What MSPs are
Medicare Savings Programs are a type of Apple Health (Medicaid) benefit that pays Medicare premiums and, for the most generous program, Medicare cost sharing. In Washington the Health Care Authority (HCA) sets the rules, and you can have a Medicare Savings Program with Original Medicare or with a Medicare Advantage plan. Washington offers four programs:
| Program | Income limit (share of the federal poverty level) | What it pays |
|---|---|---|
| QMB | Up to 110% | Part A premium (if you owe one), Part B premium, and Medicare deductibles, coinsurance and copays (not prescriptions) |
| SLMB | Above 110%, up to 120% | Part B premium |
| QI-1 | Above 120%, up to 138% | Part B premium |
| QDWI | Above 138%, up to 200% | Part A premium, for working people with disabilities |
QMB — Qualified Medicare Beneficiary
The most generous program. QMB pays:
- Your Part A premium (if you have one)
- Your Part B premium ($202.90 a month in 2026)
- Part A and Part B deductibles, including the Part B deductible ($283 in 2026) and the Part A hospital deductible ($1,736 per benefit period in 2026)
- Coinsurance and copays for Medicare-covered services, other than prescription copays
Providers who accept Medicare may not bill a QMB for Medicare deductibles, coinsurance or copays. If you get a bill like that, show the provider your Medicare and Apple Health cards, and call 1-800-MEDICARE if it continues.
SLMB — Specified Low-Income Medicare Beneficiary
SLMB pays your Part B premium ($202.90 a month in 2026). It does not pay deductibles or cost sharing; those remain your responsibility.
QI-1 — Qualifying Individual
QI-1 also pays your Part B premium, with a higher income limit than SLMB. Medicare.gov notes that QI applications are approved first-come, first-served, with priority for people who had QI the year before, and that you must reapply each year. You can't get QI-1 while you get other Apple Health (Medicaid) coverage.
QDWI — Qualified Disabled Working Individual
QDWI pays the Part A premium for people under 65 who have a disability, are working, and lost Part A with no premium because they went back to work. It has special earned-income deductions, so HCA asks you to call for help with this one.
Washington's income limits
HCA compares your countable monthly household income to a share of the federal poverty level (FPL): 110% for QMB, 120% for SLMB, 138% for QI-1 and 200% for QDWI. Washington's own rule, WAC 182-517-0100, sets these percentages. Washington raised the QMB limit from 100% and the QI-1 limit from 135% under a directive in the state's 2023–2025 operating budget, so its limits are higher than the national limits that Medicare.gov lists.
HCA updates the dollar amounts each year when the federal poverty guidelines change and prints them, for one person and for a couple, in its Medicare Savings Programs flyer (the current chart took effect April 1, 2026). HCA's worksheet has you subtract a small standard deduction from your gross monthly income first, one per household, before you compare.
No asset test. Washington stopped counting resources for Medicare Savings Programs on January 1, 2023. HCA says you won't be asked to verify bank balances or other resources, and WAC 182-517-0100 says the federal MSPs do not require a resource test. Only your income counts. HCA also says there is no estate recovery for Medicare Savings Programs.
What counts as income
- Social Security retirement, SSDI and SSI
- Pensions and annuities
- Wages from employment (some deductions apply)
- Investment income
If you are married and live with your spouse, HCA uses the couple's income and the couple limit. If you are close to a limit, apply anyway and let HCA do the math.
Automatic Extra Help when you have an MSP
Qualifying for QMB, SLMB or QI-1 automatically qualifies you for Extra Help with Part D, which lowers drug plan premiums, deductibles and copays. In 2026, people with Extra Help pay no more than $5.10 for each generic drug and $12.65 for each brand-name drug. Because Washington's MSPs have no asset test, someone whose savings are above Extra Help's own resource limit may still get Extra Help this way. More on Extra Help.
How to apply
- Online: Washington Connection (washingtonconnection.org).
