QMB vs QI in New York: what each pays (2026 limits)

Start with the cost the MSP is built around. In 2026 the standard Medicare Part B premium is $202.90 per month, according to medicare.gov. For most people that amount is taken out of the Social Security check before it arrives. An MSP pays that premium on your behalf, which means the deduction stops and the check goes up.

The two levels differ in how much further they go.

Qualified Medicare Beneficiary (QMB) pays the Part B premium and, for people who do not get Part A free, the Part A premium. It also pays Medicare deductibles and coinsurance. Medicare.gov adds that providers who accept Medicare cannot bill a QMB enrollee for those amounts. New York's page notes that a person can be QMB only or QMB plus Medicaid.

Qualifying Individual (QI) pays the Part B premium only. New York's page is clear on two restrictions: a person cannot have QI and Medicaid at the same time, and the applicant must have Medicare Part A. QI is funded by a yearly federal allotment to each state, one reason applications should not sit in a drawer.

Both levels come with a bonus. New York's MSP page says that when you enroll in an MSP you will also automatically get Extra Help, the federal program that pays most Medicare drug plan costs. That is often worth as much as the premium savings, and it is covered in our post on Extra Help and MSP.

New York sets its MSP limits as a percentage of the federal poverty level. Here is what the state's Medicare Savings Program 2026 page shows, with the general income standards chart (GIS 26 MA/05, Attachment 1, effective January 1, 2026) confirming the same numbers.

Two footnotes to that table matter in practice.

First, the $20 disregard. The state page explains that Medicaid subtracts $20 from an applicant's gross monthly income before comparing it to the limit, and shows a second column with the disregard already applied: $1,856 and $2,509 for QMB, $2,494 and $3,375 for QI. If your Social Security statement is a few dollars over the first column, the $20 disregard may be the difference; ask HIICAP or HRA to run the arithmetic.

Second, there is no resource test. The state's MSP overview says so in exactly those words: "There is no resource test for the MSP programs." Savings, a retirement account, or a second bank account do not count against an MSP application in New York. This is different from full Medicaid, which does have a resource limit, and different from many other states.

Starting October 1, 2026, income is not the only limit on the Medicare Savings Program, including QMB and QI. NYS Department of Health, GIS 26 MA/14 limits it to U.S. citizens and nationals; green-card holders (lawful permanent residents) who have finished or are exempt from the 5-year wait; Cuban-Haitian entrants; and Compact of Free Association (COFA) migrants. Other lawfully present immigrants, including refugees, asylees, parolees, and people with temporary protected status, are not eligible for the Medicare Savings Program, and New York does not fund a state-only backup for it. Income and resource dollar limits are unchanged. Medicare itself is a separate federal question. The same notice says affected non-citizens who already have Medicare may keep it until federal changes take effect January 4, 2027, and a CMS rule that is still proposed, not final, would end that Medicare on February 1, 2027, after notices from Social Security. For a specific case, call HIICAP at 1-800-701-0501 or a legal aid office.

If you have read a federal Medicare booklet, you may have seen a third tier called Specified Low-Income Medicare Beneficiary (SLMB), which sits between QMB and QI. The federal 2026 QMB limit on medicare.gov is $1,350 a month for a single person, and SLMB runs up to $1,616. New York's QMB band goes all the way to $1,836. Because the state's QMB tier already covers the range where SLMB would sit, the New York page lists just two benefit levels, QMB and QI. Someone whose income would put them in SLMB elsewhere is, in New York, in the QMB range with the fuller benefit. Our glossary of QMB, SLMB, QI, and QDWI defines each term and the other words that show up on the same letters.

There is also a Qualified Disabled and Working Individual (QDWI) program. It pays the Part A premium only, for people under 65 who had Medicare because of a disability, went back to work, and lost premium-free Part A. On New York's 2026 chart, QDWI is set at 200 percent of the federal poverty level, $2,660 a month for a single person and $3,607 for a couple, and unlike QMB and QI it carries a resource limit of $4,000 and $6,000. It is the one MSP where resources matter.

Inside the five boroughs, Medicaid and the MSP are administered by the NYC Human Resources Administration (HRA), not by a county Department of Social Services. HRA's Health Assistance page says it accepts applications from residents who are 65 or over, people of any age living with a disability or blindness, and people who receive Medicare and are not a parent or caretaker of minor children. That covers essentially everyone applying for an MSP.

Three ways in:

1. Phone. The HRA Medicaid Helpline is 1-888-692-6116. Ask for the Medicare Savings Program and how to submit the application.
2. Online. HRA's page says you can apply through ACCESS HRA, the city's online benefits portal.
3. Mail or in person. The state's MSP application is form DOH-4328, available on health.ny.gov in English and 16 other languages. The state page says paper applications must be mailed to the local district where you live; in New York City that district is HRA. HRA's Medicaid office locations are listed on nyc.gov/hra, and they move, so check the site rather than an old flyer.

HRA's page says applicants must provide proof of residency, identity, income, and immigration status, and that proof of Medicare is also now required. Do not send original documents. Our borough pages under /locations have a checklist for what HRA typically asks for.

In the other 57 counties, the MSP application goes to the county Department of Social Services (DSS), using the same DOH-4328 form mailed to the local DSS where you live. County DSS numbers are on each county's official website. Wherever you live, HIICAP at 1-800-701-0501 can help you fill out the form.

Once an MSP is approved, the state notifies Medicare, and the Part B premium stops being deducted from your Social Security payment. That change often takes a month or two to show up, and it often comes with a lump-sum refund of premiums that were deducted for months the MSP already covered. The timing varies, so if your check has not changed after a couple of months, call HRA or your county DSS to confirm the approval went through, and ask a HIICAP counselor what to expect for your case.

The Extra Help piece is automatic: your drug plan is told you have it and pharmacy copays drop. Do you have to apply every year? You renew (recertify) instead of filing a new application. The state's DOH-4328 instructions say you will need to renew (recertify) your MSP every year, and to call HRA or your local Medicaid office if no renewal notice arrives. For QI, medicare.gov adds that states approve applications first-come, first-served, with priority for people who had QI the year before. Watch for the renewal notice and return it on time. Our decoder for Medicaid renewal and Extra Help letters explains which office sends the renewal and what the fall notices mean.