A reader wrote in asking a question we hear often in different forms. Is there a program that could eliminate Medicare out-of-pocket costs, not just reduce them? The answer is yes, and it has a name most people have never heard.
It is called QMB. The Qualified Medicare Beneficiary program is the most comprehensive of the four Medicare Savings Programs.
We covered the broader landscape of those programs in an earlier article titled “Need help paying your Medicare Part B premium?” Start here. This piece goes deeper into QMB, specifically, the program that goes furthest. If you qualify, it eliminates premiums, deductibles, copayments, and coinsurance for Medicare-covered services, all at once. Providers are federally prohibited from billing you for any of those amounts, even if they do not accept Medicaid.
What QMB actually covers
QMB covers your Medicare Part A premium if you pay one, your Part B premium of $202.90 a month in 2026, and all deductibles, copayments, and coinsurance for Medicare-covered services. The billing protection is the part most people miss. Federal law prohibits any Medicare provider from billing a QMB enrollee for Medicare cost-sharing, regardless of whether that provider accepts Medicaid. If you receive a bill for a Medicare-covered service, you have the right to a refund.
Enrollment in QMB also automatically triggers Extra Help, the Part D prescription drug subsidy. In 2026 that caps your drug costs at $2,100 per year, with individual prescriptions running no more than $12.65 for brand-name drugs.
The income limits for 2026
In 2026, the monthly income limits are $1,350 for an individual and $1,824 for a couple in most states. Alaska, Hawaii, and several states, including Connecticut and Maine, set higher limits. Two things make these thresholds more generous than they appear. States apply a $20 general income disregard, raising the effective limit slightly. And roughly half of earned income from work is excluded from the calculation, so part-time earnings count for less than they seem.
The asset test and who avoids it
Most states apply a resource limit of $9,660 for individuals and $14,470 for couples. Your home, one vehicle, and personal belongings are excluded. Only liquid assets count. Twelve states have eliminated the asset test, requiring only that you meet the income threshold. If you are close to the limit on paper, check your state’s specific rules before assuming you do not qualify.
How to check and apply
Applications go through your state Medicaid office. You can find your state’s contact at Medicaid.gov, call 1-800-MEDICARE, or get free help from a SHIP counselor at shiphelp.org. Medicare encourages people to apply even when they are not sure they qualify. The income and asset calculations involve enough nuance that the only reliable way to know is to submit an application. If your income is slightly above the QMB limit, SLMB covers the Part B premium for incomes up to 120 percent of the federal poverty level, and QI covers it up to 135 percent. The Part B premium savings alone run over $2,400 a year.
Wrap up
QMB is the program that gets closest to zero-cost Medicare. The income limits are broader than most people expect, the asset rules are more flexible than they appear, and the billing protections are legally enforceable. Providers who bill a QMB enrollee for covered services can be reported to Medicare. The application is free, and the only cost of not applying is leaving real savings on the table.
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Related:
- Need help paying your Medicare Part B premium? Start here
- The $2400 Social Security benefit most seniors never claim
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