Which specific Medicare Savings Programs exist in each state and how do their income limits compare?
Executive summary
The Medicare Savings Programs (MSPs) are four state-administered Medicaid “buy‑in” programs—Qualified Medicare Beneficiary (QMB), Specified Low‑Income Medicare Beneficiary (SLMB), Qualifying Individual (QI), and Qualified Disabled and Working Individuals (QDWI)—that help low‑income Medicare beneficiaries by paying Part A and/or Part B premiums and, in QMB’s case, some cost‑sharing [1] [2]. Federal law sets baseline income and asset rules but states can expand those limits, and several states have removed asset tests entirely—so exact eligibility and dollar thresholds vary by state [3] [4].
1. The four programs and how they differ on paper
QMB pays Part A and B premiums and most Medicare cost‑sharing; SLMB and QI cover the Part B premium only; QDWI covers Part A premiums for certain disabled workers returning to work—these are the federal program designs that every state implements through its Medicaid agency [1] [2] [5].
2. Federal baselines that shape every state’s rules
Federal guidance ties MSP income limits to the Federal Poverty Level (FPL) and sets baseline asset limits (for example, Medicare Rights and the Center for Medicare Advocacy cite ~100% FPL for QMB and resource limits like $9,660/$14,470 in recent years), but those figures are updated annually and states may adopt higher or no asset limits [5] [6] [2].
3. The common income bands used nationwide
Most states follow the familiar banding: QMB eligibility is roughly at or below 100% FPL, SLMB covers approximately 100–120% FPL, and QI serves people roughly between 120–135% FPL; QDWI has a separate, higher threshold for disabled workers [2] [6]. These percentages explain why advocates call MSP eligibility “extremely low” and why many eligible people remain unenrolled [6].
4. How states actually change the math
States may raise income limits above federal minima, change which income types count, and eliminate asset tests; for example, Medicaid Rights and Medicare Interactive document that Alabama, Arizona, Connecticut, Delaware, Louisiana, Massachusetts, Mississippi, New Mexico, New York, Oregon, Vermont, and the District of Columbia do not apply MSP asset limits as of the latest updates [4] [7]. Colorado publishes its own resource thresholds—$11,160 for individuals and $17,470 for couples for QMB/SLMB/QI‑1—demonstrating state‑level variation in dollar amounts [8].
5. Concrete state examples show variation in practice
New York posts specific monthly QMB and QI income figures for 2025—QMB at $1,820 single/$2,453 couple and QI at $2,446 single/$3,229 couple—illustrating that published state numbers can differ from federal baselines and change year to year [9]. National nonprofits publish comparable charts to translate FPL tiers into monthly dollar limits for most states, but those charts are updated regularly and reflect state discretion [2] [7].
6. What this means for comparisons and beneficiaries
In short, program types are consistent in every state (QMB, SLMB, QI, QDWI) but income and asset thresholds are not: most states use the FPL bands above, some increase income or drop asset tests, Alaska and Hawaii have slightly higher limits, and several states publish their own dollar limits that depart from the federal baseline [10] [2] [4]. Enrollment in any MSP typically triggers automatic qualification for Part D “Extra Help,” magnifying the dollar value of state decisions [2] [6].
7. Reporting limits and next steps to verify state specifics
This review relies on federal guidance and state examples compiled by Medicare.gov, nonprofit trackers, and state Medicaid pages; it cannot list every state’s current dollar ceilings because those numbers are updated annually and vary by program and state [10] [7] [4]. For a definitive, up‑to‑date state comparison, consult each state Medicaid office or SHIP counselor and the regularly updated tables from Medicare Interactive, the National Council on Aging, or state agency pages [7] [1] [4].