Medical Insurance for Low Income Seniors

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If you have Medicare and limited income, you may qualify for programs that pay your premiums, cover your deductibles, and slash your drug costs — often to nearly zero. This guide explains every program available, who qualifies, exactly what is covered, and how to apply. More than 12 million Americans are already enrolled in both Medicare and Medicaid — and millions more who qualify have never applied.

🏥 People Covered by Both Programs

12 Million Dually Eligible

According to Medicaid.gov, 12 million people are enrolled in both Medicare and Medicaid — 7.2 million of them low-income seniors 65 and older. When both apply, Medicare pays first and Medicaid acts as a secondary insurer, covering costs Medicare leaves behind. Millions more who qualify have never applied.

💊 Extra Help Value Per Person

$5,700/Year — Drug Cost Relief

The SSA estimates the Medicare Extra Help / Low Income Subsidy (LIS) program is worth $5,700 per year per person. It reduces prescription drug costs to $5.10 for generics and $12.65 for brand-name drugs in 2026 — and caps annual out-of-pocket drug spending at $2,100. Enrollment in any Medicare Savings Program automatically qualifies you.

💰 Part B Savings From MSPs

$2,400+/Year on Premiums Alone

The Medicare Part B premium is $202.90/month in 2026 — that is $2,434.80 per year. All three of the most common Medicare Savings Programs (QMB, SLMB, and QI) cover this premium if you qualify. For many low-income seniors, this one program alone puts more than $2,400 back in their pocket every year.

📋 10 Key Takeaways — What Every Low-Income Senior Must Know

#	What to Know	The Short Answer
1	Medicare is not free — and costs are rising	The standard Medicare Part B premium is $202.90/month in 2026 — up from $185/month in 2025. The Part B annual deductible is $283. The Part A hospital deductible is $1,736 per benefit period. These costs hit hardest on fixed incomes. The good news: multiple programs exist to pay these costs for qualifying seniors.
2	Medicare Savings Programs (MSPs) can eliminate your Part B premium entirely	The QMB, SLMB, and QI programs are federally funded and state-administered. They pay your $202.90/month Part B premium — saving $2,434.80/year. QMB also covers Part A deductibles, copays, and coinsurance. Income limits are $1,350–$1,816/month for individuals. Many seniors who qualify have never applied.
3	Enrolling in any MSP automatically gets you Extra Help for drug costs	Extra Help (also called Low Income Subsidy or LIS) is worth $5,700/year per SSA estimates. It reduces drug copays to $5.10 for generics and $12.65 for brand-name drugs in 2026, eliminates the Part D deductible, caps annual drug spending at $2,100, and removes the late enrollment penalty. You do NOT have to apply separately — MSP enrollment triggers automatic Extra Help.
4	Full Medicaid as a dual-eligible senior acts like a free supplement plan	When a senior qualifies for both Medicare and full Medicaid, Medicare pays first for all covered services. Medicaid then pays as the secondary insurer — covering deductibles, copays, and coinsurance that Medicare does not cover. This effectively eliminates most out-of-pocket healthcare costs and covers services Medicare does not include, such as long-term care, dental, vision, and hearing in most states.
5	Medicaid income and asset limits are more flexible than most seniors realize	Medicaid uses the SSI income methodology for seniors 65+, which counts income differently from gross income. Your home, car, personal belongings, one burial fund up to $1,500, and household goods are generally NOT counted as assets. In most states, the asset limit is $2,000 — but CA allows $130,000. Exceeding the limit does not automatically disqualify you: Medically Needy / Spend-Down pathways exist in many states.
6	QMB is the most powerful program — it covers nearly everything Medicare-related	The Qualified Medicare Beneficiary (QMB) program pays your Part A premium (if applicable), your Part B premium ($202.90/month), Part A and B deductibles, copayments, and coinsurance. If you are a QMB enrollee, providers are prohibited by federal law from billing you for Medicare cost-sharing. Income limit: $1,350/month individual, $1,824/couple. Assets: $9,660/$14,470.
7	12 states have no asset test for Medicare Savings Programs — just income counts	In states including Connecticut, Delaware, Louisiana, Maine, Mississippi, and others, you only need to meet the income limits to qualify for QMB, SLMB, or QI — there is no limit on the value of your savings or assets. Even in states with asset tests, your home, car, and most personal property do not count. Many seniors assume they own too much and never apply — often incorrectly.
8	SHIP counselors give completely free, unbiased help navigating all of these programs	State Health Insurance Assistance Programs (SHIPs) are federally funded and completely free. SHIP counselors do not sell insurance and have no financial interest in what you choose. They help you understand Medicare costs, identify which MSPs and Extra Help programs you qualify for, and assist with applications. Call 1-877-839-2675 to find your local SHIP. This is the single most valuable free resource available to Medicare beneficiaries.
9	Medicaid nursing home coverage is largely protected despite recent federal cuts	The One Big Beautiful Bill Act (OBBBA) proposed $1 trillion in Medicaid cuts over 10 years. The initial cuts effective in 2026 eliminated a temporary incentive for states to expand Medicaid to adults under 65 — but nursing home Medicaid for seniors is largely protected. Home and Community Based Services (HCBS) waiver programs face more risk. This law is also facing active legal challenges in federal courts.
10	Apply even if you think you make too much — the rules are more generous than they look	MSP income rules use the SSI methodology, which excludes the first $20/month of unearned income from all applicants and roughly half of earned income from workers. This means your countable income is often significantly lower than your gross income. States may also have more generous limits than the federal standard. The only way to know for certain whether you qualify is to apply.

