Medicare Savings Programs and Extra Help (2026–2027): Eligible?
Bottom Line
Limited income and resources may qualify you for state-administered Medicare Savings Programs and federal Extra Help. MSPs help with Medicare premiums; Extra Help reduces prescription costs. Apply even above federal MSP limits because state counting rules can differ.
If your income and savings are limited, you may qualify for help paying Medicare costs through two federal programs: Medicare Savings Programs (MSPs), run by your state, which can pay your Part A and Part B premiums and sometimes other cost-sharing, and Extra Help, a federal program that lowers prescription drug costs. Many people qualify for both, and you can apply for both at the same time. You may qualify for an MSP even above its federal limits because some states use more generous counting rules.
This page explains the 2026 assistance limits and application steps. Keep any separate lender requirement for life insurance for an SBA loan independent of Medicare assistance; it does not affect these programs’ eligibility rules.
The Four Medicare Savings Programs
Medicare Savings Programs are administered by your state, and your state decides which program or programs you qualify for when you apply. In most cases your income and resources must fall below a limit, but those limits rise each year, some states don’t count certain income or resources, and you may qualify in your state even above the federal limits. The consistent advice from Medicare: even if you don’t think you qualify, apply anyway.
The four Medicare Savings Programs have the following 2026 federal limits. Income limits are slightly higher in Alaska and Hawaii; state counting rules can be more generous elsewhere too.
| Program | What it helps pay | Monthly income limit (individual / married) | Resource limit (individual / married) |
|---|---|---|---|
| QMB (Qualified Medicare Beneficiary) | Part A and B premiums, deductibles, coinsurance, copayments | $1,350 / $1,824 | $9,950 / $14,910 |
| SLMB (Specified Low-Income Medicare Beneficiary) | Part B premium only | $1,616 / $2,184 | $9,950 / $14,910 |
| QI (Qualifying Individual) | Part B premium only | $1,816 / $2,455 | $9,950 / $14,910 |
| QDWI (Qualified Disabled and Working Individual) | Part A premium only | $5,405 / $7,299 | $4,000 / $6,000 |
A few program-specific rules matter:
- QMB is the most comprehensive. If you qualify, Medicare providers are not allowed to bill you for services and items Medicare covers, including deductibles, coinsurance, and copayments. You may still owe a small Medicaid copayment where one applies. Carry your Medicare and Medicaid (or QMB) cards to every appointment, and if you get a bill you shouldn’t, show your Medicare Summary Notice as proof of QMB status.
- SLMB and QI both pay the Part B premium, and both require that you have Part A and Part B. QI is only for people who don’t qualify for any other Medicaid coverage or benefits, you must apply every year to stay in it, and states approve QI applications first-come, first-served, with priority to people who received QI the prior year. That timing makes early application worth it.
- QDWI serves a narrower group: people with a disability who are working and lost premium-free Part A after returning to work. It pays the Part A premium only.
Extra Help With Prescription Drug Costs
Extra Help is a separate federal program for people with limited income and resources that helps pay Part D premiums, deductibles, coinsurance, and other drug costs. While you receive it, you also won’t owe a Part D late enrollment penalty.
Some people get Extra Help automatically, including anyone who receives full-benefit Medicaid, help from a Medicare Savings Program with Part B premiums, or Supplemental Security Income (SSI). Everyone else applies, and you can apply for Extra Help and an MSP at the same time on Social Security’s application.
The 2026 Extra Help income and resource limits are listed below. Income figures are annual, and Alaska and Hawaii have higher income limits:
| Situation | Income limit | Resource limit |
|---|---|---|
| Individual | $23,940 | $18,090 |
| Married couple | $32,460 | $36,100 |
If you qualify and don’t already have a Part D plan, Medicare automatically enrolls you in one so you receive the savings; you can choose a different plan if you prefer. Your Extra Help continues through December 31 of the year you qualify even if your income changes mid-year, and you’ll keep it in future years unless you’re notified otherwise. If you lose it, you can reapply any time your income and resources change. Note that Extra Help is not available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa, though other local programs exist there.
