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How are Medicare benefits changing for 2026?
Changes to 2025 Medicare coverage include a $2,000 cap on Part D out-of-pocket costs, small reductions in the average premium for Medicare Advantage and Part D plans, increases for Medicare Part B and Part A premiums and cost-sharing, and adjustments to income-related premium surcharges for Part B and Part D.
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What is the income-related monthly adjusted amount (IRMAA)?
For 2025, high-income beneficiaries – earning over $106,000 a year – pay an IRMAA surcharge that’s added to their Part B and Part D premiums and determined by income from their income tax returns two years prior.

Qualified Medicare Beneficiary (QMB) program

What is the Qualified Medicare Beneficiary (QMB) program?

medicareresources.org Glossary

What is the Qualified Medicare Beneficiary (QMB) program?

Some Medicare beneficiaries struggle to pay for Medicare premiums and cost sharing even though their incomes are too high to qualify for full Medicaid benefits. A group of Medicaid-administered programs – Medicare Savings Programs (MSPs) – can help to pay Medicare premiums and out-of-pocket costs for eligible enrollees.

There are four types of MSPs, but the Qualified Medicare Beneficiary (QMB) program is the largest, and covers the majority of the people with MSPs.1

The QMB program goes further than the other MSPs in terms of what it covers. In addition to Part B premiums, QMB will also pay an enrollee’s Medicare Part A and B cost sharing (deductibles, co-insurance, and co-pays) and Part A premiums (if an enrollee owes them).2 And all MSP enrollees, including QMB enrollees, receive Extra Help – a federal program that lowers their Medicare Part D drug costs.3

How do I apply for the Qualified Medicare Beneficiary (QMB) program?

All MSPs, including the QMB program, are administered by each state’s Medicaid program. So you’ll need to contact your state’s Medicaid office to see whether you’re eligible and to submit an application.

How many people are enrolled in the Qualified Medicare Beneficiary (QMB) program?

In 2023, more than 8 million Medicare beneficiaries were receiving QMB assistance.4 That accounted for the majority of the 10 million MSP enrollees.5

Footnotes

  1. Medicare Savings Programs” MACPAC. Sep. 8, 2023 
  2. Medicare Savings Programs” Medicare.gov. Accessed May 19, 2025 
  3. Help With Drug Costs” Medicare.gov. Accessed May 19, 2025 
  4. Qualified Medicare Beneficiary (QMB) Program Group” Centers for Medicare & Medicaid Services. Accessed May 19, 2025 
  5. Medicare Savings Programs: Enrollment Trends” MACPAC. 2024. Accessed May 19, 2025