Qualified Individuals (QI) program

What is the Qualified Individuals (QI) program?

The Qualified Individuals (QI) program is a Medicare Savings Program (MSP) that pays for an enrollee’s Medicare Part B premiums. MSPs are federal programs that are administered by Medicaid in each state.

Who is eligible for the Medicare Qualified Individuals program?

To be eligible for the Medicare QI program, an applicant must have limited income and assets/resources. The specifics vary in some states, but in most states, the income limit in 2025 is $1,781 for a single person and $2,400 for a married couple. And in most states, the asset/resource limit is $9,660 for a single person and $14,470 for a married couple (limits are adjusted annually).¹

QI enrollees must reapply each year to maintain their enrollment in the program, and eligibility is determined on a first-come, first-serve basis.

How much is the Medicare Qualified Individuals program benefit?

As of 2025, most Medicare beneficiaries pay $185/month for Part B.² QI enrollees no longer have this amount deducted from their Social Security benefit – essentially amounting to an annual increase of $2,220 in Social Security benefits in 2025.

Enrollees who have been approved for QI will receive up to three months of retroactive coverage, although retroactive coverage is limited to the current calendar year.³

It can take two to three months from when a QI-eligible individual is approved for the MSP for Part B premiums to no longer be deducted from their Social Security income. Enrollees will receive a one-time deposit for the premiums that were withheld after they were approved for the MSP, along with a payment for any retroactive benefits.

Does the Qualified Individuals program provide any benefits other than the Part B premium payment?

QI enrollees automatically receive Extra Help – a federal program that lowers prescription drug costs under Part D.¹

Unlike the Qualified Medicare Beneficiary (QMB) program, which is a different Medicare Savings Program, QI does not pay for Parts A and B cost sharing (e.g. deductibles, co-pays and coinsurance) or for Part A premiums (if an enrollee owes them).