Medicare Savings Programs in New York: Who Pays Your Part B Premium

What each tier actually pays

The gap between the two rows is large. QMB does not merely reduce your premium: it means Medicare providers may not bill you for the deductible or the coinsurance on covered services. For someone with regular specialist care, that is worth considerably more than the premium itself.

QI pays the Part B premium, which is deducted from a Social Security payment for most people. Getting it back is a monthly increase in the amount that actually arrives.

Why New Yorkers get told the wrong answer

Three reasons, and all three are common.

The state expanded the program in 2023, raising the income limits well above the federal floor and consolidating SLMB into the structure. Anyone who checked before that, or who was screened by someone using national figures, got a stale answer.

New York does not count assets for these programs. Nationally, most Medicare Savings Programs apply a resource test, so guidance written for a national audience tells New Yorkers that savings will disqualify them. It will not.

Nobody sends a letter. There is no automatic enrolment for most people. The benefit exists and waits to be claimed.

If someone told you at any point that you earn too much or have too much saved, that is a reason to check again rather than a settled answer.

The 2026 limits, as the state publishes them

The programs work on monthly income, for a household of one or two. These are the figures the state Department of Health publishes for 2026:

Before income is compared with those lines, the first $20 of monthly income is disregarded, which is why the state’s own table also shows $1,856 and $2,509 for QMB and $2,494 and $3,375 for QI. If your gross income sits within $20 of a line, apply anyway.

The lines move after the federal poverty guidelines update each year, and the state republishes them; the percentages stay put. For orientation by household size:

Each additional person adds $5,680 to 100% FPL. Annual figures, before taxes.

Treat that as an orientation, not a decision. The application does the real arithmetic, and it is free to submit.

How to apply

Where: the local department of social services, which in New York City is the Human Resources Administration. Not NY State of Health. This is the same split that governs all Medicaid applications for people 65 and older. Which door.

What to bring: proof of identity, proof of New York residence, your Medicare card, and proof of income. Because New York applies no asset test to QMB and QI, you should not be required to document savings for these programs; if you are asked, ask which program the request relates to.

Free help: HIICAP, New York’s Medicare counseling program, at 1-800-701-0501, and legal services organizations handle these applications regularly and know the current thresholds. A hospital social worker is also a fast route if the question comes up during a stay.

What it does not do

It is not Medicaid. Qualifying for QMB or QI does not by itself give you full Medicaid coverage with its broader benefits, including long-term care. Some people qualify for both, which is a different status. What being dual eligible means.

It does not change your plan. You keep the Medicare arrangement you have, whether Original Medicare or a Medicare Advantage plan. What changes is who pays the premium and, in QMB, the cost sharing.

And it does not backdate indefinitely. Apply when you think you might qualify rather than after confirming it, because the application is free and the delay is not.