if you do not use many Medicare services. The Part B premium is your largest recurring cost, so removing it can help. But if you see doctors regularly or use hospital services, you will still owe deductibles and copayments.

QI: A Smaller Help with Part B Premium

QI stands for may have access to Individual. QI pays part of your Medicare Part B premium — usually 50% to 75% of it, depending on your state and the year. Like SLMB, QI does not cover deductibles or copayments.

QI has an income limit slightly higher than SLMB's, roughly 135% to 175% of the federal poverty level depending on your state. For 2024, that is approximately $2,090 to $2,700 per month for a single person. QI also has an asset limit, usually the same as SLMB and QMB.

QI is the smallest of the three programs and is often the last resort if you do not meet the income limits for QMB or SLMB. However, QI funding is limited in many states and runs out before the year ends. If you are enrolled in QI, your state may stop paying your premium share partway through the year if the state's money runs out.

How to Find Out Which Program You Might Join

Your state determines which program you can join based on your income and assets. The first step is to contact your state Medicaid office or your state's health insurance program to ask about income limits for the current year. You can find your state Medicaid office by calling 1-800-MEDICARE (1-800-633-4227) and asking for the number, or by searching online for "[your state] Medicaid office."

When you call, have your income information ready. You will need to know your gross monthly income from all sources: Social Security, pensions, wages, interest, dividends, and any other money coming in. You will also need to know the total value of your liquid assets — savings accounts, checking accounts, stocks, bonds, and similar things. Your home and one car do not count.

If your income is below your state's QMB limit, you can join QMB. If it is above QMB but below SLMB, you can join SLMB. If it is above SLMB but below QI, you can join QI. Your state will tell you which programs you are within the income range for, and you can choose which one to apply for.

The Application Process and What Happens Next

You apply through your state, not through Medicare. Most states let you apply by mail, phone, or in person at a local Medicaid office. Some states have online applications. When you call 1-800-MEDICARE, the representative can tell you how to apply in your state and what documents you need to bring or send.

Typically, you will need to provide proof of income (recent pay stubs, Social Security statement, pension letter), proof of assets (bank statements), proof of citizenship or immigration status, and proof that you are enrolled in Medicare Part A and Part B. Your state will tell you exactly what counts as proof.

Processing time varies by state, but most decisions come within 30 to 60 days. Once you are enrolled, your state sends you a card or letter confirming your coverage. You show this to your healthcare providers, and the program pays them directly. You do not pay and then get reimbursed.

What Changes Require You to Report and Reapply

Your enrollment in QMB, SLMB, or QI is not permanent. If your income increases, your assets increase, or you move to a different state, you must report the change. Your state will tell you how often to report changes — usually once a year, but sometimes more often.

If your income rises above your program's limit, you will lose coverage. If you move to a different state, your old state's coverage ends and you must apply in your new state, which may have different income limits and rules. If you turn 65 and become newly may be able to access for Medicare, or if you lose other insurance, report that too.

If your circumstances change and you are no longer enrolled, you can reapply later if your income drops again. There is no penalty for losing coverage and reapplying. Many people cycle in and out of these programs as their income and life circumstances change.

Frequently Asked Questions

Can I be enrolled in more than one of these programs at the same time?

No. You can only be enrolled in one program at a time. Your state will enroll you in the highest-level program you are within the income range for, unless you ask to be enrolled in a lower-level program instead. If you want to switch programs, contact your state Medicaid office.

What if I have Medicaid in addition to Medicare?

If you are already on Medicaid, you may be automatically enrolled in one of these programs, or your state may ask you to choose. Medicaid and QMB/SLMB/QI are separate programs, but many people have both. Your state can tell you whether you are enrolled in one of these programs and what coverage you have.

Do these programs work with Medicare Advantage plans?

Yes. QMB, SLMB, and QI work with both Original Medicare and Medicare Advantage plans. If you have a Medicare Advantage plan, these programs still pay your Part B premium and, in the case of QMB, your deductibles and copayments within that plan.

What happens if I move to a different state?

Your coverage from your old state ends. You must apply in your new state, which may have different income limits and rules. Contact your new state's Medicaid office as soon as you move to start the application process. There may be a gap in coverage while your new state processes your application.

Can I apply if I am not yet 65?

Yes, if you are already enrolled in Medicare before age 65 (for example, because you have been on disability for two years). You can apply for QMB, SLMB, or QI at any age as long as you are enrolled in Medicare Part A and Part B and meet your state's income and asset limits.