QI Medicare Savings Program: Eligibility, income limits and more

Medicare is great… until your wallet realizes Medicare has a monthly “subscription fee” called the Part B premium.
If that premium is turning your budget into a dramatic soap opera, the QI Medicare Savings Program
(short for Qualifying Individual) might be the plot twist you need.

QI is one of the Medicare Savings Programs (MSPs) run by states to help people with limited income
and resources pay certain Medicare costs. Specifically, QI helps pay the Medicare Part B premium.
And yes, that can be a big dealbecause when your Part B premium gets covered, your monthly cash flow suddenly
feels like it can breathe again.

What is the QI Medicare Savings Program?

The QI program is a state-administered MSP designed for people who:
have Medicare Part A and Part B, have limited income and resources, and don’t qualify
for certain other Medicaid benefits. In plain English: it’s for people who are “too high” for some MSP tiers, but
still need help paying the Part B premium.

What QI covers

• Helps pay Medicare Part B premiums (that’s the main benefit).
• If you qualify for QI, you also typically qualify for Extra Help (the Low-Income Subsidy) to lower
  Medicare Part D prescription drug costs.

What QI usually does NOT cover

• It generally does not pay deductibles, copays, or coinsurance the way some other MSPs (like QMB) can.
• It is not full Medicaid coverage.

Think of QI as the “premium lifter” of the MSP family: it focuses on the Part B premium so you don’t have to.

QI vs. QMB vs. SLMB: Why does QI exist?

Medicare Savings Programs are often grouped by income level. The exact rules can vary by state, but federally
they’re commonly described like this:

• QMB: the most comprehensive help (can cover premiums and cost-sharing), usually for the lowest income tier.
• SLMB: helps pay Part B premiums, generally for a middle-low income tier.
• QI: helps pay Part B premiums for a slightly higher income tier than SLMB.

Your state decides which MSP category you qualify for when you apply. Even if you apply “for QI,” the agency may
place you into a different MSP if that’s the best match.

Eligibility requirements for the QI program

1) You must have Medicare Part A and Part B

QI is designed for people enrolled in both Part A (Hospital Insurance) and Part B (Medical Insurance).
If you have Part A but not Part B, you’d generally need to enroll in Part B to qualify.

2) Your income must be under the limit

QI uses monthly income limits. States can apply special counting rules (and some states may be more
generous than the basic federal limits), but the federal reference limits are still a helpful starting point.

3) Your resources (assets) must be under the limit

QI also uses a resource limit (sometimes called an asset limit). Resources often include things like
money in checking and savings, stocks, and bonds. Many everyday items do not count (more on that below).

4) You generally can’t be receiving certain other Medicaid benefits

QI is typically intended for people who don’t qualify for other Medicaid coverage/benefits.
If you might qualify for Medicaid or a different MSP category, your state may place you there instead.

5) You must reapply every year (and funding is limited)

One of the most important “QI quirks” is that QI is not guaranteed year to year. States generally
approve QI on a first-come, first-served basis, and many states prioritize people who received QI
the previous yearso applying early matters.

QI income limits and resource limits for 2025

Medicare publishes reference limits each year. These are federal baseline limits. Your state may use
different counting rules or higher thresholds, but these numbers are widely used as the standard benchmark.

2025 QI limits (most states)

Alaska and Hawaii have higher income limits due to different federal poverty guideline calculations.
If you live in either state, your monthly income limit may be higher than the “most states” numbers above.

Important: Your countable income is what matters, not necessarily your “gross paycheck” or the
number you see on a Social Security award letter. States may disregard certain income amounts or income types.

What counts as income for QI?

States do the official calculation, but common income types that may be counted include:

• Social Security benefits (retirement or disability)
• Pensions
• Wages (if you still work)
• Some veterans benefits (depending on the type)
• Withdrawals or distributions that are treated as income under state rules

Many states also apply disregards (like a small standard “ignore” amount) and may not count certain assistance
programs the same way. This is why people sometimes qualify even when their “back of the napkin math” says they won’t.

Example: A quick “could I be close?” income check

Suppose Gloria (single) receives $1,620/month from Social Security and $120/month from a small pension.
That’s $1,740/month before any state-specific disregards. Compared to the 2025 reference limit of $1,781/month,
she’s close enough that applying is absolutely worth itbecause the state’s countable-income method might put her under.

What counts as a resource (asset) for QI?

Resources typically include “money you can use,” such as:

• Checking and savings account balances
• Stocks, bonds, mutual funds
• Certificates of deposit (CDs)
• Some additional real property (not the home you live in)

Common resources that often do NOT count

While details can vary, many MSP resource tests commonly exclude items like:

• Your primary home
• One car (in many cases)
• Household goods and personal belongings
• Burial spaces and certain burial funds (within limits, depending on rules)

If you’re thinking, “My resources are basically a couch and a microwave,” you’re not aloneand yes, that can be good
news for eligibility.

How to apply for the QI Medicare Savings Program

You apply through your state Medicaid agency (not directly through Medicare). Even if you’re applying
specifically for QI, your state typically screens you for all MSP categories.

Step-by-step application roadmap

1. Contact your state Medicaid office (online, phone, mail, or in persondepends on the state).
2. Gather documents:
   • Your Medicare card (showing Part A and Part B)
   • Proof of income (Social Security award letter, pay stubs, pension statements)
   • Proof of resources (recent bank statements, investment statements)
   • Proof of identity and residency (state ID, utility billvaries by state)
3. Submit the application and respond quickly if the agency requests additional verification.
4. Watch for your determination notice. If approved, your Part B premium payment typically begins
   according to the effective date assigned by the state.

