Medicare Savings Programs in New York: 2026 income limits and how to apply

Who qualifies

You must have Medicare and live in New York. Since January 1, 2023, New York has two programs instead of three (the Medicaid Update of January 2023 raised the QMB limit). The QMB limit now also covers people who would have been in the federal SLMB group.

For comparison, the federal QMB limit is $1,350 a month for one person, so many more people qualify in New York.

What counts and what does not

• No asset test. New York state law removed the asset test for QMB and SLIMB in April 2008 (QI in 2002). The application does not ask about savings, bank accounts, a home or a car.
• Income counts, such as Social Security, pensions, wages and other regular income. If you are married and live together, both incomes count.
• The first $20 a month is not counted. It is taken off your gross income before it is compared to the limit. So a single person with gross income $20 above the QMB limit can still qualify.
• If you are a little over the limit, apply anyway and let your local office check.

What each program pays

• QMB pays your Part A premium (if you have one) and your Part B premium ($202.90 a month in 2026), plus Part A and Part B deductibles and coinsurance.
• QI pays your Part B premium. You must have Part A. You cannot get QI and Medicaid at the same time.

If you get QMB or QI, you also get Extra Help with Part D drug costs.

Can I have Medicaid too?

Yes, for QMB. You can have QMB only, or QMB and Medicaid together. QI is only for people who do not have Medicaid. For full Medicaid, people with Medicare have a resource limit of $33,038 for one person or $44,796 for a couple, but the Medicare Savings Programs do not.

How to apply

1. Get the form. Use the Medicare Savings Program application, DOH-4328. You can download it from health.ny.gov or get it at your local office.
2. Fill it in. It is short. It asks about your Medicare, your household and your income. It does not ask about savings.
3. Follow the form instructions (DOH-4328 Instructions) on what proof to attach, such as a copy of your Medicare card or income letters.
4. Send it:
   • Outside New York City: mail it to the Department of Social Services in the county where you live. The list of county offices is at health.ny.gov.
   • In New York City: apply through the Human Resources Administration (HRA). HRA Medicaid Helpline: 1-888-692-6116.
   • Online: through NY State of Health (nystateofhealth.ny.gov, 855-355-5777).
5. Questions: call the New York Medicaid Helpline at 1-800-541-2831 or email [email protected].

After you apply

• Renewals: your local office will contact you when it is time to renew. Answer any renewal letter by its deadline so your coverage does not stop.
• Report changes to your local office, such as a move or a change in income.
• Appeals: if you are denied, your notice explains how to ask for a fair hearing and the deadline. Ask quickly so you do not miss it.

Things people often miss

• People with savings often skip applying. In New York, savings do not count.
• People with incomes well above the federal limits can still qualify for QI.
• Getting QMB or QI is the easiest way to get Extra Help, which also lowers drug copays.
• New York has a separate drug program for people 65 and over, EPIC. You can have EPIC and a Medicare Savings Program. EPIC Helpline: 1-800-332-3742.

Free help

• HIICAP (Health Insurance Information, Counseling and Assistance Program): free, unbiased Medicare counseling. Call 1-800-701-0501.
• New York Medicaid Helpline: 1-800-541-2831.

See also Medicare Part B and all benefits in New York.

Phone numbers: Free help lines for New York agencies

Check what you may qualify for