Quick answers
- What does Ohio call Medicare Savings Programs?
- Medicare Premium Assistance Programs (MPAP), under Ohio Administrative Code 5160:1-3-02.1. They are QMB, SLMB, QI-1 and QDWI.
- What is the QMB income limit in 2026?
- $1,350 a month for one person and $1,824 for a married couple, after the 20-dollar income disregard.
- Does Ohio have an asset test?
- Yes. Countable resources must be no more than $9,950 for one person or $14,910 for a couple in 2026. Your home and one car don't count.
- Where do I apply?
- Online at benefits.ohio.gov, or through your county Department of Job and Family Services. Questions go to the Ohio Medicaid Consumer Hotline, 1-800-324-8680.
- Do I get Extra Help too?
- Yes. If Ohio approves you for QMB, SLMB or QI-1, you get Extra Help with Part D drug costs automatically.
What does each Ohio program pay?
Medicare Savings Programs are federal programs that each state's Medicaid agency runs. Ohio's rule, Ohio Administrative Code 5160:1-3-02.1 (effective November 1, 2025), calls them the Medicare Premium Assistance Programs, or MPAP. The Ohio Department of Medicaid (ODM) sets the rules, and your county Department of Job and Family Services (JFS) decides your case. There are four programs:
| Program | What it pays | Good to know in Ohio |
|---|---|---|
| QMB (Qualified Medicare Beneficiary) | Part A premium (if you owe one), Part B premium, and Medicare deductibles, coinsurance and copays | Starts the month after approval; no retroactive coverage |
| SLMB (Specified Low-Income Medicare Beneficiary) | Part B premium | You must be enrolled in Part A; can go back up to 3 months before the month you apply |
| QI-1 (Qualifying Individual) | Part B premium | Only if you don't qualify for other Ohio Medicaid; can go back up to 3 months |
| QDWI (Qualified Disabled and Working Individual) | Part A premium | For people under 65 who lost premium-free Part A because they went back to work |
None of the four pays for Part D, but they all lead to Extra Help, which does (see below). The Part B premium is $202.90 a month in 2026, so SLMB or QI-1 alone saves $2,434.80 over a full year. QMB also covers the Part B deductible ($283 in 2026) and the Part A hospital deductible ($1,736 per benefit period in 2026), and providers who accept Medicare may not bill you for Medicare cost sharing. Read more in Can a doctor bill me if I have QMB?
Ohio's 2026 income and resource limits
Ohio uses the federal minimum limits: QMB at 100 percent of the federal poverty level, SLMB above 100 and up to 120 percent, and QI-1 above 120 and up to 135 percent. Ohio has not raised them, and it does have an asset test. These are the 2026 monthly limits for countable income, which already include the 20-dollar general income disregard:
| Program | Income, one person | Income, married couple | Resources, one person | Resources, married couple |
|---|---|---|---|---|
| QMB (100% of poverty level) | $1,350 | $1,824 | $9,950 | $14,910 |
| SLMB (120%) | $1,616 | $2,184 | $9,950 | $14,910 |
| QI-1 (135%) | $1,816 | $2,455 | $9,950 | $14,910 |
Why ODM's table looks 20 dollars lower. Ohio Medicaid's "2026 Monthly Financial Eligibility" sheet shows the poverty-level amounts themselves. Ohio's rule then subtracts a 20-dollar general income exclusion (once per couple) before comparing your income to them. Medicare.gov's limits, used above, add the 20 dollars in. Both describe the same test.
The resource limits come from ODM's Medicaid Eligibility Procedure Letter No. 191, which set the 2026 MPAP resource limit at $9,950 for an individual and $14,910 for a couple. QDWI has a higher income limit (200 percent of the poverty level) but a much lower resource limit, twice the SSI limit. Ohio also ignores the January Social Security cost-of-living raise until the month after the new poverty guidelines are published, so a COLA doesn't knock you off in January.
Your home, household goods, one car used for transportation and certain burial funds don't count. See What assets count for Medicare Savings Programs in Ohio? for the details, or try our savings programs calculator for a quick estimate.
How to apply in Ohio
- Apply online or through your county. Use the Ohio Benefits portal at benefits.ohio.gov, or contact your county Department of Job and Family Services to apply by phone, mail or in person. Someone you trust can apply for you as an authorized representative.
- Have your papers ready. Your Medicare card, Social Security number, proof of income (Social Security letter, pension statements) and proof of resources (bank statements, stock and life insurance statements).
- Get Medicare first if you need to. If you have never had Part A or Part B, Ohio's rule says the county will tell you to enroll through Social Security first, and it can help. Report your Medicare approval to the county right away so premium payments can start.
- Answer the county's mail. Federal rules give Ohio up to 45 days to decide most applications. Send any requested documents on time and keep copies.
- Watch your Social Security check. Once Ohio starts paying your Part B premium, it stops coming out of your benefit. The change can take a few months to show up.
Questions about an application or case go to the Ohio Medicaid Consumer Hotline, 1-800-324-8680. Step by step: How do I apply for a Medicare Savings Program in Ohio?
When coverage starts and ends
- QMB begins the first day of the month after the county approves it. Ohio's rule says plainly: "No retroactive coverage is available for QMB."
