Medicare Savings Programs in California

If you're new to these programs, start with how Medicare Savings Programs work.

California has three programs that help pay your medical bills if you have Medicare. All three pay the $202.90 a month that Medicare costs you, which is usually taken out of your Social Security check. Your county Medi-Cal office decides who qualifies.

You may qualify if

• You have Medicare.
• You make less than about $1,350 a month if you live alone, or $1,824 as a couple. You can make a bit more and still get help with the monthly cost, as the table below shows.
• You have less than $130,000 in savings if you live alone, or $195,000 as a couple. Your home and one car do not count.

Not sure you qualify? Apply anyway, because the county makes the call and some of your income may not count. If you would rather not do it alone, a Pair Team advocate can check with you in one call.

What each program pays for

The $202.90 is the price of Medicare Part B, the part of Medicare that pays for doctor visits.

All three programs also get you Extra Help, which lowers what you pay for prescriptions. You don't need an extra form for it.

Across the country, more than 8 million people on Medicare were in QMB in 2023, about 1 in 8, the Centers for Medicare & Medicaid Services says.

What counts as income

Income means Social Security, pensions and most other money coming in. California takes $20 off first, so you can make about $20 more than the table shows. The limits go up each spring.

California has a savings limit again in 2026

Savings means money in the bank, stocks, and property you don't live in. In 2024 and 2025, California had no limit. A limit came back on January 1, 2026: $130,000 for one person and $195,000 for a couple. Each extra person in the home adds $65,000. These limits last through June 2027, with lower limits planned after that, California's Department of Health Care Services says.

Already have Medi-Cal? Check your Social Security statement

If you have full Medi-Cal, the state may already pay your monthly Medicare cost. If $202.90 still comes out of your Social Security check, call your county. Ask if you're in a Medicare Savings Program.

How to apply

1. Get your papers together. The county will want your Medicare card, your Social Security letter or latest statement, your bank balances, and a photo ID.
2. Apply one of three ways.
   • Online at BenefitsCal.com, which also checks if you can get Medi-Cal.
   • By mail or in person with form MC 14A. Send it to the Medicare Savings Program contact at your county Medi-Cal office.
   • By phone: call your county office, or the Medi-Cal helpline at 1-800-541-5555.
3. Get free help if you want it. The Health Insurance Counseling and Advocacy Program (HICAP) is California's free Medicare counseling. Its counselors (1-800-434-0222) will tell you which program fits and help with the form, and they don't sell insurance.
4. Wait for the answer. Counties have about 45 days to decide. Once you're approved, the state tells Medicare, and the $202.90 stops coming out of your check within a few months.
5. Ask about back months. SLMB and QI can start up to three months before you applied, and the form asks about this. QMB only starts going forward.

If you have QMB, no one can bill you for Medicare copays

If you have QMB, doctors, hospitals and pharmacies cannot bill you for Medicare copays or the rest of the bill. That's the law, and it holds even if they don't take Medi-Cal, and even in a Medicare Advantage plan. No one can ask you to give up this right. If a bill comes anyway:

• Don't pay it yet, and check that the visit was after your QMB start date.
• Call the billing office, say you're a Qualified Medicare Beneficiary, and ask for a statement that shows you owe nothing.
• If they keep billing you, call 1-800-MEDICARE (1-800-633-4227).

What a Pair Team advocate does

Most people who call us about Medicare costs have something else going on too. Often it's a stack of county forms, no ride to the doctor, or a landlord who wants an answer by Friday. This is what we do:

• Figure out which program you can likely get, in one phone call.
• Help you gather your papers and apply on BenefitsCal, then follow up with the county until you have an answer.
• Help you fix bills you should not have gotten, and ask for your money back if you already paid.
• Help with what usually comes with it: Extra Help for prescriptions, rides to appointments, food, utilities and housing.

An advocate is covered by Medicare if you qualify. It takes two minutes to find out.

Check if you qualify for a Pair Team advocate

Frequently asked questions

Does Medi-Cal pay for Medicare Part B?

Yes, Medi-Cal pays for Medicare Part B through the Medicare Savings Programs, which it runs in California. All three programs pay its $202.90 monthly cost.

What is the QMB income limit in California in 2026?

The QMB income limit in California in 2026 is $1,330 a month for one person and $1,804 for a couple. That's after California takes $20 off your income.

Does California have a savings limit for Medicare Savings Programs in 2026?

Yes, California has a savings limit again as of January 1, 2026: $130,000 for one person and $195,000 for a couple. There was no limit in 2024 and 2025.

Do I need to apply for Extra Help separately?

You don't need to apply for Extra Help separately, because QMB, SLMB and QI all come with it.

Can I have QMB and Medi-Cal at the same time?

Yes, you can have QMB and Medi-Cal at the same time. People with both are sometimes called "QMB Plus" or dual eligible. QI is the exception: you can't have QI and full Medi-Cal together, but full Medi-Cal may already pay your monthly Medicare cost.

What if I make a little too much?

If you make a little too much, apply anyway, because California doesn't count the first $20 of your income. SLMB and QI also have higher limits than QMB, and the county may find another Medi-Cal program for you. If you're not sure, call HICAP at 1-800-434-0222.

Sources

• Medicare Savings Programs in California, DHCS
• Medicare Savings Programs, Medicare.gov
• Qualified Medicare Beneficiary (QMB) Program, CMS
• 2026 Medicare Parts A and B Premiums and Deductibles, CMS
• Medi-Cal: Other Medi-Cal Programs, DB101 California
• Medicare Savings Programs, California Health Advocates
• Medicare Savings Programs, Los Angeles County DPSS
• QMB improper billing, Medicare Interactive
• Reinstatement of the Medi-Cal Asset Limit, Justice in Aging