Sources: CMS (cms.gov/newsroom, Nov 14, 2025): Part B $202.90/mo, deductible $283, Part A deductible $1,736. Medicaid.gov (confirmed): 77.9M covered, 12M dual eligibles, 7.2M low-income seniors. NCOA (ncoa.org, confirmed 2026): MSP income limits, Extra Help $5,700/yr, drug copays $5.10/$12.65. Nolo.com (confirmed 2026): QMB income $1,350/$1,824, SLMB $1,616/$2,184, QI $1,816/$2,455. CheckMedicaid.com (Jan 2026): 12 states no asset test. MedicaidPlanningAssistance.org (confirmed 2026): OBBBA cuts, nursing home protected, HCBS targeted. SHIP: 1-877-839-2675.

💰 Medicare Savings Programs — What Each One Covers

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All Four MSPs Share One Critical Benefit

Every Medicare Savings Program — QMB, SLMB, QI, and QDWI — automatically enrolls you in Extra Help (Low Income Subsidy) for prescription drugs. This is worth approximately $5,700/year per SSA estimates, reduces drug copays to $5.10 (generics) and $12.65 (brand-name) in 2026, eliminates the Part D deductible (up to $615 otherwise), caps annual drug spending at $2,100, and removes any late enrollment penalty for Part D. You do not need to apply separately — it is automatic.

Most Comprehensive

QMB — Qualified Medicare Beneficiary

Medicare cost-sharing with this program

Pays Part B premium: $202.90/mo
Pays Part A premium (if applicable)
Pays Part A + B deductibles
Pays Medicare copays and coinsurance
Providers CANNOT bill you for cost-sharing
Auto-enrolls in Extra Help ($5,700/yr)
Income: ≤$1,350/mo individual
Assets: ≤$9,660 individual

Mid-Range Income

SLMB — Specified Low-Income Medicare Beneficiary

$202.90

Part B premium paid by program each month

Pays Part B premium only ($202.90/mo)
Saves $2,434.80/year on premiums
Does not cover deductibles or copays
Auto-enrolls in Extra Help ($5,700/yr)
Income: $1,350–$1,616/mo individual
Assets: ≤$9,660 individual
Income range: $2,184 married couple max
SLMB can be retroactive up to 3 months

Higher Income — Apply Early

QI — Qualifying Individual

$202.90

Part B premium paid — apply early, first-come basis

Pays Part B premium ($202.90/mo)
First-come, first-served — limited funding
Must reapply every year
Not available if you already get full Medicaid
Auto-enrolls in Extra Help ($5,700/yr)
Income: up to $1,816/mo individual
Assets: ≤$9,950 individual
Income: up to $2,455/mo married couple

For Disabled Workers

QDWI — Qualified Disabled and Working Individual

Part A

Premium paid for disabled workers who returned to work

Pays Part A premium only
For disabled workers who lost premium-free Part A
Must have returned to work
Must be under 65 years old
Income: up to 200% FPL
Assets: up to $4,000 individual
Less commonly needed by seniors 65+
Auto-enrolls in Extra Help

📋 How to Apply for Any Medicare Savings Program

Apply through your state Medicaid office — not through Social Security or Medicare directly. Visit medicare.gov/savings-programs or call 1-800-MEDICARE (1-800-633-4227) to find your state's application process. You can apply online, by mail, or in person. States have 45–90 days to process applications. For free help completing your application, call SHIP at 1-877-839-2675 — this is always completely free and unbiased.

