The three Medicare Savings Programs
Medicare Savings Programs are a Medicaid benefit, so in Washington they are part of Apple Health. Washington's rule, WAC 182-517-0100, sets the income levels:
- QMB (Qualified Medicare Beneficiary), up to 110% of the federal poverty level: pays the Part B premium, the Part A premium if you owe one, and Medicare deductibles, coinsurance and copays (not prescriptions). Doctors and hospitals that take Medicare can't bill you for Medicare cost sharing.
- SLMB (Specified Low-Income Medicare Beneficiary), over 110% up to 120%: pays the Part B premium.
- QI-1 (Qualifying Individual), over 120% up to 138%: pays the Part B premium. It can't be combined with other Apple Health medical coverage, and payments depend on yearly federal funding; if the money runs out, payments resume at the start of the next year.
The federal minimum that Medicare.gov shows is 100%, 120% and 135%. Washington's QMB and QI-1 limits are higher, so more people qualify here. A fourth program, QDWI, pays the Part A premium for some working people under 65 with disabilities.
No asset test since 2023
Washington removed the resource test for QMB, SLMB and QI-1 effective January 1, 2023. HCA now says plainly that there are no asset tests and that you won't be asked to verify bank account balances. A home, a retirement account or savings no longer stop you from qualifying; only countable income matters. When Washington counts income, it excludes the first 65 dollars of monthly earnings and half of the rest, so wages count for less than Social Security or a pension.
If you have full Apple Health
If your income and situation qualify you for full Apple Health coverage as well as Medicare, Apple Health generally pays your Part B premium and Medicare cost sharing too. Washington also has a state-funded Medicare buy-in program, under WAC 182-517-0300, that pays the Part B premium for some people on categorically needy or medically needy Apple Health who don't qualify for a federal Medicare Savings Program. See Apple Health and Medicare and Medicare vs. Apple Health.
How to apply
- Apply online at Washington Connection, or mail HCA's Application for Medicare Savings Program.
- For help with an application, call the DSHS customer service line at 1-877-501-2233; for questions about existing Apple Health coverage, call Apple Health customer service at 1-800-562-3022.
- Have your Social Security award letter, pension statements and recent pay stubs ready.
Check your numbers first with the Medicare Savings Programs screener, which uses Washington's limits. More detail is on Medicare Savings Programs in Washington.
Get help
Being in a Medicare Savings Program can open more plan choices and enrollment periods, including Apple Health Medicare Connect plans. A licensed insurance agent with Benefits Life can explain how that works with your plan, at no cost to you: (206) SENIORS (206-736-4677), TTY 711.
Related questions
Can I have Apple Health and Medicare Advantage?
Apple Health Medicare Connect and your other choices.
Does Medicare cover dental?
What Medicare and Apple Health cover for teeth.
What is Washington's Medicare phone number?
Official numbers for Medicare, Social Security and Apple Health.
Sources
- WAC 182-517-0100 — Federal Medicare savings programs
- Health Care Authority — Medicare Savings Programs flyer 22-500 (income chart effective April 1, 2026, shown after the general income deduction; PDF)
- WAC 182-517-0300 — State-funded Medicare buy-in programs
- Washington State Health Care Authority — Medicare Savings Program
- Health Care Authority — Apple Health income and resource standards, April 1, 2026 (PDF)
- Washington State Register — WSR 22-21-043 (resource limits removed, effective January 1, 2023)
- WAC 182-512-0840 — Work-related income exclusions
- Medicare.gov — Medicare Savings Programs
Frequently asked questions
What income qualifies in 2026?
Under HCA's April 2026 standards, QMB goes up to $1,483 a month for one person, SLMB up to $1,616, and QI-1 up to $1,855. For a couple the limits are $2,004, $2,185 and $2,510. Part of any wages is excluded, so working people can earn more.
Do my savings count?
No. The Health Care Authority says there are no asset tests for Medicare Savings Programs, so you won't be asked to verify bank balances. Extra Help, the Social Security program for drug costs, still counts resources if you apply for it separately.
Will Apple Health pay my Part D premium too?
Not directly, but everyone in a Medicare Savings Program gets Extra Help automatically. Extra Help pays all or part of a Part D plan premium and lowers drug copays.
How long until the premium stops coming out of my Social Security check?
It can take some time for Social Security's records to update after approval. If the premium was deducted from your check for months the state also paid, Social Security generally refunds it, and Washington doesn't count that refund as income.
Medicare in your Washington county
Plans, local agents and help, county by county: Adams · Asotin · Benton · Chelan · Clallam · Clark · Columbia · Cowlitz · Douglas · Ferry · Franklin · Garfield · Grant · Grays Harbor · Island · Jefferson · King · Kitsap · Kittitas · Klickitat · Lewis · Lincoln · Mason · Okanogan · Pacific · Pend Oreille · Pierce · San Juan · Skagit · Skamania · Snohomish · Spokane · Stevens · Thurston · Wahkiakum · Walla Walla · Whatcom · Whitman · Yakima
