If you want a lower Medicare Part B premium, the route depends on your income. The standard Part B premium is $202.90 a month in 2026.1Centers for Medicare & Medicaid Services. 2026 Medicare Parts A and B Premiums and Deductibles Beneficiaries with limited income and resources can have that premium paid entirely by their state through a Medicare Savings Program. Higher earners who pay an income-related surcharge can ask Social Security to reduce it after certain life changes. And some Medicare Advantage plans offer a “give-back” that lowers the premium deducted from your Social Security check.
Medicare Savings Programs: The Main Route to a Lower Premium
Medicare Savings Programs (MSPs) are the primary way to reduce or eliminate the Part B premium. Your state Medicaid agency runs these programs and decides which one you qualify for based on your monthly income and countable resources.2Medicare. Medicare Savings Programs There are four programs. One covers nearly all of your Medicare costs; two cover just the Part B premium; the fourth is a narrow program for working people with disabilities.
Each program uses income limits tied to the Federal Poverty Level, plus a $20 monthly general income exclusion that Social Security applies automatically. Resource limits also apply in most states, and both thresholds update annually. Limits run slightly higher in Alaska and Hawaii.3Social Security Administration. Medicare Savings Programs Income and Resource Limits The numbers below are the federal floors; many states use more generous limits, and a few have dropped the asset test entirely.2Medicare. Medicare Savings Programs Don’t rule yourself out based only on the federal figures.
Qualified Medicare Beneficiary (QMB)
QMB is the most comprehensive of the four. If you qualify, the state pays your Part B premium, your Part A premium if you owe one, and all deductibles, coinsurance, and copayments for Medicare-covered services.2Medicare. Medicare Savings Programs For 2026, the federal limits are:
- Monthly income up to $1,350 for an individual or $1,824 for a married couple
- Resources below $9,950 for an individual or $14,910 for a couple
Specified Low-Income Medicare Beneficiary (SLMB)
SLMB pays the monthly Part B premium only. It does not touch deductibles or copays. You must have both Part A and Part B to qualify.2Medicare. Medicare Savings Programs For 2026:
- Monthly income up to $1,616 for an individual or $2,184 for a couple
- Resources below $9,950 for an individual or $14,910 for a couple
Qualifying Individual (QI)
QI also pays the Part B premium only, and it allows somewhat higher income. For 2026:
- Monthly income up to $1,816 for an individual or $2,455 for a couple
- Resources below $9,950 for an individual or $14,910 for a couple
QI works differently from the other MSPs in one respect: funding is limited, so states approve applications on a first-come, first-served basis, with priority for people who received QI the previous year. You have to reapply every year to stay enrolled.2Medicare. Medicare Savings Programs
Qualified Disabled and Working Individuals (QDWI)
QDWI is narrower. It’s for people under 65 who have a disability, returned to work, and lost their premium-free Part A because of that return to work. It pays the Part A premium only, not Part B.4Social Security Administration. Qualified Disabled Working Individuals For 2026:
- Monthly income up to $5,405 for an individual or $7,299 for a couple
- Resources below $4,000 for an individual or $6,000 for a couple
What Counts Toward the Resource Limit
Countable resources include savings and checking accounts, stocks, bonds, mutual funds, retirement accounts, and real estate other than your primary home. In states that use the federal resource rules, the following don’t count:
- Your primary home
- One car
- Household goods and wedding or engagement rings
- Burial spaces
- Burial funds up to $1,500 per person
- Life insurance with a cash value under $1,500
Some states exclude additional resources or apply higher thresholds.2Medicare. Medicare Savings Programs Confirm with your state Medicaid office before assuming your assets disqualify you.
How to Apply
Applications go to your state Medicaid agency, not to Medicare.2Medicare. Medicare Savings Programs Most states let you apply online, by mail, by fax, by phone, or in person.5Centers for Medicare & Medicaid Services. Medicare Savings Program Model Application Have these ready:
- Proof of income: recent pay stubs, tax returns, or benefit award letters from Social Security or the VA
- Financial records: bank statements and documentation of other assets
- Your Medicare card and Social Security number
- Proof of residency, such as a utility bill or lease
The state should respond within 45 days. If you don’t hear back by then, call the agency. Respond quickly to any request for more documents, because delays hold up approval.6Centers for Homedicare & Medicaid Services. Medicare Savings Program Model Application
After You’re Approved
Your state Medicaid program pays the Part B premium directly, so the deduction from your Social Security check stops (or is reduced, in the case of the give-back situations described below). For QMB, the state also picks up Medicare cost-sharing, so your out-of-pocket costs for covered services drop to zero. Report any change in income or resources promptly, since late reporting can produce incorrect benefits.5Centers for Medicare & Medicaid Services. Medicare Savings Program Model Application Most programs review eligibility periodically, and QI requires a new application each year.