Starting April 1, 2026, dependent relatives you financially support now count toward your household size when calculating income limits — which raises your income threshold and makes qualification easier if you support adult children, grandchildren, or other dependents living with you.

Sources: NCOA (ncoa.org, confirmed 2026): QMB/SLMB/QI program details, drug copays, Extra Help value $5,700/yr, Part B premium $202.90. Nolo.com (confirmed 2026): income and asset limits all four MSPs. CenterForMedicareAdvocacy.org (confirmed): SLMB retroactive 3 months. Medicare.gov (confirmed): providers cannot bill QMB enrollees for cost-sharing. CheckMedicaid.com (Jan 2026): state Medicaid office application process, 45–90 day processing. SHIP: 1-877-839-2675.

🏥 Medicaid for Low-Income Seniors — Full Coverage Options

Medicaid Covers 77.9 Million Americans

Largest Source of Health Coverage in the U.S.

Medicaid is a joint federal-state program covering over 77.9 million people — making it the single largest source of health coverage in the United States. For seniors 65+, Medicaid income eligibility follows SSI methodology, which uses more flexible income counting rules than gross income comparisons. The income threshold for most non-elderly adults is 138% FPL ($22,025/year), but seniors use a different, often more accessible pathway.

💡 What Medicaid Covers That Medicare Does Not

When a senior is enrolled in both Medicare and full Medicaid, they gain access to services Medicare does not cover:

Long-term care — nursing home coverage (Medicaid is the primary payer for nursing home care in the U.S.)
Home and Community Based Services (HCBS) — personal care, home health aides, adult day programs
Dental care — most states include at least emergency dental
Vision care — eyeglasses and eye exams in most states
Hearing aids — in many states
Transportation to medical appointments
Medicare cost-sharing — copays, deductibles, and coinsurance Medicare leaves unpaid

Medicaid Type	Who It Covers	Income Limit	Asset Limit (Most States)
Regular / ABD Medicaid	Aged (65+), Blind, or Disabled individuals with limited income. No nursing home level of care required.	Varies by state. Generally near 100% FPL (~$1,330/mo individual). States set their own limits.	$2,000 individual. CA: $130,000. Exempt: home, car, household goods.
Nursing Home Medicaid	Seniors who need nursing home level of care. Functionally and financially determined.	$2,982/month individual (most states, 2026). Nearly all income goes to care costs except Personal Needs Allowance.	$2,000 individual (most states). CA: $130,000. NY: $33,038. Exempt: home (with conditions), car, personal items.
HCBS Waivers	Seniors needing nursing home level of care who prefer to remain at home or in community settings.	$2,982/month individual (most states, 2026). Same as nursing home income limit.	$2,000 individual (most states). Waitlists may apply — not an entitlement in most states.
Medically Needy / Spend-Down	Seniors with income above Medicaid limits who have high medical expenses. Available in many states.	Income above limit is “spent down” to the Medically Needy Income Level (MNIL) via medical expenses. Varies by state.	Varies by state. Works like a deductible — once medical bills equal excess income, Medicaid activates.
PACE Program	Frail seniors who qualify for nursing home level of care but live in the community. Medicare + Medicaid combined.	Must qualify for both Medicare and Medicaid. Available in 32+ states. No copays or premiums.	Must meet Medicaid financial eligibility. Combines all medical and long-term care services in one coordinated program.

⚠️ OBBBA Medicaid Cuts — What Seniors Should Know

The One Big Beautiful Bill Act (OBBBA) proposes $1 trillion in Medicaid cuts over 10 years. The initial changes effective January 2026 eliminated a temporary financial incentive for states that had expanded Medicaid to adults under 65 under the Affordable Care Act. Nursing Home Medicaid for seniors 65+ is largely protected from these cuts. Home and Community Based Services (HCBS) waiver programs face more risk of funding reductions. This law is actively facing legal challenges in federal courts, and its full implementation is not certain. Check your state Medicaid agency for updates specific to your state program.

