Direct answer: Medicare Extra Help and Medicare Savings Programs (MSP) in 2026 are two separate programs for people with limited income and savings. Extra Help lowers what you pay for Part D drugs. An MSP is run by your state. It can pay your $202.90 Part B premium, and its top tier also pays your Medicare deductibles and coinsurance.
Part B costs $202.90 a month in 2026 for most people. That adds up to $2,434.80 a year, and it comes out of your Social Security check before you see the money. If you live on $1,500 a month, that is more than a month and a half of income gone to one premium.
Help with that bill already exists. Medicare Extra Help and Medicare Savings Programs (MSP) in 2026 can cover the premium, and much more. Still, many people who could get help never apply. They often assume their home or a small IRA rules them out.
If you are reading this at the kitchen table, worried about a parent’s bills, take a breath. You can apply for both programs any time of year, and applying is free.
I spent 18 years in insurance marketing, and I have seen ads mix these programs up with plan perks on purpose. This guide keeps them apart. It uses 2026 numbers from Medicare.gov and Social Security.
What are Extra Help and the Medicare Savings Programs?
Extra Help is the federal Part D Low-Income Subsidy. Social Security takes the application. It helps with drug plan premiums and pharmacy copays. It also sets your Part D deductible to $0.
Medicare Savings Programs are run by each state, usually through the Medicaid office. There are four of them, and each one pays a different part of your Medicare bill.
- QMB (Qualified Medicare Beneficiary) pays the Part A and Part B premiums. It also pays the deductibles and coinsurance for Medicare-covered care.
- SLMB (Specified Low-Income Medicare Beneficiary) pays the Part B premium.
- QI (Qualifying Individual) pays the Part B premium. You must reapply every year.
- QDWI (Qualified Disabled and Working Individual) pays the Part A premium for some working people with disabilities.
Swipe sideways to see every column.
| Extra Help | Medicare Savings Program | |
|---|---|---|
| Who runs it | Social Security | Your state Medicaid office |
| What it pays | Part D premium, deductible and drug copays | Part B premium; QMB also pays Part A and B cost sharing |
| When to apply | Any time of year | Any time of year |
| Link to the other program | The form can start an MSP application | QMB, SLMB and QI give you Extra Help automatically |
Why does Medicare need these programs?
Medicare was never free. Most people get Part A without a premium. But you still owe the Part B premium every month, even if you never see a doctor.
Then come the bills for the care you use. Here is what someone on Original Medicare faces in 2026, per Medicare.gov’s 2026 cost page:
- Part B deductible: $283 a year
- Part B coinsurance: 20% of the cost of most covered services
- Part A hospital deductible: $1,736 per benefit period
- Skilled nursing care: $0 for days 1 to 20, then $217 a day for days 21 to 100
Here is how fast that adds up. Picture a hospital stay followed by 30 days of rehab. You owe the $1,736 deductible, plus $217 a day for days 21 to 30. That is $2,170 more. On a fixed income, one bad month like that can drain a savings account. QMB is built to take those bills off the table.
Extra Help covers the drug side. Part D plans charge premiums and copays every month. Extra Help shrinks both.
What do the 2026 income and resource limits say?
Each program checks two things. Income is the money that comes in, like Social Security or a pension. Resources are what you have saved, like a bank balance or stocks. Your home and one car do not count as resources.
Extra Help limits
Medicare.gov’s Extra Help page lists these 2026 limits for most states:
- Single: yearly income up to $23,940, resources up to $18,090
- Married: yearly income up to $32,460, resources up to $36,100
Income limits are higher in Alaska and Hawaii. The resource numbers above assume you set some money aside for burial. Without that, CMS lists $16,590 for a single person and $33,100 for a couple.
The pharmacy savings are real. Under the CMS 2026 rules, most people with Extra Help pay no more than $5.10 for a covered generic and $12.65 for a covered brand-name drug. After you reach $2,100 in out-of-pocket drug costs, covered drugs cost $0 for the rest of the year. Some people with full Medicaid pay even less.
Medicare Savings Program limits
These are the federal monthly limits from Medicare.gov’s Medicare Savings Programs page. Some states set higher limits.
Swipe sideways to see every column.
| Program | Single, per month | Couple, per month | Resources (single / couple) |
|---|---|---|---|
| QMB | $1,350 | $1,824 | $9,950 / $14,910 |
| SLMB | $1,616 | $2,184 | $9,950 / $14,910 |
| QI | $1,816 | $2,455 | $9,950 / $14,910 |
QDWI uses different limits: $5,405 a month for a single person and $7,299 for a couple. Its resource limits are $4,000 and $6,000.
Here is a worked example. Say you are single, with $1,500 a month in income and $6,000 in the bank. You are over the QMB line but under the SLMB line. If you qualify for SLMB, the state pays your $202.90 premium. That puts $2,434.80 a year back in your pocket. SLMB also gives you Extra Help automatically.
QMB goes further. Say you get a $1,000 Medicare-covered bill from a specialist. The 20% coinsurance would be $200. With QMB, the provider generally cannot bill you for it.
What fine print trips people up?
QI money can run out. States fund QI on a first-come, first-served basis. People who had QI the year before get first priority. So apply early in the year, and reapply on time.
The Extra Help form has an opt-out box. When you apply with Social Security, it sends your information to your state to start an MSP application. If you check the box to opt out, that step does not happen. Leave it alone unless you have a real reason.