Medicare’s published 2027 Extra Help amounts include no deductible, copays up to $5.80 for generics and $14.40 for brand-name drugs at participating pharmacies, and $0 for covered drugs after qualifying costs, including certain subsidy payments, reach $2,400. People with full Medicaid and QMB pay no more than $4.90 per covered drug. The premium subsidy is limited to the applicable benchmark, so a chosen plan may leave a premium difference. These are 2027 figures; distinguish them from the 2026 eligibility limits above when reviewing Part D deductibles and out-of-pocket limits.
Why These Programs Also Protect Your Enrollment
Beyond the direct savings, qualifying for help can shield you from Medicare’s late enrollment penalties, which generally increase monthly premiums rather than creating a one-time fee. Two rules are worth knowing: generally, you won’t owe a Part B late enrollment penalty if you enroll in a Medicare Savings Program, and you generally won’t owe a Part D penalty while you qualify for Extra Help. For context, the standard Part B premium is $202.90 per month in 2026, so having an MSP pick up that premium is a meaningful dollar amount, and the Part D penalty calculation is based on a national base beneficiary premium of $38.99 in 2026.
If You Qualify for Both Medicare and Medicaid
People who qualify for both Medicare and some form of Medicaid, called dual eligibles, have additional plan options. Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans that enroll people entitled to both Medicare and Medicaid assistance, provide care coordination, and must include Part D drug coverage. Availability varies by location, since insurers decide where they offer plans, and coverage differs between plans, so comparing D-SNP coverage options makes sense only once you’ve confirmed your Medicaid eligibility category and which plans operate where you live. States cover some Medicare costs depending on the state and your eligibility, and CMS classifies eligibility categories (such as QMB-only, QMB Plus, SLMB, QI, and QDWI) that affect what a plan can coordinate.
There are also special enrollment rules. Since January 1, 2025, dually eligible and Extra Help-eligible individuals can use a monthly special enrollment period to elect Original Medicare plus a standalone drug plan or switch between standalone drug plans, and full-benefit dual eligibles in certain states can use an integrated care SEP to enroll in aligned integrated D-SNPs. If your circumstances change, for example you gain or lose Medicaid, ask about the enrollment periods that apply rather than assuming you must wait for open enrollment.
Younger Beneficiaries and Other Situations
If you’re under 65 and on Medicare due to disability, MSP and Extra Help eligibility work the same way, but your supplemental coverage choices are more complicated, because Medigap availability for under-65 buyers differs by state. Before assuming anything about availability or price, start by identifying your state’s rules and your eligibility basis, which is the key step in buying Medigap before age 65. Federal MSP and Extra Help limits quoted above apply regardless of age.
How to Apply, Step by Step
- Apply to your state for Medicare Savings Programs. MSPs are run by each state, so contact your state’s Medicaid or human services office. Your state determines which program you qualify for.
- Apply for Extra Help through Social Security, or ask your local State Health Insurance Assistance Program (SHIP) for free help. Applying for Extra Help can also start your MSP application, since Social Security forwards your information to your state unless you ask it not to.
- Gather income and resource documentation. Expect questions about your income, what you own, and your Medicare status. States differ on what income and resources they count, which is why applying is worthwhile even above the federal limits.
- Reapply when required. QI requires annual renewal, and Extra Help continues only if you still meet the limits in future years, so watch for renewal mail and respond promptly.
- Review your drug plan annually. If you have Extra Help or Medicaid, you may be able to change your drug coverage once per month, which gives you flexibility most beneficiaries don’t have.
What These Programs Are Worth, and What’s Next
Taken together, an MSP can eliminate your Part B premium (and, at QMB level, your deductibles, coinsurance, and copayments for covered services), while Extra Help can cut your drug costs to a few dollars per prescription and remove penalty risk. There is no application fee; the state or Social Security can determine whether you qualify.
These programs address premiums and cost-sharing, but choosing between Original Medicare plus a supplement, a Medicare Advantage plan, and drug coverage still depends on your doctors, prescriptions, and budget. Whether you qualify for assistance or not, it pays to plan for your full Medicare costs before each enrollment decision, comparing what you’d actually pay across a full year rather than premium alone.
Gather your income information, Medicare card and prescription list, then apply through your state Medicaid office and Social Security. After eligibility is determined, compare available plans against your providers, medications and actual assistance level.