Sources: Medicaid.gov (confirmed): 77.9M covered, mandatory eligibility groups, SSI methodology for seniors 65+. WTOP News (Mar 11, 2026): income threshold 138% FPL = $22,025/year under 65; dual eligibility overview; Medicare primary / Medicaid secondary. MedicaidPlanningAssistance.org (confirmed 2026): Nursing Home income limit $2,982/mo, asset limit $2,000, CA $130,000, NY $33,038, OBBBA analysis, HCBS targeted, nursing home protected. NY Medicaid page (confirmed 2026): PACE in 32+ states. WA Medicaid page (confirmed 2026): MNIL spend-down $994/mo example.

📊 What Medicare Actually Costs Without Help

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Part B Premium Rose Nearly 10% This Year

The standard Medicare Part B premium jumped to $202.90/month in 2026 — an increase of $17.90/month from $185 in 2025. The Part B deductible also rose to $283/year (from $257). For seniors on Social Security, this premium is automatically deducted from their monthly check. On a fixed income, a nearly 10% premium increase in a single year is significant — which is exactly why Medicare Savings Programs exist.

Medicare Cost	Amount	Notes
Part A Premium (Hospital)	$0 for most	99% of beneficiaries pay $0 — they worked 40+ quarters (10 years) and paid Medicare taxes. If you have 30–39 quarters: $311/mo. Fewer than 30 quarters: $565/mo.
Part A Hospital Deductible	$1,736 per benefit period	Not an annual deductible — applies per “benefit period” (hospital stay). A new benefit period starts 60 days after discharge. Multiple hospitalizations in one year can trigger multiple deductibles. QMB covers this entirely.
Part B Premium (Medical)	$202.90/month	Standard premium for most beneficiaries. Higher for those with MAGI over $109,000/year (individual). QMB, SLMB, and QI all cover this premium. $2,434.80/year if paid without assistance.
Part B Annual Deductible	$283/year	Must be met before Part B coverage begins for most services. Covered entirely by QMB. Not covered by SLMB or QI.
Part B Coinsurance	20% of approved cost	After the deductible, you pay 20% of the Medicare-approved amount for all Part B services (doctor visits, outpatient care, lab tests, imaging, durable medical equipment). There is NO cap on this 20% under Original Medicare alone — it can add up significantly. QMB covers this. Medigap plans also cover it.
Part D (Prescription Drugs)	$34.50/mo avg + costs	Average stand-alone Part D premium: $34.50/month. Deductible: up to $615/year. Annual OOP cap: $2,100. Extra Help eliminates deductible and reduces copays to $5.10/$12.65. Avg Medicare Advantage Part D premium: $11.50/month.
Medicare Advantage Max OOP	$9,250/year in-network	MA plans cap in-network out-of-pocket costs at $9,250 in 2026 (down from $9,350). Average MA premium: $14.00/month. Many plans have $0 premium but still have cost-sharing. Dual eligibles enrolled in MA plans also get their QMB benefits applied.
Skilled Nursing Facility	$217/day — Days 21-100	Medicare covers days 1–20 at $0. Days 21–100 cost $217/day in coinsurance. After 100 days, Medicare coverage ends entirely — at which point Medicaid nursing home coverage may apply for those who qualify.

Sources: CMS Fact Sheet (Nov 14, 2025): Part B $202.90/mo, deductible $283, Part A deductible $1,736, SNF coinsurance $217/day days 21-100. Federal Register (Nov 19, 2025): standard Part B premium formula, 99% get premium-free Part A. NCOA (ncoa.org, 2026): avg Part D $34.50/mo, Part D OOP cap $2,100, avg MA premium $14.00/mo, MA OOP max $9,250. RRB.gov (confirmed): Part A deductible $1,736. MedicareResources.org (confirmed 2026): Part D deductible max $615.

❓ Frequently Asked Questions

All three are Medicare Savings Programs (MSPs) run by your state Medicaid agency. The main differences are income limits and what costs they cover:

QMB (Qualified Medicare Beneficiary): Most comprehensive. Income limit $1,350/month individual ($1,824 couple). Covers your Part B premium ($202.90/mo), Part A premium if applicable, Part A and B deductibles, copays, and coinsurance. Providers cannot legally bill you for Medicare cost-sharing. Also auto-qualifies you for Extra Help drug coverage ($5,700/yr value).
SLMB (Specified Low-Income Medicare Beneficiary): Income $1,350–$1,616/month individual ($2,184 couple). Covers Part B premium only — saves $2,434.80/year. Does not cover deductibles or copays. Auto-qualifies for Extra Help. Can be retroactive up to 3 months.
QI (Qualifying Individual): Highest income limit — up to $1,816/month individual ($2,455 couple). Covers Part B premium. First-come, first-served funding — apply early. Must reapply every year. Not available if you already get full Medicaid benefits. Auto-qualifies for Extra Help.

