Can I Get Medicare Part B for Free?

🔑 10 Key Takeaways

1. Medicare Part B is never automatically free. Unlike Part A, which most people get at no cost, every Part B enrollee owes a monthly premium — the standard monthly premium for 2026 is $202.90, an increase of $17.90 from $185.00 in 2025.

2. Three federal programs can make Part B completely free. The QMB, SLMB, and QI Medicare Savings Programs pay your Part B premium if your income and assets fall below certain thresholds — and the thresholds are more generous than you’d expect.

3. Over a million eligible people aren’t enrolled. More than a million people are thought to be eligible for a Medicare Savings Program but aren’t enrolled.

4. Twelve states and D.C. have eliminated asset limits for Medicare Savings Programs. Alabama, Arizona, Connecticut, Delaware, Louisiana, Massachusetts, Mississippi, New Mexico, New York, Oregon, Vermont, and the District of Columbia do not have asset limits for MSPs as of January 2026.

5. California’s asset limits are dramatically higher than federal levels. California’s Medicare Savings Program resource limits were set at $130,000 for individuals as of January 1, 2026 — compared to roughly $9,660 at the federal level.

6. Part A is free for most people. Approximately 99% of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment.

7. If you haven’t worked 10 years, Part A can cost up to $565/month. Those with fewer than 30 quarters of coverage pay the full Part A premium of $565 a month in 2026, while those with 30–39 quarters pay $311.

8. The 2026 Part B deductible is $283. The annual deductible for all Medicare Part B beneficiaries increased to $283 in 2026, up $26 from 2025.

9. High earners pay dramatically more. Income-related monthly adjustment amounts affect roughly 8% of people with Medicare Part B, with premiums climbing to $689.90/month for the highest earners.

10. Qualifying for any MSP automatically gets you “Extra Help” for prescriptions. Enrollment into MSPs automatically qualifies you to receive the Medicare Part D Low Income Subsidy, estimated by the Social Security Administration to have an annual value of $5,700.

💊 No, Medicare Part B Is Not Free — But Here’s How to Pay $0 Anyway

Let’s address the most common misconception head-on. While Part A (hospital insurance) is premium-free for anyone with 40 or more quarters of work history, Part B (outpatient and doctor visits) always carries a premium. There are no exceptions based on age, disability status, or veteran service alone.

However, three federally mandated Medicare Savings Programs can cover your Part B premium entirely. These programs are run by your state’s Medicaid agency, meaning the rules, application process, and even the income/asset limits can vary significantly depending on where you live.

Even if you don’t think you qualify, you should still apply — that’s official guidance straight from Medicare.gov. Many states use more generous income calculations than the federal minimums, and working income is often discounted by 50% or more.

🏥 Medicare Savings Program	💰 What It Pays	📊 2026 Federal Income Limit (Individual)	📊 2026 Federal Income Limit (Couple)
🟢 QMB (Qualified Medicare Beneficiary)	Part A premium, Part B premium, deductibles, coinsurance, copays	~$1,350/month	~$1,824/month
🔵 SLMB (Specified Low-Income Medicare Beneficiary)	Part B premium only	~$1,616/month	~$2,184/month
🟡 QI (Qualifying Individual)	Part B premium only	~$1,816/month	~$2,455/month
🟠 QDWI (Qualified Disabled Working Individual)	Part A premium only	~200% FPL	~200% FPL

💡 The income disregard most people miss: All MSP programs subtract a $20 “general income disregard” from your monthly income before checking eligibility. If you earn income from a current job, roughly half of that earned income is excluded too. This means someone earning more than the listed limit could still qualify.

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🏛️ Part A Is Free for 99% of People — Here’s Who Falls Through the Cracks

You won’t pay a Part A premium if you qualify to get or are already getting retirement or disability benefits from Social Security, or if you or another qualifying person like your current or former spouse paid Medicare taxes while working for at least 10 years.

That covers the vast majority of Americans. But the remaining 1% face surprisingly steep costs that nobody warns them about.