Automatic Extra Help With Drug Costs
Enrollment in any MSP automatically qualifies you for Extra Help (the Low-Income Subsidy), which lowers your Part D drug costs. Medicare mails a purple “Deemed Status Notice” confirming it.7Medicare. Medicare’s Extra Help Program With full Extra Help in 2026, you pay no Part D plan premium, no deductible, and only small copays: up to $5.10 for generics and $12.65 for brand-name drugs. Once your total drug costs reach $2,100 for the year, copays drop to $0.8Medicare. Help With Drug Costs QMB enrollees who also have full Medicaid pay no more than $4.90 per covered drug.
What This Means for Medigap
Because QMB already eliminates your Medicare cost-sharing, a Medigap policy would duplicate coverage you already have. Federal rules generally bar Medigap insurers from selling policies to people on Medicaid, including QMB. If you had a Medigap policy before qualifying, you can suspend it for up to two years and restart it without new medical underwriting or pre-existing condition waiting periods if you lose Medicaid eligibility within that window.
Reducing an Income-Related Surcharge (IRMAA)
Premium reductions aren’t only for low-income beneficiaries. If you earn above $109,000 as an individual or $218,000 as a couple filing jointly, Social Security adds an Income-Related Monthly Adjustment Amount (IRMAA) to your Part B premium. The surcharge is based on your tax return from two years earlier, so 2026 premiums use your 2024 return.9Social Security Administration. Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event Form SSA-44 IRMAA surcharges in 2026 range from $81.20 to $487.00 per month on top of the $202.90 standard premium, putting the top bracket at $689.90.1Centers for Medicare & Medicaid Services. 2026 Medicare Parts A and B Premiums and Deductibles
If your income has dropped since the tax year Social Security used, you can ask for a new determination. You qualify to do this after a “life-changing event”:10Social Security Administration. Request to Lower an Income-Related Monthly Adjustment Amount
- Marriage, divorce, or death of a spouse
- Stopping work or reducing hours
- Loss of income-producing property through disaster, arson, fraud, or theft (not a voluntary sale)
- Loss of pension income due to plan termination or reorganization
- Employer settlement payment from a bankrupt or reorganizing employer
File Form SSA-44 through your Social Security account online, by fax, or by mail, or call Social Security at 800-772-1213. If the change stems from an amended tax return rather than a life-changing event, call Social Security instead of filing the form.10Social Security Administration. Request to Lower an Income-Related Monthly Adjustment Amount
Medicare Advantage Give-Back Benefit
Some Medicare Advantage plans offer a Part B “give-back,” using part of their CMS rebate payments to cover a portion of your Part B premium. The result is a smaller premium deduction from your Social Security check each month. In 2026, roughly a third of individual Medicare Advantage plans available for general enrollment include some level of Part B reduction, and more than a third of those offer reductions of $100 or more per month.
Availability and amounts vary by area, so check what’s offered where you live during open enrollment. If you’re already enrolled in an MSP, the give-back payment goes to your state Medicaid agency (which is paying your premium) rather than to you. The give-back is worth a look if your income puts you above MSP thresholds but you’d still like a lower premium.
If Your Income Is Too High for an MSP
Even without an MSP, you may still qualify for Extra Help with Part D drug costs on your own. The 2026 resource limits for full Extra Help are $16,590 for an individual and $33,100 for a couple. If you’ve set aside money for burial expenses and notify Social Security, those rise to $18,090 and $36,100.11Centers for Medicare & Medicaid Services. Calendar Year 2026 Resource and Cost-Sharing Limits for Low-Income Subsidy The 2026 income limits weren’t yet published at this writing, since they follow the final Federal Poverty Level figures. Apply through Social Security’s website or your state Medicaid agency. Extra Help lowers drug costs, not the Part B premium, but it’s often the next-best option when MSP eligibility is out of reach.