- In person: a DSHS Community Services Office. Find the nearest one at dshs.wa.gov/office-locations.
- By mail: HCA's Application for Medicare Savings Program. You can also call the Health Care Authority at 1-800-562-3022, extension 16129, to have one mailed to you.
- With long-term care: if you also need long-term services and supports, DSHS Home and Community Services handles combined applications.
Have your Medicare card, Social Security number and proof of income (such as your Social Security benefit letter and pension statements) ready. Once a program starts paying your Part B premium, it stops coming out of your Social Security check, which can take a few months to show up. Open and answer any renewal mail from Apple Health promptly.
Why these programs are underused
Common reasons people who qualify never apply:
- They don't know the programs exist
- They assume their savings are too high, not knowing Washington has no asset test
- They didn't qualify years ago and haven't checked since Washington raised its limits
- They confuse MSPs with full Apple Health coverage
The Part B premium alone comes to $2,434.80 a year in 2026, so a program that pays it makes a real difference.
If you previously didn't qualify
Income limits rise each year with the federal poverty level, Washington raised its QMB and QI-1 percentages, and it dropped the asset test in 2023. If you checked before and didn't qualify, check again.
A Medicare Savings Program doesn't change your Medicare coverage by itself, but it can open other choices, such as dual special needs plans (D-SNPs) for people with both Medicare and Apple Health, where they are available. See Apple Health and Medicare and D-SNPs in Washington. A licensed insurance agent with Benefits Life can explain the plans from the companies they work with that fit your situation, at no cost to you. Call (206) SENIORS (206-736-4677), TTY 711, or see plans in your ZIP code.
Sources
- Washington Health Care Authority — Medicare Savings Program
- Washington Health Care Authority — Medicare Savings Programs flyer, HCA 22-500 (income standards effective April 1, 2026)
- WAC 182-517-0100 — Medicare savings programs (amended by WSR 26-01-043, effective January 19, 2026)
- WSR 24-02-013 — HCA rule raising the QMB and QI-1 income limits (2023–2025 operating budget directive)
- WSR 22-21-048 — HCA public notice, State Plan Amendment 22-0034 (MSP resource verification ended January 1, 2023)
- Medicare.gov — Medicare Savings Programs
- Medicare.gov — Help with drug costs (Extra Help)
- CMS — CY 2026 Resource and Cost-Sharing Limits for Low-Income Subsidy
- CMS — 2026 Medicare Parts A & B premiums and deductibles
Frequently asked questions
What are Medicare Savings Programs?
They are Apple Health (Medicaid) programs, run in Washington by the Health Care Authority, that pay Medicare premiums and, for QMB, Medicare deductibles and coinsurance. Washington offers four: QMB, SLMB, QI-1 and QDWI.
What does QMB cover?
QMB pays your Part A premium if you owe one, your Part B premium, and Medicare deductibles, coinsurance and copays (not prescription copays). Providers who accept Medicare may not bill a QMB for Medicare cost sharing.
Do I qualify for a Medicare Savings Program in Washington?
Washington compares your countable monthly income to the federal poverty level: up to 110% for QMB, up to 120% for SLMB and up to 138% for QI-1. These limits are higher than the national limits shown on Medicare.gov. Washington does not count savings or other assets, so only income matters. HCA's flyer lists the current dollar amounts.
Does qualifying for an MSP help with Part D costs?
Yes. Anyone approved for QMB, SLMB or QI-1 gets Extra Help with Part D automatically, which lowers drug plan premiums, deductibles and copays. Because Washington has no asset test for MSPs, this can be a path to Extra Help for people whose savings are above Extra Help's own resource limit.
How do I apply?
Apply online at Washington Connection (washingtonconnection.org), at a DSHS Community Services Office, or by mailing HCA's paper Medicare Savings Program application. You can call the Health Care Authority at 1-800-562-3022, extension 16129, to have an application mailed to you.
Medicare in your Washington county
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