🔍 Work History	💲 2026 Monthly Part A Premium	📌 Who This Affects
40+ quarters (10+ years)	$0 (free)	Most Americans, including those claiming on a spouse’s record
30–39 quarters	$311/month	People who worked part-time or took extended career breaks
Fewer than 30 quarters	$565/month	Immigrants, stay-at-home parents without spousal credits, gig workers
Disability-based (SSDI for 24+ months)	$0 (free)	Automatically enrolled regardless of work history
ESRD or ALS	$0 (free)	Immediate eligibility, no work history requirement

💡 The spousal credit that saves thousands: You don’t need your own 40 quarters. If your current spouse, ex-spouse (married at least 10 years), or even a deceased spouse earned 40 quarters, you qualify for premium-free Part A on their record. This single rule rescues thousands of stay-at-home parents from paying $565/month — yet many never learn about it.

🗺️ State-by-State: Where Getting Free Part B Is Easiest (and Where It’s Nearly Impossible)

This is the section that most Medicare guides completely ignore. While the MSP programs are federally mandated, each state sets its own rules for how strictly it applies income and asset limits. The differences are staggering.

States with no asset limits for Medicare Savings Programs (as of January 2026):

In these states, your savings account, investments, and other resources are irrelevant when applying for free Part B through the QMB, SLMB, or QI programs. Only your income matters.

🏆 State / Territory	🛡️ Asset Limit Status	💡 Key Advantage
Alabama	❌ No asset limit	Income-only eligibility
Arizona	❌ No asset limit	Income-only eligibility
Connecticut	❌ No asset limit	Also has continuous Medigap guaranteed issue
Delaware	❌ No asset limit	New as of recent years
District of Columbia	❌ No asset limit	Income-only eligibility
Louisiana	❌ No asset limit	Income-only eligibility
Massachusetts	❌ No asset limit	Also has continuous Medigap guaranteed issue
Mississippi	❌ No asset limit	Income-only eligibility
New Mexico	❌ No asset limit	Income-only eligibility
New York	❌ No asset limit	Also has continuous Medigap guaranteed issue
Oregon	❌ No asset limit	Income-only eligibility
Vermont	❌ No asset limit	QMB income limit set at 150% FPL — higher than federal

States with elevated asset limits:

📍 State	💰 MSP Asset Limit (Individual)	💰 MSP Asset Limit (Couple)	📌 Notable Detail
California	$130,000	$195,000	Reinstated Jan. 2026 after two years of no limits
Colorado	$11,160	$17,470	Higher than federal standard
Most other states	~$9,660–$9,950	~$14,470–$14,910	Federal standard limits apply

💡 The California story everyone needs to understand: California eliminated all asset limits for Medi-Cal and Medicare Savings Programs in 2022, making it the most generous state in the nation. However, citing budgetary constraints, California reinstated the asset limit effective January 1, 2026, to $130,000 for individuals. Even with the reinstatement, California’s limit is still roughly 13 times higher than the federal standard — a massive advantage for Golden State residents.

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💵 The Real Cost of Medicare Part B in 2026: Every Dollar Broken Down

The standard Part B premium tells only part of the story. Between the deductible, coinsurance, and income-related surcharges, your actual Part B spending can vary wildly depending on your financial profile and how often you use medical services.

💳 Cost Component	💲 2026 Amount	📝 Details
Standard monthly premium	$202.90	Applies to individuals earning ≤$109,000 or couples ≤$218,000
Annual deductible	$283	Must be met before Medicare pays for Part B services
Coinsurance after deductible	20% of approved amount	No annual out-of-pocket cap under Original Medicare
Part A inpatient deductible	$1,736 per benefit period	Resets 60 days after hospital discharge
Part A daily coinsurance (days 61–90)	$434/day	Applies during extended hospital stays
Part A lifetime reserve days	$868/day	Only 60 lifetime reserve days available total
Skilled nursing facility coinsurance (days 21–100)	$217/day	After initial 20-day fully covered period

The increase in the 2026 Part B standard premium and deductible is mainly due to projected price changes and assumed utilization increases consistent with historical experience. However, CMS noted that if the Trump Administration had not taken action to address unprecedented spending on skin substitutes, the Part B premium increase would have been about $11 more a month.

📈 How Your Income Secretly Multiplies Your Part B Premium

Most people discover the Income-Related Monthly Adjustment Amount the hard way — through a surprise letter from the Social Security Administration telling them their premium has doubled or tripled. The surcharge is based on your tax return from two years ago, creating a painful lag effect for recent retirees.