Which to apply for: Apply for QMB first — it is the most valuable. If your income is above the QMB limit, apply for SLMB. If above SLMB, try QI. Apply to all three simultaneously through your state Medicaid agency — they will determine which program you qualify for and place you in the best one.

Sources: NCOA (ncoa.org, confirmed 2026): QMB/SLMB/QI income limits and coverage. Nolo.com (confirmed 2026): all four MSP income/asset limits. CenterForMedicareAdvocacy.org (confirmed): SLMB retroactive 3 months. Medicare.gov: providers cannot bill QMB enrollees.

Not necessarily — and this is the most common reason seniors never apply when they actually could qualify. Here is what you need to understand about how assets are counted:

Your home is excluded. Your primary residence does not count as an asset for Medicaid or MSPs (with some conditions for nursing home Medicaid). You can own your home outright and still qualify.
Your car is excluded. One vehicle is not counted as an asset in most states.
Personal belongings and household goods are excluded. Furniture, appliances, clothing, and similar items are not counted.
One burial fund up to $1,500 is excluded. Life insurance with cash value under $1,500 may also be excluded.
12 states have NO asset test at all for MSPs — in those states, only income is considered.
California allows up to $130,000 in countable assets. The federal standard is $2,000, but states set their own rules.
Even if you exceed the asset limit, you may still qualify through the Medically Needy / Spend-Down pathway, which lets you “spend down” excess income on medical bills to qualify.

The bottom line: always apply even if you think you might not qualify. Your state Medicaid agency will make the actual determination. The only cost of applying is your time.

Sources: MedicaidPlanningAssistance.org (confirmed 2026): asset limits, exclusions (home, car, household goods, burial funds). CA Medicaid: $130,000 asset limit reinstated Jan 2026. Nolo.com (confirmed 2026): 12 states no asset test. CheckMedicaid.com (Jan 2026): asset exclusions confirmed.

Extra Help (officially the Low Income Subsidy, or LIS) is a federal Medicare program that specifically helps pay for Part D prescription drug costs — not overall medical coverage. It is different from Medicaid in that it is narrowly focused on drug coverage costs.

In 2026, Extra Help provides: no Part D deductible (saving up to $615), generic drug copays capped at $5.10, brand-name drug copays capped at $12.65, annual out-of-pocket drug cap of $2,100, no late enrollment penalty for Part D, and no Part D premium if enrolled in a benchmark plan.

The SSA estimates the total value of Extra Help at approximately $5,700 per year. There are two ways to get it: (1) Enroll in any Medicare Savings Program (QMB, SLMB, QI) — Extra Help is then automatic, no separate application. (2) Apply directly through SSA at ssa.gov or call 1-800-772-1213 — income limit is 150% FPL (~$22,590/year for a single person), and resource limits are $16,590 individual/$33,100 couple.

Medicaid, by contrast, covers much broader healthcare: doctor visits, hospital stays, nursing home care, home health services, and more — depending on your state's Medicaid program.

Sources: NCOA (ncoa.org, confirmed 2026): Extra Help $5,700/yr value, copays $5.10/$12.65, OOP cap $2,100, no late penalty. CMS LIS memo (confirmed 2026): resource limits $16,590/$33,100. SSA (ssa.gov): Extra Help income 150% FPL, application at SSA. Medicare.gov (confirmed): Extra Help via MSP enrollment is automatic.

Yes — and 12 million Americans already do. People enrolled in both Medicare and Medicaid are called “dual eligibles.” Of these, 7.2 million are low-income seniors 65 and older. Being dually eligible is one of the most financially protective healthcare situations available in the United States.

Here is how dual eligibility works: Medicare is your primary insurer — it pays first for all Medicare-covered services (hospital stays, doctor visits, outpatient care, some home health). Medicaid is your secondary insurer — after Medicare pays its share, Medicaid picks up the remaining costs: deductibles, copays, coinsurance, and services Medicare does not cover at all (nursing home care, dental, vision, hearing in most states).

