New York Medicare Savings Programs: QMB, QI, Extra Help, and EPIC

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.

New York Medicare Savings Program 2026 income limits, side by side

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.

Immigration status from October 1, 2026

Starting October 1, 2026, income is not the only limit. NYS Department of Health, GIS 26 MA/14 limits the Medicare Savings Program, including QMB and QI, 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.

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).

What to do next

1. Compare your monthly income with the 2026 figures above, remembering the $20 disregard. Our QMB vs QI post walks through the arithmetic.
2. Read how to apply for the DOH-4328 form, the documents, and where it goes in New York City versus the rest of the state.
3. Call HIICAP at 1-800-701-0501 to check the numbers for free, or try the MSP screener for an educational estimate of which band to ask about.