🧾 2024 Income (Single Filer)	👫 2024 Income (Joint Filer)	💲 2026 Monthly Part B Premium	⬆️ Surcharge Over Standard
≤$109,000	≤$218,000	$202.90	$0
$109,001–$137,000	$218,001–$274,000	$284.10	+$81.20
$137,001–$171,000	$274,001–$342,000	$405.80	+$202.90
$171,001–$205,000	$342,001–$410,000	$527.50	+$324.60
$205,001–$500,000	$410,001–$750,000	$649.20	+$446.30
≥$500,000	≥$750,000	$689.90	+$487.00

💡 The Roth conversion trap: Many financial advisors recommend converting traditional IRA funds to Roth IRAs before Medicare enrollment. But the conversion income counts toward your MAGI, potentially triggering IRMAA surcharges. A $200,000 Roth conversion in 2024 could push a retired couple from $202.90/month to $405.80/month per person in 2026 — that’s an extra $4,870 in Medicare premiums for the year that financial planners sometimes fail to flag.

🩺 Social Security and Part B: The Automatic Deduction Most Retirees Don’t Expect

If you’re collecting Social Security benefits, your Part B premium is automatically deducted from your monthly check. You don’t get a separate bill — the money simply vanishes before it hits your bank account.

This creates a frustrating situation for low-income retirees: someone receiving $1,200/month in Social Security sees only $997.10 after the Part B deduction. For someone living on a fixed income, that $202.90 monthly bite represents a significant chunk of their budget.

🔄 How You Get Medicare	📋 How Part B Premium Is Paid	⚠️ Watch Out For
Collecting Social Security	Automatically deducted from monthly check	Reduction may not be obvious; check your benefit statement
Collecting Railroad Retirement Board	Automatically deducted	Same automatic deduction rules apply
Not collecting Social Security yet	Billed directly by CMS (quarterly)	Late payments can result in coverage termination
Enrolled in MSP (QMB/SLMB/QI)	State Medicaid pays premium	Processing delays can cause temporary billing; don’t panic

💡 The “hold harmless” provision: Federal law protects most Social Security recipients from a Part B premium increase that would reduce their Social Security check below the prior year’s amount. If the annual cost-of-living adjustment to Social Security isn’t large enough to absorb the Part B increase, your premium may be capped at a lower amount. However, this protection does not apply to new enrollees, those who pay IRMAA surcharges, or people whose premiums are paid by Medicaid.

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🏥 Getting Free Part B in California: A Special Case Worth Understanding

California deserves its own section because its Medicare Savings Program rules operate on a completely different scale than most states. Until 2024, California had eliminated asset tests entirely for Medi-Cal and Medicare Savings Programs. While asset limits returned in 2026, they remain far more generous than anywhere else.

California’s Medi-Cal programs provide QMB benefits for individuals with countable income at or below 100% of the Federal Poverty Guidelines — $1,305 per month for singles or $1,763 for couples.

Beyond the standard MSPs, California offers the 250% Working Disabled Program, which provides Medi-Cal coverage (including Part B premium payment) to disabled individuals earning up to 250% of the federal poverty level — approximately $3,263/month for individuals or $4,408/month for couples in 2025 (2026 figures pending spring publication). This is significantly more generous than any standard federal MSP.

🐻 California MSP Program	💲 Monthly Income Limit (Individual)	💲 Monthly Income Limit (Couple)	💰 Asset Limit (2026)
QMB	$1,305	$1,763	$130,000 / $195,000
SLMB	$1,306–$1,565	$1,764–$2,116	$130,000 / $195,000
QI-1	$1,565–$1,761	$2,116–$2,380	$130,000 / $195,000
250% Working Disabled	~$3,263	~$4,408	$130,000 / $195,000

💡 Critical 2026 change for Californians: Any transfer of assets made between January 1, 2024 and December 31, 2025 will not be considered in eligibility renewals in 2026. If you moved money during the asset-limit-free window, you won’t be penalized for it. But new applicants in 2026 must verify their assets at the time of application.

🔍 The Hidden Fourth Program: QDWI for Workers Who Lost Disability Benefits

Almost no one talks about the Qualified Disabled Working Individual program, yet it fills a crucial gap for a very specific group: people who had SSDI and Medicare, returned to work, lost their disability cash benefits because they earned too much, and subsequently lost their premium-free Part A.