The result: most or all of your healthcare costs can be covered at no charge to you. Dual-eligible seniors typically pay very little out of pocket for medical care. If you have Medicare and believe your income and assets may be low enough for Medicaid, apply — the state will determine eligibility. Call SHIP at 1-877-839-2675 for free help navigating this process.

Sources: Medicaid.gov (confirmed): 12M dual eligibles, 7.2M low-income seniors. WTOP News (Mar 11, 2026): Medicare primary / Medicaid secondary for dual eligibles. Medicare.gov (confirmed): dual enrollment overview. SHIP: 1-877-839-2675.

PACE — Program of All-Inclusive Care for the Elderly — is a specialized program that combines Medicare and Medicaid benefits into a single, coordinated care program for frail seniors who qualify for nursing home level of care but prefer to live in the community.

PACE provides: medical care, hospital care, prescription drugs, home health services, adult day health center services, physical and occupational therapy, social services, meals, transportation to all appointments, and in some cases dental and vision — all coordinated through a single PACE organization. You never deal with paperwork, separate billing, or coordinating between insurers.

To qualify, you must: be 55 or older, live in a PACE service area, meet the nursing home level of care requirement in your state, and be able to live safely in the community with PACE support. You must be enrolled in Medicare and/or Medicaid (or able to pay privately). If you qualify for Medicaid, there are generally no copays or premiums through PACE. PACE is currently available in 32+ states. Call 1-800-MEDICARE or visit pace4you.org to find a program near you.

Sources: MedicaidPlanningAssistance.org/NY (confirmed 2026): PACE program description, 32+ states. Medicare.gov (confirmed): PACE overview. Medicaid.gov: PACE eligibility.

If your income is above the Medicaid limit, you have several options:

Medicare Savings Programs (QMB, SLMB, QI): These have higher income limits than full Medicaid and can still save you $2,400+/year on Part B premiums alone, plus Extra Help for drugs. Income limits reach up to $1,816/month individual (QI). Apply even if you think you are over the limit — the $20 income disregard and SSI methodology often lower your countable income significantly.
Medically Needy / Spend-Down: Available in many states, this pathway lets seniors with income above Medicaid limits become eligible by “spending down” the excess on medical bills. Once your medical expenses in a given period bring your income down to the Medically Needy Income Level (MNIL), Medicaid activates for the remainder of that period. Ask your state Medicaid agency whether your state has a Medically Needy program.
Extra Help directly through SSA: Even if you do not qualify for Medicaid or MSPs, you can apply directly for Extra Help at SSA if your income is at or below 150% FPL (~$22,590/year individual). This covers drug costs with no premiums, deductibles, or high copays.
Medicare Advantage (Part C) plans: Some Medicare Advantage plans in your area may have $0 premiums, dental, vision, hearing, and other benefits not in Original Medicare — worth comparing through Medicare.gov Plan Finder.
SHIP counselors: Call 1-877-839-2675 for free, personalized guidance on all options available at your income level in your state.

Sources: NCOA (ncoa.org): MSP income limits, Extra Help at 150% FPL. MedicaidPlanningAssistance.org/WA (confirmed 2026): Medically Needy / Spend-Down example. CMS: Extra Help SSA application. Medicare.gov: Plan Finder. SHIP: 1-877-839-2675.

If you receive Social Security, your Medicare Part B premium ($202.90/month in 2026) is automatically deducted from your monthly Social Security check before you receive it. You never see that $202.90 — it goes directly to Medicare.

When the Part B premium increases (as it did by $17.90 this year), your Social Security check effectively decreases by that amount — unless the Social Security cost-of-living adjustment (COLA) is large enough to offset the increase. For many seniors, particularly those with lower Social Security benefits, premium increases can consume part or all of the annual COLA, leaving net income flat or declining.

There is one protection: the hold-harmless provision. Under federal law, current Social Security beneficiaries cannot have their Social Security payment decrease due to a Part B premium increase. Your Part B premium cannot increase by more than your COLA dollar amount. However, this protection only applies to existing beneficiaries — new enrollees in 2026 pay the full $202.90 regardless.

The best protection against rising Part B premiums for low-income seniors is enrollment in a Medicare Savings Program. If you qualify for QMB, SLMB, or QI, the state pays your $202.90/month premium — and you receive your full Social Security amount without that deduction.

