QMB stands for Qualified Medicare Beneficiary. It is one of the Medicare Savings Programs, run by each state's Medicaid agency, and it exists to take over the costs of Medicare for people whose income and resources fall below a limit. It is worth understanding precisely, because the protection it carries is stronger than most people realise and is routinely ignored by providers who do not recognise it.
What it takes over
The programme pays the Medicare premiums, deductibles and coinsurance that a person would otherwise owe. Those amounts are not small and they are published: in 2026 the standard Part B premium is $202.90 each month, the Part B deductible is $283, and Part B coinsurance is usually 20% of the Medicare-approved amount for each covered service. On the hospital side the Part A deductible is $1,736 for each benefit period. Taking that set of costs off a household's budget is the whole point of the programme.
The billing protection is the part people miss
Federal rules prohibit providers from billing a person enrolled in QMB for Medicare deductibles, coinsurance or copayments, whether or not the provider accepts Medicaid. That prohibition is not a courtesy and it does not depend on the provider knowing about it, which matters because improper billing of QMB enrollees is common enough that CMS has published repeated guidance about it. A person who is billed anyway should say they are in QMB and, if that does not settle it, take it to the counselling service named below.
Where the decision is made, and what this site can tell you
Eligibility is decided by the state Medicaid agency, not by Medicare and not by any website, and the income and resource limits are updated annually. What this site can tell you is scale rather than eligibility: every state page here carries a count of the people in that state covered by Medicaid as well as Medicare, from CMS's own enrollment file, dated and sourced. That is the closest published measure of how many households in a state are in the territory these programmes serve.
Questions people ask about qmb
Is QMB the same as Medicaid?
No. It is one of the Medicare Savings Programs, administered by the state Medicaid agency. Some people qualify for QMB and for full Medicaid; some qualify for QMB alone.
Can a doctor bill me if I am in QMB?
Not for Medicare deductibles, coinsurance or copayments. That prohibition applies whether or not the provider takes Medicaid.
Where do I apply?
Through your state's Medicaid agency. Your State Health Insurance Assistance Program will help you do it, free, and is not paid on the outcome.
Does this site know whether I qualify?
No, and it never will. Eligibility turns on income and resources that no dataset holds. This page explains what the programme is and what it pays.