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Medicare Savings Plans 2027

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) — Last updated October 8, 2026

Medicare Savings Programs, sometimes called Medicare savings plans, are state-run programs that help people with limited income and resources pay Medicare costs. The three main programs are QMB, SLMB and QI.

People in a Medicare Savings Program automatically qualify for Extra Help with Part D drug costs. Income and asset limits are set by federal rules but vary by state, and some states are more generous.

See help for low-income Part D beneficiaries.

✔ Licensed in all 50 states
✔ Based on CMS 2027 data
✔ Free plan comparison

Key Highlights

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QMB can pay Part A and Part B premiums, deductibles, coinsurance and copays.

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SLMB and QI pay the Part B premium.

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Members automatically qualify for Extra Help.

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Apply through your state Medicaid office.

Compare plans and enroll online

The Three Main Programs

Program What It Pays Notes
QMB (Qualified Medicare Beneficiary) Part A and B premiums, deductibles, coinsurance and copays Providers generally cannot bill you for Medicare cost sharing
SLMB (Specified Low-Income Medicare Beneficiary) Part B premium Higher income limit than QMB
QI (Qualifying Individual) Part B premium Funded yearly; apply each year

How to Apply

Step by Step

1

Contact your state Medicaid office. Or apply online if your state allows.

2

Gather proof of income and resources. Bank statements, Social Security letters.

3

Apply even if you are close to the limit. States count income differently.

4

Watch for a decision. Approval also gives you Extra Help.

Medicare Savings Plans (2027)

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Extra Help With Drugs

Extra Help lowers Part D premiums, deductibles and copays. Everyone in a Medicare Savings Program qualifies automatically.

$700

Maximum 2027 Part D deductible, up from $615.

$2,400

2027 Part D out-of-pocket cap, up from $2,100.

About $36

Average 2027 standalone Part D premium, up less than $1 (CMS).

$7

Projected average drug portion of a Medicare Advantage premium for 2027, down from $11.32.

Medicare Savings Programs and Medicare Advantage

You can be in a Medicare Savings Program with either Original Medicare or Medicare Advantage. If you also qualify for full Medicaid, a Dual Special Needs Plan may coordinate both.

Special Needs Plans (SNPs) are Medicare Advantage plans built for specific groups. Benefits, networks and drug lists are designed around the members they serve, and many include care coordinators. For 2027, Special Needs Plans are one of the few areas where large insurers are adding plans, even as they cut PPOs.

Type Who Qualifies What Is Different
Dual Special Needs Plan (D-SNP) People with both Medicare and Medicaid Coordinates both programs; often very low costs and added benefits
Chronic Condition SNP (C-SNP) People with qualifying conditions such as diabetes, heart failure or chronic lung disease Doctors, drugs and programs built around the condition
Institutional SNP (I-SNP) People living in a nursing home or who need that level of care at home Care delivered where the member lives

Reading Your Annual Notice of Change

Check Every Line

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Your 2027 premium and deductible

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Copays for doctors, specialists and hospital stays

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The out-of-pocket maximum

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Changes to your drug list, tiers and coverage rules

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Whether your doctors, hospitals and pharmacy are still in network

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Changes to dental, vision, hearing and other extras

Plans must send the Annual Notice of Change by September 30. It is the single most useful document you get each fall, because it tells you exactly how your plan changes on January 1.

2027 income and resource limits

Special Enrollment Periods

Outside the fall and early-year windows, you generally need a Special Enrollment Period to change plans. Common reasons include:

You May Qualify If

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Your plan is leaving your area or ending

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You move outside your plan’s service area

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You lose employer or union coverage

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You qualify for Extra Help or a Medicare Savings Program, or your Medicaid status changes

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You want to join a 5-star plan, once a year

Each Special Enrollment Period has its own time limit, so act as soon as the event happens.

Prior Authorization and Referrals

Most Medicare Advantage plans require prior authorization for some services, such as certain surgeries, advanced imaging, skilled nursing stays and some drugs. Your doctor usually requests it, but ask whether a planned service needs approval so a denial does not surprise you.

If a request is denied, you or your doctor can appeal. Medicare rules set deadlines for plans to decide, with faster deadlines when waiting could seriously harm your health.

Emergency, Urgent and Out-of-Area Care

Every Medicare Advantage plan covers emergency care and urgent care anywhere in the U.S., in or out of network, and you do not need prior approval for an emergency. Routine care away from home is a different story: HMOs generally do not cover it, while PPOs cover out-of-network care at a higher cost.

If you spend months away from home each year, ask each plan how it handles care in your second location. It is one of the most common reasons people switch plans mid-year.

Appeals and Complaints

If your plan denies a service, a drug or payment for care, you have the right to appeal. The plan’s denial notice explains how. There are several levels of appeal, starting with the plan and moving to independent reviewers.

For problems that are not about coverage, such as customer service or wait times, you can file a grievance with the plan. You can also contact 1-800-MEDICARE or your State Health Insurance Assistance Program for help.

The 2027 Part B Premium

The Part B premium is the one big number not released with the plans. CMS normally announces it in November. The 2026 Medicare Trustees Report projects a 2027 standard premium of about $209.50 a month and a deductible of about $292, up from $202.90 and $283 in 2026. You keep paying it with Medicare Advantage.

If You Miss December 7

If you miss the Annual Enrollment deadline, your current plan renews automatically for 2027, with the changes in your Annual Notice of Change. If you are in Medicare Advantage, you get one more chance from January 1 to March 31, 2027, to switch Medicare Advantage plans or return to Original Medicare and join a Part D plan.

