QMB, SLMB, QI, QDWI: a New York glossary for Medicare Savings Program letters

The federal limits on medicare.gov are lower for every program except QDWI, and they include a savings test New York does not use. Medicare.gov says it plainly: "You may still qualify for these programs in your state even if your income or resources are higher than the federal limits listed." If you see federal numbers in a Social Security mailing, New York's are the ones that count.

Say it: "Q-M-B."

Plain meaning: the fullest Medicare Savings Program. Medicaid pays your Part B premium ($202.90 a month in 2026), pays your Part A premium if you do not get Part A free, and covers Medicare's deductibles, coinsurance, and copays for Medicare-covered care.

Billing protection: medicare.gov states that Medicare providers "aren't allowed to bill you for services and items Medicare covers, including deductibles, coinsurance, and copayments." New York's page puts it as: Medicaid eligibles who qualify for QMB cannot be charged Medicare copays. If a doctor's office bills you anyway, show your Medicaid card and call HIICAP.

Extra Help: automatic. The state's MSP overview says MSP enrollment also brings the federal Extra Help program for drug costs.

New York limits, 2026: $1,836 a month for a single person and $2,489 for a couple, which is 138 percent of the federal poverty level. The state page also shows a "+$20" column ($1,856 and $2,509), explained below.

What New York does differently: the federal QMB band stops at 100 percent of the poverty level ($1,350 single on medicare.gov), and the federal program has a resource limit of $9,950. New York's band runs to 138 percent and has no resource test at all. That is why SLMB disappeared here.

Start date: the HIICAP training notebook says QMB takes effect the month after the month of application and does not reimburse past premiums.

With or without Medicaid: you can have QMB alone (a "partial-benefit dual") or QMB together with full Medicaid (a "full-benefit dual"). Our post on what dual eligible means explains the difference.

Say it: "slim-bee."

Plain meaning: federally, the middle tier. It pays the Part B premium only, for people with income above the federal QMB line but at or below 120 percent of the poverty level ($1,616 single in 2026 on medicare.gov).

In New York: the state's page lists only two levels, QMB and QI. The New York State Office for the Aging's 2026 counselor training notebook says why: SLMB "is no longer available in New York as it was absorbed into the other programs as part of the 2023 expansion of MSP income limits. SLMB continues as a separate MSP in other states."

What that means for you: if a federal booklet or a relative in another state says you "sound like SLMB," in New York that income sits inside the QMB band. You would apply for the MSP and be considered for QMB, which pays more. You are not missing a program; you are inside a bigger one.

Where you might still see it: Social Security letters, medicare.gov, and out-of-state pharmacy or plan paperwork. Not on New York forms.

Say it: "Q-I." Older New York City forms call it "QI-1." Same program; the "QI-2" tier ended federally years ago.

Plain meaning: Medicaid pays your Part B premium, $202.90 a month in 2026, and nothing else. Extra Help comes with it automatically.

New York limits, 2026: $2,474 a month for a single person and $3,355 for a couple, which is 186 percent of the poverty level, plus the $20 disregard. No resource test.

Rules that trip people: the state page says you cannot have QI and Medicaid at the same time, and you must have Part A to get QI. It also says states are allotted money for QI yearly, and the DOH-4328 instructions say the MSP is renewed every year. Do not sit on a QI renewal.

Back premiums: unlike QMB, QI can reimburse Part B premiums for up to three months before the effective date, within the same calendar year, according to the HIICAP notebook. The DOH-4328 form has a yes-or-no box for this; check yes and include three months of income proof if you want it considered.

What New York does differently: the federal QI limit on medicare.gov is $1,816 single with a $9,950 resource limit. New York's is $2,474 with none.

Say it: "Q-D-W-I."

Plain meaning: a narrow program for people under 65 who had Medicare because of a disability, went back to work, and lost premium-free Part A as a result. Medicaid pays the Part A premium, which in 2026 is $565 a month for people with fewer than 30 quarters of work credit and $311 for 30 to 39 quarters, per the state's 2026 Medicaid levels notice. It does not pay Part B.

New York limits, 2026: $2,660 a month for a single person and $3,607 for a couple (200 percent of the poverty level) on the state's income chart. This is the one MSP in New York with a resource limit: $4,000 for a single person and $6,000 for a couple.

Where it is listed: New York's consumer MSP page does not mention QDWI. It appears on the state's 2026 income and resource chart and in the HIICAP training materials. If you think it fits you, say "QDWI" by name when you call HRA, your county, or HIICAP, and expect a Medicaid application rather than the short MSP form.

Retroactive: the HIICAP notebook says QDWI can start up to three months before the month of application if income and resources were within limits.

MSP (Medicare Savings Program). The umbrella term for QMB, SLMB, QI, and QDWI. New York's DOH-4328 form is titled "Medicare Savings Program Application" and covers QMB and QI.

Extra Help, also called the Low-Income Subsidy or LIS. The federal program, run through Social Security, that pays most Part D drug plan costs. Medicare.gov's 2026 figures: $0 plan premium and deductible in a benchmark plan, copays up to $5.10 for generics and $12.65 for brand-name drugs. People with Medicaid, an MSP, or SSI get it automatically.

Deemed. Medicare's word for getting Extra Help automatically because of Medicaid, an MSP, or SSI, rather than by applying to Social Security. A "deemed status" notice is the purple letter; a "loss of deemed status" notice is the grey one. Our letters decoder explains both.

