(2026-03)Medicaid Eligibility Guide for Medicare Cost-Sharing Coverage (revised 3/1/2026)#
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Medicare Cost Sharing – Revised 3/1/2026 Medicaid Eligibility Guide For Medicare Cost-Sharing Coverage Individuals with Medicare Part A and/or Part B, who have limited income, may get help paying for their out-of-pocket Medicare expenses from the Medicaid Program. The Medicare Cost-Sharing groups include: 1. Qualified Medicare Beneficiaries (QMB); • In the QMB Program, Medicaid will pay your Medicare Part A and Part B premiums, deductibles, and coinsurance. • You must be eligible for Medicare, Part A (Hospital Insurance). • Your total monthly income must be less than $1,380 for an individual or $1,854 for a couple. • It does not matter what your resources are in this group. There is no resource test. Eligibility begins the month after the month you are approved. There is no retroactive QMB coverage. • You will receive a Medicaid card. 2. Specified Low-Income Medicare Beneficiary (SLMB) • You must have Medicare, Part A (Hospital Insurance). • Your total monthly Income must be less than $1,646 for an individual or $2,214 for a couple. • It does not matter what your resources are in this group. There is no resource test. • Eligibility begins with the month a person is qualified, which may be up to three months before the month of application. • In the SLMB Program, Medicaid will pay only your Medicare Part B premium as of the date that the Division of Medicaid starts your eligibility. A SLMB does not qualify for any additional Medicaid benefits. You will not receive a Medicaid card. More Information