Sources: CMS (Nov 14, 2025): Part B premium $202.90/mo, increase of $17.90. RRB.gov (confirmed): hold-harmless provision. SSA.gov (ssa.gov/benefits/medicare): premium deducted from Social Security automatically. Medicare Rights Center (Nov 2025): impact analysis on Social Security recipients.

🔍 Which Program Fits You? — Quick Eligibility Finder

Answer two quick questions to get a personalized recommendation on which low-income medical insurance program is the best fit for your situation.

🔍 Medical Insurance Eligibility Finder

What is your approximate monthly income (Social Security + all other sources combined)? What is your current Medicare / insurance situation?

📍 Find Local Help — Medicaid, SHIP, and Enrollment Centers Near You

Allow location access when prompted for the most accurate nearby results. Each button finds a different type of free help or enrollment resource near your location.

Finding resources near you…

📞 Key Contacts — Free Help and Applications

🟢 Medicare — Plans and Savings Programs

1-800-633-4227

1-800-MEDICARE. Find your state Medicaid agency for MSP applications, check Medicare Savings Program eligibility, find plans, and get general Medicare help. 24 hours/day, 7 days/week. TTY: 1-877-486-2048.

🟣 SHIP — Free Medicare Counseling

1-877-839-2675

State Health Insurance Assistance Programs. Completely free, unbiased, no sales. SHIP counselors help you understand Medicare, apply for MSPs and Extra Help, compare plans, and resolve billing problems. Find your local SHIP at shiphelp.org.

🔴 SSA — Extra Help / SSI Applications

1-800-772-1213

Social Security Administration. Apply for Extra Help (LIS) for drug costs, check SSI eligibility, request benefit verification letters, and handle Medicare enrollment. Mon–Fri 8am–7pm. TTY: 1-800-325-0778.

🟢 Medicaid — State Applications

medicaid.gov

Apply for Medicaid and Medicare Savings Programs through your state Medicaid agency. Visit medicaid.gov/about-us/contact-us to find your state Medicaid office contact. Applications can be made online, by phone, by mail, or in person. Allow 45–90 days for processing.

🟡 NCOA BenefitsCheckUp

benefitscheckup.org

Free online tool from the National Council on Aging. Searches thousands of programs that can help pay for healthcare, prescriptions, food, utilities, and more. Finds all programs you may qualify for including MSPs, Extra Help, SNAP, and others. No personal information required to browse.

🔴 Medicare Rights Center Helpline

1-800-333-4114

Free national Medicare helpline. Answers questions about Medicare costs, coverage disputes, appeals, and enrollment. Advocates for Medicare beneficiaries. Also at medicarerights.org.

Phone numbers verified March 2026: 1-800-MEDICARE: 1-800-633-4227. SHIP: 1-877-839-2675. SSA: 1-800-772-1213. Medicaid: medicaid.gov/about-us/contact-us. NCOA BenefitsCheckUp: benefitscheckup.org. Medicare Rights Center: 1-800-333-4114.

📝 How to Apply — Step-by-Step Action Plan

Use BenefitsCheckUp first — it takes 5 minutes. Go to benefitscheckup.org (free, from the National Council on Aging). Enter your state, age, income range, and benefits you already receive. The tool will identify all programs you may qualify for, including MSPs, Extra Help, SNAP, LIHEAP, and others. This is the fastest way to see the full picture before applying anywhere.
Call SHIP for free, personalized guidance. Call 1-877-839-2675 to reach your State Health Insurance Assistance Program. SHIP counselors will review your specific situation — income, assets, current Medicare coverage, medications, and health needs — and tell you exactly which programs you should apply for, in which order, and how. This service is completely free and unbiased.
Apply for QMB first — through your state Medicaid agency. Visit medicare.gov/savings-programs to find your state's application process. Most states allow online applications; some have mail-in or in-person options. Have ready: photo ID, proof of income (Social Security award letter, any pension statements), proof of Medicare enrollment (Medicare card), and documentation of any assets if your state has an asset test.
If income is above QMB, ask about SLMB and QI in the same application. When you apply, your state will automatically assess whether you qualify for QMB, SLMB, or QI — you do not need separate applications. If QMB is denied, ask whether you qualify for SLMB or QI. Even $200/month in Part B premium savings is meaningful on a fixed income.
Apply for full Medicaid separately if you think you may qualify. If your income and countable assets appear to be within Medicaid limits, apply for full Medicaid through your state. Even if you initially do not qualify, ask about the Medically Needy / Spend-Down pathway if your state offers it. A certified Medicaid planner can also help if your situation is complex.
Apply for Extra Help directly at SSA if MSP applications are pending. While waiting for MSP approval, apply directly for Extra Help at SSA (1-800-772-1213 or ssa.gov). If you qualify based on income (150% FPL or lower), you get drug coverage relief immediately — and it will convert to the automatic MSP-based Extra Help once your MSP application is approved.

