What QMB pays in Ohio
Under OAC 5160:1-3-02.1(J), when you're eligible for QMB, Ohio Medicaid pays:
- Your Part B premium ($202.90 a month in 2026) and your Part A premium, if you have to pay one;
- Medicare deductibles, including the Part B deductible ($283 in 2026) and the Part A hospital deductible ($1,736 per benefit period);
- Medicare copays and coinsurance, such as the 20 percent Part B coinsurance.
Federal law also protects you: Medicare providers, including pharmacies, may not bill people in QMB for Medicare cost sharing. Read Can a doctor bill me if I have QMB? for what to do if a bill arrives. QMB doesn't pay for Part D, but QMB members get Extra Help automatically.
Who qualifies
- Medicare. You must be enrolled in Part A or Part B. If you don't have premium-free Part A, Ohio's rule has the county coordinate with Social Security so you can enroll and Ohio can pay the premium.
- Income. Up to 100 percent of the federal poverty level: $1,350 a month for one person or $1,824 for a couple in 2026, after the 20-dollar disregard.
- Resources. Up to $9,950 for one person or $14,910 for a couple. Your home and one car don't count.
- Ohio residence and the usual Medicaid citizenship or immigration rules.
Ohio hasn't raised QMB above the federal minimum, so pages claiming higher Ohio limits are wrong. If your income is a little higher, look at SLMB and QI-1.
When it starts
QMB begins the first day of the month after your county Job and Family Services office approves it, with no retroactive months. Apply at benefits.ohio.gov or through your county; questions go to the Ohio Medicaid Consumer Hotline, 1-800-324-8680. Medicare.gov says to show your Medicare card and your Medicaid or QMB card every time you get care.
With QMB and Extra Help you have more chances to change coverage during the year. To compare Medicare plans from the companies they work with, you can request a call from a licensed insurance agent. See also Medicare Savings Programs in Ohio.
Related questions
Can a doctor bill me if I have QMB?
Your billing protection.
QMB vs. SLMB vs. QI in Ohio
The other programs.
How do I apply for a Medicare Savings Program in Ohio?
Steps and papers.
Sources
- Ohio Administrative Code — Rule 5160:1-3-02.1, Medicare premium assistance programs (QMB benefits and coverage dates)
- CMS — Qualified Medicare Beneficiary (QMB) Program Group
- Medicare.gov — Medicare Savings Programs (2026 QMB limits)
- Ohio Department of Medicaid — MEPL No. 191, 2026 MPAP resource limit (PDF)
More questions 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 the Medicare Premium Assistance Program in Ohio?
Part of the guide: Medicare Savings Programs in Ohio · All questions
Frequently asked questions
Does QMB in Ohio have retroactive coverage?
No. Ohio's rule, OAC 5160:1-3-02.1, says QMB starts the first day of the month after the county approves it and that no retroactive coverage is available. That's why it pays to apply as soon as you think you might qualify.
Can I have QMB and a Medicare Advantage plan?
Yes. QMB pays your premiums and protects you from being billed for Medicare cost sharing whether you're in Original Medicare or a Medicare Advantage plan. For 2027, the only Ohio D-SNPs are tied to the MyCare program, and some MyCare companies offer one for people who get only Medicare Savings Program help.
Do I still need a Part D plan with QMB?
Yes, for drug coverage. QMB doesn't cover Part D, but it gives you Extra Help automatically. If you don't pick a drug plan, Medicare will enroll you in one.
What is the QMB limit for a married couple?
In 2026, countable income up to $1,824 a month and resources up to $14,910 for a couple.
Medicare in your Ohio county
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