QI Program Income Limits 2026: What You Need to Know
October 26, 2026
QI Program Income Limits for 2026
The Qualifying Individual (QI) program is one of four Medicare Savings Programs that help people with limited income pay their Medicare Part B premium. For 2026, QI eligibility still runs on the same federal formula the Centers for Medicare & Medicaid Services (CMS) has used for years: your countable monthly income must fall at or above 120% of the federal poverty level (FPL) but below 135% of the FPL, plus a standard $20 income disregard that most states apply automatically.
The exact dollar thresholds change every year because the federal poverty guidelines are updated annually by the U.S. Department of Health and Human Services (HHS), typically in January. States then roll the new QI income limits into their Medicaid systems, usually by April 1 of the same year, which is why the figures published for 2026 reflect that update rather than a single number that applies everywhere.
QI Eligibility by the Numbers
Why Your State's Dollar Figures May Differ
Alaska and Hawaii use higher federal poverty guidelines than the other 48 states, so their QI income limits run higher in dollar terms even though the underlying 120% to 135% FPL band is identical. A few states, including New York and Connecticut, also apply more generous income or resource counting rules under their own Medicaid plans. Because of this, the clearest way to confirm your exact 2026 QI income limit is to check your state Medicaid agency's current chart or the federal Medicare Savings Programs page, since no single nationwide dollar figure applies to every applicant.
QI also has a resource, or asset, limit that's separate from income, and CMS and the Social Security Administration (SSA) update it each January. Checking accounts, savings, and most investments count toward this limit, while your home, one vehicle, and personal belongings generally don't. If your income lands just above the QMB program income limits for 2026 or the SLMB limit, QI is usually the next program worth checking.
QMB vs. SLMB vs. QI
| Feature | Income Band (% of FPL) | RecommendedWhat It Pays |
|---|---|---|
| QMB (Qualified Medicare Beneficiary) | 100% or below | Part A and Part B premiums, deductibles, coinsurance, and copays |
| SLMB (Specified Low-Income Medicare Beneficiary) | 100% up to 120% | Part B premium only |
| QI (Qualifying Individual) | 120% up to 135% | Part B premium only |
What the QI Program Pays For
QI only reimburses your Part B premium; it doesn't cover Part A premiums, deductibles, coinsurance, or copays the way the QMB program does. If you're approved, your state deducts the premium amount directly from what would otherwise come out of your Social Security check, so the savings show up automatically each month without you having to file for reimbursement.
Approval for QI also qualifies you automatically for Medicare Extra Help, the federal subsidy that lowers Part D prescription drug premiums, deductibles, and copays, with no separate application needed. If you're enrolled in a Medicare Advantage plan instead of Original Medicare, it's also worth comparing QI against your plan's Medicare giveback benefit, since giveback plans lower your Part B premium a different way and the two forms of help aren't always compatible. Pairing Extra Help with the other steps in our guide on how to reduce Medicare Part D costs in 2026 can stretch your savings further.
Key Takeaway
QI pays only your Part B premium, but approval also triggers automatic Extra Help enrollment for Part D costs, so one application can lower two separate bills.
QI Funding Is Capped Each Year
Unlike QMB and SLMB, QI operates on a limited federal budget set by Congress each year. According to Medicaid.gov, approval is handled on a first-come, first-served basis, current QI recipients get priority for renewal, and everyone enrolled in QI must reapply annually, so don't assume last year's approval carries over automatically in 2026.
Does the QI Program Fit Your Situation?
- I'm enrolled in Medicare Part B but my income is too high for the SLMB program
- I don't qualify for full Medicaid benefits in my state
- My savings and other countable resources fall under my state's current limit
- I'd like help paying my monthly Part B premium specifically, not my deductibles or copays
- I'm willing to reapply for this program every year to keep my benefit
How to Apply for QI in 2026
You apply for QI through your state Medicaid agency, not through Medicare or Social Security directly. Most states let you start the application online, by phone, or in person, and you'll typically need recent pay stubs or award letters, bank statements, and proof of any other income. Processing times vary by state, so apply as early in the year as you can given QI's limited annual funding.
If your income or resources are too high for QI, it's worth checking whether you still qualify for savings through a dual-eligible special needs plan or by reviewing your overall Medicare out-of-pocket costs to find other ways to reduce what you pay. Confirming your Medicare eligibility details before you apply can also help your state agency process your QI application faster.
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Frequently Asked Questions
SLMB covers income from 100% up to 120% of the federal poverty level (FPL), while QI covers income from 120% up to 135% of the FPL. Both programs pay only the Part B premium, but QI allows a somewhat higher income.
Yes. Because QI funding is capped annually by Congress, you must reapply each year to keep receiving the benefit, even if nothing about your income or resources has changed.
No. QI only reimburses the Part B premium. If you need help with Part A premiums, deductibles, and coinsurance, check whether you qualify for the QMB program instead.
QI is designed for people who don't qualify for full Medicaid. If you're later approved for full Medicaid benefits, you would generally receive Medicaid's coverage rather than QI, since QI exists specifically for people above the Medicaid income threshold.