The short version
If you have Medicare and limited income, four programs can lower your costs. Two of them, QMB and QI, are the New York Medicare Savings Programs (MSP), run by Medicaid, and they pay the Part B premium (in 2026, $202.9 a month). Extra Help is the federal program that pays most Medicare drug plan costs, and in New York it comes automatically with an approved MSP. EPIC is a New York State program for people 65 and older that lowers pharmacy copays at much higher income levels than the others.
Having Medicare and Medicaid at the same time is called being dual eligible. Full-benefit duals have full Medicaid on top of Medicare. Partial-benefit duals have an MSP without full Medicaid. Both count as dual eligible, and both are the people this site is written for.
Side by side
| Program | What it pays | 2026 New York income figure | Who decides |
|---|---|---|---|
| QMB (Qualified Medicare Beneficiary) | Part B premium, Part A premium if you pay one, Medicare deductibles and coinsurance. Providers who accept Medicare cannot bill you for those amounts. Automatic Extra Help. | At or below 138% FPL: $1,836 single / $2,489 couple per month. No resource test. | HRA in NYC; county DSS elsewhere |
| QI (Qualifying Individual) | Part B premium only. Automatic Extra Help. Cannot be combined with Medicaid; requires Part A. | Above 138% up to 186% FPL: $2,474 single / $3,355 couple per month. No resource test. | HRA in NYC; county DSS elsewhere |
| Extra Help (Part D Low-Income Subsidy) | $0 drug plan premium and deductible for a benchmark plan; copays capped at $5.10 generic / $12.65 brand in 2026. | Automatic with an MSP or Medicaid. Applying directly: $23,940 single / $32,460 couple per year, with resource limits of $18,090 / $36,100 (medicare.gov). | Social Security (direct applications) |
| EPIC (Elderly Pharmaceutical Insurance Coverage) | Lowers Part D copays and can help with the Part D premium, for New Yorkers 65 and older who have or are eligible for Part D and do not receive full Medicaid. | Annual income below $75,000 single / $100,000 married (health.ny.gov). No resource test. | NYS EPIC program |
Figures: New York State Department of Health Medicare Savings Program 2026 page and GIS 26 MA/05 Attachment 1; medicare.gov (Extra Help and Part B); health.ny.gov EPIC eligibility page. All checked September 10, 2026. This table is not a recommendation and does not say which program you can join.
The $20 disregard
New York subtracts $20 from an applicant’s gross monthly income before comparing it to the MSP limit. The state page shows a second column with the disregard already applied: $1,856 / $2,509 for QMB and $2,494 / $3,375 for QI. If your Social Security statement is a few dollars over the first column, ask HIICAP or HRA to run the arithmetic before assuming you are over.
Why there is no resource test
The state’s MSP overview says it in one sentence: “There is no resource test for the MSP programs.” Savings, a retirement account, or co-op shares do not count against a QMB or QI application in New York. This is different from full Medicaid, which does have a resource limit, and different from many other states. It is also the single most common reason people who would be approved never apply.
Why New York lists only two MSP levels
Federal Medicare booklets describe a third tier, SLMB, between QMB and QI. New York’s QMB band runs all the way to 138% of the federal poverty level, which already covers the range where SLMB would sit, so the state page lists just QMB and QI. Someone whose income would put them in SLMB elsewhere is, in New York, in the QMB range with the fuller benefit. There is also a fourth program, QDWI, for people under 65 who returned to work and lost premium-free Part A; it is the one MSP with a resource limit ($4,000 / $6,000 in 2026). Our glossary of QMB, SLMB, QI, and QDWI defines each term, with the other words that appear on the same letters.
How the programs interact
- MSP brings Extra Help. An approved QMB or QI enrollment is reported to Medicare, and Extra Help follows without a separate application.
- An Extra Help application starts an MSP application. When you apply for Extra Help through Social Security, federal law requires the data to be sent to the state to begin an MSP application unless you opt out.
- Full Medicaid usually includes QMB. If you have full Medicaid and Medicare, ask whether QMB is on your case and whether the Part B premium is being paid for you.
- EPIC is for people not on full Medicaid. If Extra Help already covers your drug costs, EPIC may add little; if you are 65 or older and above the Extra Help figures, EPIC may be the program that helps.
What this site does not do
We do not rate, rank, or push a specific insurer or plan. We do not apply for anything on your behalf. We do not replace notices from HRA, your county, Social Security, EPIC, or Medicare.
Free help
Call HIICAP at 1-800-701-0501 for unbiased counseling on all four programs. In New York City, the HRA Medicaid Helpline is 1-888-692-6116; Social Security is 1-800-772-1213; the EPIC Helpline is 1-800-332-3742 (TTY 1-800-290-9138).
Questions about your own income or situation?
HIICAP, New York’s free Medicare counseling program. Free, unbiased, and they do not sell plans. Mon–Fri, 8:30 a.m.–5:00 p.m.
Sources
New York State Department of Health, Medicare Savings Program 2026 and MSP overview; GIS 26 MA/05 Attachment 1 (income and resource standards effective January 1, 2026); Medicare.gov, Medicare Savings Programs, help with drug costs, and Medicare costs; NYS DOH EPIC eligibility. Confirm on health.ny.gov and Medicare.gov.
County, household size, and approximate monthly income. You get an educational estimate of which program band to ask HIICAP or HRA about. It never decides eligibility and never applies for anything.