Full-benefit dual and partial-benefit dual. Full-benefit means Medicare plus full Medicaid. Partial-benefit means Medicare plus an MSP only, with no Medicaid card for doctor visits. QMB-only and QI are partial-benefit.

FPL (federal poverty level). The yearly income line the federal government publishes each winter. Program limits are set as a percentage of it, which is why every limit on this page changes in January. New York's QMB is 138 percent, QI is 186 percent, QDWI is 200 percent.

The $20 disregard. Medicaid ignores the first $20 of monthly income when it compares your income to the limit. That is why the state page shows two columns, such as $1,836 and $1,856 for a single QMB applicant. The higher column is the one your gross income is really measured against.

Resource test, or asset test. A limit on savings, stocks, bonds, and similar assets. The state's MSP overview says, "There is no resource test for the MSP programs." Full Medicaid does have one ($33,038 for a single person and $44,796 for a couple in 2026), and QDWI has its own small one.

Excess income, spend-down, surplus. Three names for the same Medicaid rule: if your income is over the full-Medicaid line, you can still get Medicaid in months when your medical bills bring you down to it. QI cannot be combined with Medicaid, so a person in the QI range who wants Medicaid has to choose between QI and a spend-down. A HIICAP counselor can walk through which is worth more.

LDSS, and HRA. LDSS is a Local Department of Social Services, the county Medicaid office. In New York City the office is the Human Resources Administration (HRA). Paper MSP applications go to the one where you live.

NY State of Health. New York's health insurance marketplace, which since late 2025 also handles applications and renewals for many people with both Medicare and Medicaid and for MSP applicants. Your renewal may come from it instead of HRA or the county.

DOH-4328. The two-page state form for QMB and QI. The documents checklist lists what goes with it.

Notice of Action, or Notice of Decision. The letter that says whether a program was approved, changed, or ended, with the effective date and how to appeal. The DOH-4328 instructions say it arrives within 45 days of filing.

Part A buy-in. A route, described in the HIICAP notebook, for New Yorkers 65 and older who did not sign up for premium Part A on time. It enrolls them in Part A and B so they can apply for QMB, the only MSP level that pays a Part A premium.

Late enrollment penalty. The extra Part B premium charged for signing up late. The HIICAP notebook says MSP enrollment eliminates it, and you do not owe it again if the MSP later ends.

EPIC. New York's state drug program for people 65 and older, separate from all of the above. It stacks on top of Extra Help. See EPIC vs Extra Help.

None of this is a determination. It is a way to say the right word when you call.

• Under 65, on Medicare because of a disability, working, and paying a Part A premium? Ask about QDWI.
• 65 or older, or on Medicare for any reason, with monthly income at or below $1,856 single or $2,509 couple after the disregard? Ask about QMB, and ask whether full Medicaid is also worth applying for.
• Income between the QMB line and $2,494 single or $3,375 couple? Ask about QI, and ask about three months of back premiums.
• Someone told you "SLMB"? In New York, ask about QMB.
• Over all of those lines but drug costs are the problem? Ask about Extra Help through Social Security, and EPIC if you are 65 or older.

HIICAP at 1-800-701-0501 will do this sorting with you for free, using your real numbers.

• Comparing your income to the federal limits on medicare.gov instead of New York's higher ones.
• Skipping the application because you have savings. QMB and QI have no savings test in New York.
• Applying for QI when you also want Medicaid. The two cannot be held together; ask which is worth more.
• Saying "QI-1" on the phone to Social Security and "QI" to HRA and thinking they are different programs. They are not.
• Assuming QDWI does not exist because it is not on the state's consumer page.
• Forgetting that all four limits change every January, and that the MSP is renewed every year.

What does QMB mean on my Medicaid card or letter?

It means the state has approved you for the Qualified Medicare Beneficiary program. Medicaid pays your Part B premium and covers Medicare's deductibles, coinsurance, and copays for Medicare-covered services. Medicare.gov says providers are not allowed to bill QMB enrollees for those amounts. You also get Extra Help for drug costs automatically. You may or may not also have full Medicaid; the letter will say.

Why does Social Security's letter mention SLMB when New York does not have it?

Federal mailings describe all four programs because most states run all four. New York's Office for the Aging counselor notebook says SLMB was absorbed into the other programs when the state expanded MSP income limits in 2023, so New York's QMB band now covers the income range SLMB serves elsewhere. Apply for the MSP; the office decides between QMB and QI.

What is the difference between QI and QI-1?

Nothing. QI-1 is the older name for the Qualifying Individual program that pays the Part B premium; a QI-2 tier existed federally years ago and ended. New York City's forms sometimes still print "QI-1." The state's page uses "QI."

Is QDWI available in New York?

Yes, though the state's consumer MSP page does not list it. The state's 2026 income and resource chart sets QDWI at $2,660 a month for a single person and $3,607 for a couple, with a resource limit of $4,000 and $6,000, and says Medicaid pays the Part A premium for people found eligible. It is for people under 65 who lost premium-free Part A by going back to work.

Which of these programs has a savings limit in New York?

Only QDWI, at $4,000 for a single person and $6,000 for a couple. The state's MSP overview says there is no resource test for QMB or QI. Full Medicaid, which is not an MSP, has a resource limit of $33,038 for a single person and $44,796 for a couple in 2026.

Do these limits change?

Every January, when the federal poverty level is updated. The figures on this page are 2026 figures from the state's income chart, revised February 5, 2026, and from medicare.gov. Check health.ny.gov for the current year before applying.