Telehealth

Many Medicare Advantage plans may cover telehealth visits for some services, sometimes at a lower copay than an office visit. Telehealth is convenient for follow-ups and minor issues, but it does not replace confirming that your regular doctors are in network.

Pros and Cons of Medicare Advantage

Advantages

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Often a low or $0 premium

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A yearly out-of-pocket maximum

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Drug coverage usually included

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Many plans may include dental, vision and hearing benefits

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One card and one plan

Tradeoffs

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Networks; HMOs require in-network care except emergencies

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Prior authorization and referrals are common

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Copays add up if you use a lot of care

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Plans and networks can change every year

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Switching to Medigap later may require health questions

Turning 65 in 2027

If you turn 65 in 2027, your Initial Enrollment Period lasts seven months: the three months before your birthday month, your birthday month and the three months after. Signing up during the first three months means your coverage starts on the first day of your birthday month.

Turning 65 Checklist

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Sign up for Part A and Part B, unless you have qualifying employer coverage and choose to delay Part B

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Decide between Medicare Advantage and Original Medicare with Medigap

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Join a drug plan, or a Medicare Advantage plan with drugs, to avoid a Part D late penalty

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If you choose Medigap, buy during your six-month Medigap Open Enrollment Period

Star Ratings

Medicare rates every Medicare Advantage and Part D plan from 1 to 5 stars each fall, based on things like preventive care, how well the plan manages chronic conditions, member complaints, customer service and drug pricing accuracy. The ratings are shown in Medicare Plan Finder.

Using Star Ratings

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A rating of 4 stars or higher is generally a good sign of quality and service

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Five-star plans have a special enrollment period, so you can switch into one once during the year

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New plans may not have a rating yet, which is not a bad sign by itself

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Ratings measure the plan overall, not how well it covers your specific doctors and drugs

Help Paying Medicare Costs

If your income and savings are limited, two programs can cut your Medicare costs sharply:

Medicare Savings Programs

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Run by your state Medicaid office

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Can pay your Part B premium, and sometimes deductibles and coinsurance

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Income and asset limits vary by state

Extra Help (Part D)

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Run by Social Security

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Lowers Part D premiums, deductibles and copays

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People in a Medicare Savings Program qualify automatically

If you qualify for both Medicare and full Medicaid, you may also be able to join a Dual Special Needs Plan. See help for low-income Part D beneficiaries.

Getting Help

You do not have to compare plans alone, and you should not have to pay for help. These are the free options:

Free Help Comparing Plans

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Medicare Plan Finder on Medicare.gov, available any time

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1-800-MEDICARE (1-800-633-4227), available 24 hours a day, seven days a week

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Your State Health Insurance Assistance Program (SHIP), which offers free, unbiased counseling

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A licensed insurance agent or broker, who can compare plans from several insurers at no cost to you

Before any call, have your Medicare card, your list of drugs and doses, your doctors and your preferred pharmacies ready. It turns a long conversation into a short one.

Bottom Line

The Bottom Line

Medicare Savings Programs can pay your Part B premium and more if your income and resources are limited. Apply through your state Medicaid office, and you will automatically get Extra Help with drug costs.

Compare plans and enroll online

Frequently Asked Questions

➤ What are Medicare savings plans?

Medicare savings plans are state-run Medicare Savings Programs that help pay Medicare costs for people with limited income and resources. The main programs are QMB, SLMB and QI, and each covers different costs. Income and resource limits vary by program and state, so check with your state Medicaid office.

➤ What does QMB pay?

QMB pays Part A and B premiums, deductibles, coinsurance and copays. Providers who accept Medicare generally cannot bill QMB members for Medicare-covered services. If you qualify for QMB, you also automatically qualify for Extra Help with Part D drug costs.

➤ What do SLMB and QI pay?

SLMB and QI pay the Part B premium, which is $202.90 a month in 2026 and projected at $209.50 for 2027. They do not cover deductibles or coinsurance. QI is funded each year and applications are approved first come, first served, so apply early.

➤ How do I apply?

Apply through your state Medicaid office. You will usually need proof of income, resources and Medicare enrollment, such as your Medicare card and bank statements. Your State Health Insurance Assistance Program (SHIP) can help you check whether you may qualify and complete the application for free.

➤ Do I get Extra Help automatically?

Yes, if you are in a Medicare Savings Program, you automatically qualify for Extra Help with Part D costs. Extra Help can lower your Part D premiums, deductibles and copays. If you do not choose a drug plan yourself, Medicare may enroll you in one.

➤ Can I have a Medicare Savings Program and a Medicare Advantage plan?

Yes. A Medicare Savings Program can help pay your Part B premium and, for QMB members, other Medicare costs whether you have Original Medicare or Medicare Advantage. Some people who also qualify for full Medicaid may be eligible for a Dual Eligible Special Needs Plan (D-SNP).

➤ Is a Medicare Savings Program the same as Medicaid?

No, but both are run through your state Medicaid office. A Medicare Savings Program helps pay Medicare premiums and, in some cases, cost sharing, while full Medicaid can cover additional services. Some people qualify for both programs.

Have Questions?

Speak with a licensed insurance agent

1-855-398-0716

TTY users 711

Mon-Fri: 8am-9pm ET

Find & Compare Plans Online

Speak with a licensed insurance agent

1-855-398-0716TTY 711

Mon-Fri: 8am-9pm ET

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