Sources: NCOA BenefitsCheckUp (benefitscheckup.org): free tool confirmed. SHIP (shiphelp.org): 1-877-839-2675, free unbiased counseling. Medicare.gov/savings-programs: application process and state agency locator. CheckMedicaid.com (Jan 2026): 45–90 day processing. SSA (ssa.gov): Extra Help direct application at 150% FPL.

✅ Summary — Low Income Medical Insurance for Seniors

12 million Americans have both Medicare and Medicaid. If you are a senior with limited income, you may qualify for programs that cover your premiums, deductibles, and drug costs.
QMB is the most comprehensive program — it covers your Part B premium ($202.90/mo), Part A and B deductibles, and all copays. Income limit: $1,350/month individual. Apply through your state Medicaid office.
Any MSP (QMB, SLMB, or QI) automatically gives you Extra Help — worth $5,700/year in drug cost relief. No separate application needed once enrolled in an MSP.
Your home and car do not count as assets in most Medicaid and MSP programs. Apply even if you think you own too much.
SHIP counselors give completely free help — call 1-877-839-2675. No sales pitch, no cost, unbiased guidance on every program available to you.
Nursing Home Medicaid is largely protected from the proposed OBBBA cuts. Home-based care programs face more uncertainty. Check with your state for updates.
Start at benefitscheckup.org — the NCOA's free tool identifies every program you may qualify for in about 5 minutes.

⚕️ Disclaimer

This widget is provided for educational and informational reference only. It is not a substitute for individualized legal, financial, or medical advice. Medicaid eligibility, income limits, asset rules, and program availability vary significantly by state and are updated regularly. Medicare premiums, deductibles, and program rules change each year. Always verify current eligibility requirements directly with your state Medicaid agency, Medicare.gov, or a certified SHIP counselor. BudgetSeniors.com is an independent educational publication not affiliated with CMS, SSA, or any government agency.

Primary sources: CMS Fact Sheet (Nov 14, 2025, cms.gov): Part B $202.90/mo, deductible $283, Part A deductible $1,736, SNF $217/day days 21-100, Part D OOP cap $2,100, avg Part D $34.50/mo, avg MA premium $14.00/mo. Federal Register (Nov 19, 2025): standard Part B premium formula. Medicaid.gov (confirmed): 77.9M covered, 12M dual eligibles, 7.2M low-income seniors, SSI methodology for 65+, mandatory eligibility groups. WTOP News (Mar 11, 2026): income threshold 138% FPL = $22,025/year; Medicare primary / Medicaid secondary for dual eligibles. MedicaidPlanningAssistance.org (confirmed 2026): nursing home income limit $2,982/mo, asset limit $2,000, CA $130,000, NY $33,038, OBBBA analysis (nursing home protected, HCBS targeted, facing legal challenges), PACE 32+ states, Medically Needy spend-down. NCOA (ncoa.org, confirmed 2026): MSP income limits (QMB $1,350/$1,824, SLMB $1,616/$2,184, QI $1,816/$2,455), Extra Help $5,700/yr, drug copays $5.10/$12.65. Nolo.com (confirmed 2026): all MSP income/asset limits, asset exclusions. CenterForMedicareAdvocacy (confirmed): SLMB retroactive 3 months, QI first-come first-served. CheckMedicaid.com (Jan 2026): 12 states no asset test, April 2026 dependent counting change. CMS LIS memo (confirmed 2026): Extra Help resource limits $16,590/$33,100. RRB.gov (confirmed): hold-harmless provision. SHIP: 1-877-839-2675. SSA: 1-800-772-1213. Medicare Rights Center: 1-800-333-4114. NCOA BenefitsCheckUp: benefitscheckup.org. Medicare.gov/savings-programs: MSP application portal.

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