Pro tip: Apply early in the year

Because QI funding can be limited and handled first-come/first-served, applying early (especially if you had QI
last year) can improve your chances.

Will QI reimburse premiums you already paid?

In some situations, people may receive reimbursement for Part B premiums paid for months before their QI effective date,
if they were eligible during those months and the state allows retroactive coverage. Rules can get technicalsome states
treat timing and calendar-year boundaries differentlyso it’s smart to ask your state office or a local counselor how
retroactive reimbursement works where you live.

Common reasons people get denied (and what to do next)

• Income slightly over the limit: Ask whether certain income is excluded or whether another MSP category fits.
• Resources over the limit: Make sure the agency excluded what should be excluded (like a primary home).
• Missing documents: This is a big onemany denials are “procedural,” not a true eligibility decision.
• QI funding full: If QI slots are filled, ask about reapplying, other MSPs, or other assistance programs.

If you’re denied, you typically have the right to appeal. And even if QI isn’t available, other programs may still help
lower Medicare costs.

FAQ: Quick answers about QI Medicare Savings Program

Is QI the same in every state?

No. The program is federal in structure but state-run, and states can use different counting rules and processes.
You may qualify even if you appear over the federal limits due to state-specific disregards.

Does QI automatically enroll me in Extra Help?

MSP participation commonly triggers Extra Help for Part D, which can lower premiums and drug costs. If you get QI,
ask your state how the Extra Help enrollment happens and what timeline to expect.

Do I have to reapply every year?

Yes, QI usually requires annual reapplication. Put it on your calendar like a birthdayexcept this one saves you money.

Can I have QI and full Medicaid?

In many cases, QI is for people who do not qualify for other Medicaid coverage/benefits. If you qualify for Medicaid,
your state may enroll you in a different program category instead of QI.

500+ words of real-world experiences (what it’s like dealing with QI in practice)

Let’s talk about the part nobody puts on the brochure: the lived experience of trying to get help with Medicare costs
while your mail pile slowly turns into modern art.

Experience #1: “I didn’t think I qualifiedturns out I did.”
A common story is someone looking at the income limit, doing quick math with their Social Security and a small pension,
and deciding it’s not worth applying. Then a counselor (often through a local aging organization or state health
insurance counseling service) explains that eligibility is based on countable income, not always gross income.
Certain disregards and exclusions may apply. People who apply anyway sometimes find they squeak inespecially when
the state applies standard disregards, excludes certain income types, or calculates household size differently than
the applicant assumed. The emotional takeaway is surprisingly consistent: relief, followed by “Why is this so hard
to understand in the first place?”

Experience #2: The paperwork isn’t “hard,” but it is persistent.
Many applicants say the most annoying part isn’t the form itselfit’s the follow-up requests. The state might ask for:
the most recent bank statement, then a statement from a different account, then clarification on a one-time deposit
(like a tax refund or a family gift), and sometimes updated proof if processing takes longer than expected.
The best real-world strategy people report is to build a tiny “QI folder” (paper or digital) with:
Medicare card copies, Social Security award letters, pension stubs, and bank statements. That way, if a letter arrives
asking for something in 10 days, you don’t have to go full detective.

Experience #3: “Waitmy Social Security check changed.”
When QI starts paying the Part B premium, many people notice their Social Security deposit increases because the Part B
premium is no longer being deducted. That’s a genuinely happy moment. But it can also cause confusion because it feels
like income “went up,” and some people worry it will disqualify them. In reality, what’s happening is the premium is
being paid on your behalf, and your benefit deposit reflects that. People often say the best reassurance came from
a benefits counselor explaining the difference between the benefit amount and the premium deduction.

Experience #4: Retroactive reimbursement feels like finding money in an old jacket.
Some people report receiving reimbursement for premiums they paid in prior months (depending on state rules and timing).
When it happens, it’s usually not instant, and it may arrive separately from the approval notice. Applicants who had
the smoothest experience tended to do two things: (1) they applied as soon as they were eligible, and (2) they kept
proof of premium payments/deductions (such as benefit statements showing the Part B deduction). The lesson: if you think
you might qualify, apply sooner rather than laterwaiting can mean leaving real dollars on the table.

Experience #5: The “annual reapply” surprise.
QI’s yearly renewal catches people off guard. A lot of folks assume “once approved, always approved.” With QI, you
typically need to reapply annually, and funding may be limited. People who stay in the program often treat the renewal
like a seasonal routine: gather documents, reapply early, respond quickly. It’s not glamorous, but it’s effectiveand
it can keep that Part B premium from taking another bite out of monthly necessities.

Note: The examples above are representative scenarios (not individual legal or benefits advice). Your actual
outcome depends on your state’s rules, timelines, and your specific financial situation. When in doubt, applyand ask
questions until the answers make sense in plain English.

Conclusion

The QI Medicare Savings Program can be a powerful way to reduce Medicare costs by covering the
Part B premium for eligible beneficiaries. The two biggest keys are knowing the 2025 income and
resource limits and applying early (because QI funding can be limited). Even if you’re not sure
you qualify, applying can open doors to QI, another Medicare Savings Program, and often Extra Help for
prescription drug costs.