The QDWI program pays the Part A premium for these individuals, keeping them connected to hospital insurance even as they rejoin the workforce. Income limits are set at 200% of the federal poverty level, and the program is available in every state.

♿ QDWI Eligibility Criteria	✅ Requirements
Medicare status	Lost premium-free Part A due to return to work
Disability	Must still meet Social Security’s definition of disabled
Employment	Currently working
Income	Below 200% FPL
Assets	Below $4,000 individual / $6,000 couple (federal; states may vary)

❓ Frequently Asked Questions

Who qualifies for free Medicare Part B?

Nobody gets Part B free based solely on age, work history, or disability status. The only path to a zero-dollar Part B premium is through one of the three Medicare Savings Programs — QMB, SLMB, or QI — which require your income and (in most states) your assets to fall below certain limits. For QI, the broadest program, your counted monthly income must be under $1,816 for an individual or $2,455 for a couple in 2026. If you earn income from working, the effective limit is even higher because states exclude roughly half of earned income.

Can I get Medicare Part A for free?

Yes, if you or your spouse paid Medicare taxes for at least 40 quarters (roughly 10 years of work). This covers about 99% of enrollees. If you don’t qualify through your own or a spouse’s work record, you can purchase Part A — but it costs either $311 or $565 per month in 2026 depending on your quarter count.

How much is Medicare Part B in 2026?

The standard premium is $202.90/month, with an annual deductible of $283. After meeting the deductible, you’re responsible for 20% coinsurance on most Part B services. Higher-income beneficiaries pay IRMAA surcharges that can push the monthly premium up to $689.90.

How does Social Security affect my Part B premium?

If you receive Social Security benefits, your Part B premium is automatically deducted from your monthly payment. The SSA also uses your income (reported on your tax return from two years prior) to determine whether you owe IRMAA surcharges on top of the standard premium.

Can I get free Part B in California specifically?

California’s Medicare Savings Programs have significantly higher asset limits than most states — $130,000 for individuals and $195,000 for couples. The income limits follow federal guidelines, but California also offers the 250% Working Disabled Program with income limits nearly double those of the standard QI program. Apply through your county Department of Public Social Services or online through BenefitsCal.

What if my income is just slightly above the MSP limits?

Apply anyway. You may qualify in some states for these programs even if your income or resources are higher than the federal limits listed, because some states don’t count certain types or specific amounts of income or resources. The $20 general disregard and the 50% earned income exclusion can bring your counted income well below your actual income.

Does qualifying for an MSP help with prescription drug costs too?

Yes — this is one of the most valuable hidden benefits. Enrollment into MSPs automatically qualifies you to receive the Part D Low Income Subsidy (Extra Help), and LIS enrollees pay no premium as long as they’re enrolled in a benchmark Part D plan, with no deductible and fixed copayments up to $5.10 for generic and $12.65 for brand-name drugs in 2026.

What happens if I can’t afford Part B and don’t qualify for any savings program?

If you’re above the MSP income limits but still struggling, consider these options: enroll in a Medicare Advantage plan (many have $0 premiums and include Part B equivalent coverage), look into your state’s Medicaid spend-down program (where medical expenses reduce your countable income), or contact your State Health Insurance Assistance Program (SHIP) for free counseling on all available options. Every state has a SHIP office staffed with trained counselors who can review your specific situation at no cost.

If I delay Part B, can I still get free coverage later through an MSP?

Yes, but timing matters. You can apply for MSP assistance at any time your income and assets qualify. However, if you delayed Part B enrollment without qualifying employer coverage and later enroll during the General Enrollment Period, you’ll carry a permanent late enrollment penalty added to your premium — and the MSP will pay that higher amount. The penalty doesn’t go away just because a savings program picks up the tab.

The bottom line: Part B is not free by default for anyone, but a surprisingly wide swath of Americans qualifies for programs that eliminate the premium entirely. The 12 states and D.C. that have removed asset limits, combined with California’s extraordinarily generous $130,000 threshold, mean that millions more people could qualify than currently realize it. Contact your state’s Medicaid office or SHIP counselor before assuming you have to pay full price — the five minutes it takes to check could save you $2,434 every single year.

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