- SLMB, QI-1 and QDWI can begin as early as the third month before the month you apply, as long as you met every requirement, including Part A enrollment, in those months.
- QI-1 is only for people who don't qualify for any other Ohio Medicaid category. Medicare.gov notes that QI must be renewed each year and that states approve it first come, first served, with priority for people who had it the year before.
- Help stops if you no longer qualify, if you leave Part B, or at death. Report changes in income, resources or Medicare coverage to your county JFS office.
Extra Help comes with it
Medicare.gov says people who get help from their state paying Part B premiums through a Medicare Savings Program get Extra Help with Part D drug costs automatically, without a separate application to Social Security (42 CFR 423.773(c)). In 2026, Extra Help caps what you pay at $5.10 for each generic drug and $12.65 for each brand-name drug, and you owe no Part D late enrollment penalty while you have it. Extra Help's own limits are higher than the MSP limits, so some Ohioans who miss an MSP still qualify for it. See Extra Help in Ohio.
Estate recovery doesn't apply to MSP help
Ohio's Medicaid estate recovery rule, OAC 5160:1-2-07, excludes Medicare premium assistance program benefits paid on or after January 1, 2010. Federal law (42 U.S.C. 1396p(b)(1)(B)(ii)) requires that exclusion. Getting QMB, SLMB or QI-1 does not put your home at risk. Other Medicaid help, such as nursing-home or home care services received at 55 or older, can be subject to estate recovery; see Ohio Medicaid and Medicare.
After you're approved
An MSP doesn't change your Medicare coverage, but it opens choices. With Extra Help you can change standalone Part D plans once a month. For 2027, the only dual special needs plans (D-SNPs) in Ohio are tied to the MyCare program, and some MyCare companies offer a separate D-SNP for people who get only Medicare Savings Program help. If you have full Medicaid too, see MyCare Ohio and D-SNPs in Ohio. To compare Medicare plans from the companies they work with, you can request a call from a licensed insurance agent. Benefits Life is not connected with Ohio Medicaid or your county JFS office, which decide who qualifies.
Sources
- Ohio Administrative Code — Rule 5160:1-3-02.1, Medicare premium assistance programs (MPAP), effective Nov. 1, 2025
- Ohio Department of Medicaid — 2026 Monthly Financial Eligibility, Aged, Blind, or Disabled Individuals (PDF)
- Ohio Department of Medicaid — MEPL No. 191, 2026 COLA and MPAP resource limit (PDF)
- Ohio Administrative Code — Rule 5160:1-3-05.14, Medicaid resource exclusions
- Ohio Administrative Code — Rule 5160:1-2-07, Medicaid estate recovery
- Medicare.gov — Medicare Savings Programs (2026 limits)
- Medicare.gov — Help with drug costs (Extra Help)
- eCFR — 42 CFR 423.773, Requirements for eligibility (Extra Help deemed eligibility)
- eCFR — 42 CFR 435.912, Timely determination of eligibility
- CMS — Qualified Medicare Beneficiary (QMB) Program Group (billing protections)
Every question in this guide
- Can a doctor bill me if I have QMB?
- How do I apply for a Medicare Savings Program in Ohio?
- How do I apply for Extra Help with Medicare drug costs in Ohio?
- What is the difference between QMB, SLMB and QI in Ohio?
- What are the Medicare Savings Program income limits in Ohio?
- What assets count for Medicare Savings Programs in Ohio?
- What is QMB in Ohio?
- What is the Medicare Premium Assistance Program in Ohio?
Frequently asked questions
What is the Ohio QMB income limit for 2026?
Countable income up to $1,350 a month for one person or $1,824 for a married couple, which is 100 percent of the federal poverty level plus the 20-dollar general income disregard. Ohio Medicaid's own table lists amounts 20 dollars lower because it shows the poverty level before the disregard.
Does QMB pay my Part A premium?
Yes, if you have to pay one. Most people get premium-free Part A, but if you don't, QMB pays the Part A premium as well as the Part B premium. Ohio's rule has the county agency help people without premium-free Part A enroll in Part A and Part B through Social Security.
How long does Ohio take to approve a Medicare Savings Program application?
Federal Medicaid rules give states up to 45 days to decide most applications, or up to 90 days when a disability decision is needed. Answer any request for documents quickly, because a missing paper is the most common reason for delays.
Does QMB start right away?
QMB starts the first day of the month after Ohio approves it, and Ohio's rule allows no retroactive QMB coverage. SLMB and QI-1 can go back up to three months before the month you apply, if you were eligible then.
Will Ohio take my house to pay back Medicare Savings Program help?
No. Ohio's estate recovery rule excludes Medicare premium assistance paid on or after January 1, 2010. Other Medicaid services, such as long-term care, can still be subject to estate recovery.
Medicare in your Ohio county
Plans, local agents and help, county by county: Franklin · Cuyahoga · Hamilton · Summit · Montgomery · Lucas · Butler · Stark · Lorain · Warren · Delaware · Lake · Mahoning · Clermont · Trumbull · Licking · Medina · Greene · Fairfield · Portage · All 88 counties →