Some people get Extra Help without applying. You get it automatically if you have full Medicaid or Supplemental Security Income, or if your state pays your Part B premium. You will get a letter in the mail. Keep it, because pharmacies sometimes ask for proof.
QMB protects you from some bills, but only if providers know. Show your Medicare card and your Medicaid or QMB card at every visit. Some states still charge a small Medicaid copay.
Extra Help stops the Part D late penalty. While you have Extra Help, you do not pay the Part D late enrollment penalty.
Territories are different. Extra Help is not available in Puerto Rico or the other U.S. territories. People there should ask the local Medicaid office about other help.
Should you trust the federal chart?
The usual advice is to look at the chart, and if your numbers are too high, move on. I disagree. The chart is where you start, not a final no.
If your income is a little over
Medicare.gov says you may qualify for an MSP in your state even if your income is above the federal limits. States can choose to leave out some income or assets. For Extra Help, Social Security does not count some kinds of income, such as SNAP and housing help. Its Understanding Extra Help booklet lists them. Earnings from a job and family members living with you can also change the math.
If you own a home or have a small IRA
Your home does not count as a resource. Retirement accounts can count, and the rules vary. Let Social Security or the state make that call. Do not decide for them.
If you were turned down before
The limits go up most years. Your life changes too. A spouse’s death or a drop in income can change your answer. If the last no came years ago, apply again.
Where the money goes
This is the part I know from the inside. In insurance lead generation, the money comes from plan enrollments. When an agent or call center signs you up for a plan, someone gets paid. When you file an MSP form with your state, nobody gets paid.
That is why you see so many TV ads about plan perks and so few about QMB. Some ads talk about getting money back on your Part B premium. That is a feature of certain Medicare Advantage plans. It has nothing to do with a state MSP, and it is often much smaller.
A dual-eligible plan pitch can also blur the lines. A D-SNP is a Medicare Advantage plan. An MSP is a state benefit you can have with Original Medicare or with an Advantage plan. Do not let a plan enrollment take the place of the state application.
For free, unbiased help, use your State Health Insurance Assistance Program, or SHIP. The federal Administration for Community Living funds SHIP counselors. They do not sell plans.
Related: see Medicare Part B premiums and IRMAA in 2026, Medicare Part D drug coverage in 2026, and Medicare Special Needs Plans explained.
Six moves to get the help you qualify for
- Check whether you already have help. Look at your Social Security benefit statement. If no Part B premium is taken out, your state may already be paying it. Full Medicaid or SSI also means you have Extra Help.
- Gather your papers. Get bank statements, tax returns, and IRA or 401(k) statements. Add pension and annuity statements, and any Veterans or Railroad Retirement benefits. Do this for your spouse too.
- Apply for Extra Help with Social Security. You can apply online, by phone, or at a local office. Leave the MSP referral turned on.
- Call your state Medicaid office. Ask for a Medicare Savings Program application by name. Ask whether your state ignores any income or assets.
- Use your letter. When the award letter comes, show it at the pharmacy and to each doctor’s office.
- Set a yearly reminder. QI must be renewed each year. Limits change, so check again even if you were told no.
What not to do
- Do not pay anyone to apply for you. Both applications are free.
- Do not rule yourself out based on a post you saw online.
- Do not throw away mail from Social Security or your state Medicaid office.
Frequently asked questions
Does Extra Help pay my Part B premium?
No. Extra Help only covers the Part D drug side. Help with the $202.90 Part B premium comes from a Medicare Savings Program through your state. The good news is that one form can start both. When you apply for Extra Help with Social Security, your information goes to your state for an MSP review unless you opt out.
If I have QMB, can a doctor bill me the 20%?
For Medicare-covered services, providers generally may not bill QMB members for Medicare deductibles or coinsurance. Show your Medicare card and your Medicaid or QMB card at every visit. If a bill still comes, call the office and tell them you have QMB. If the bills keep coming, contact Medicare or your state Medicaid office. Some states charge a small Medicaid copay.
Can I get Extra Help if I have a Medicare Advantage plan?
Yes. If your Advantage plan includes drug coverage, Extra Help works on that drug benefit the same way it works on a stand-alone Part D plan. Your plan premium and pharmacy copays can drop. Once your Extra Help letter arrives, call the plan and ask them to confirm it is on your file.
Do I have to reapply every year?
For Extra Help, usually not. Medicare.gov says you keep it as long as you still meet the limits. Social Security may mail you a review form from time to time. Each state runs its own MSP renewals, so watch your mail. QI is the strict one. You must reapply every year, and states fund it first come, first served.
Can a family member apply for me?
Yes, with your permission. An adult child or another helper can fill out the Extra Help form for you. They can also call the state Medicaid office with you. They will need correct numbers for your income and savings. A free SHIP counselor can sit down with a caregiver and go through the forms line by line.
Your next step
Today, check your Social Security statement and see whether a Part B premium is being taken out. If it is, and your income is near the limits above, apply for Extra Help with Social Security and leave the MSP referral on. Then call your state Medicaid office this week and ask for a Medicare Savings Program by name.
Sources
- Medicare.gov: Help with drug costs (Extra Help)
- Medicare.gov: Medicare Savings Programs
- Medicare.gov: Medicare costs
- SSA: Apply for Medicare Part D Extra Help
- SSA: Understanding the Extra Help With Your Medicare Prescription Drug Plan (EN-05-10508)
- Medicaid.gov: Where can people get help with Medicaid and CHIP?
- ACL: State Health Insurance Assistance Program (SHIP)