North Dakota Medicare Savings Program 2026: QMB, SLMB and QI Limits

The North Dakota Medicare Savings Program pays your Medicare Part B premium — $202.90 a month in 2026 — and at the top level pays your deductibles and copays too. It is run by North Dakota Medicaid, not by Medicare, and roughly one in three people who qualify never apply. This North Dakota medicare savings program guide gives the 2026 limits as North Dakota applies them, the asset rule, how it triggers Part D Extra Help, and where to apply.

Limits below are from the National Council on Aging’s 2026 table built on the federal poverty guidelines, checked against North Dakota’s own rules; they reset each spring when the new guidelines take effect.

North Dakota Medicare Savings Program at a Glance (2026)

The Three Levels of the North Dakota Medicare Savings Program

• QMB (Qualified Medicare Beneficiary): pays the Part A and Part B premiums and the deductibles, coinsurance and copays. Providers who take Medicare may not bill a QMB enrollee for Medicare cost-sharing at all.
• SLMB (Specified Low-Income Medicare Beneficiary): pays the Part B premium only.
• QI (Qualifying Individual): also pays the Part B premium only, with a slightly higher income limit; funding is capped and first-come, first-served each year.

North Dakota labels: North Dakota uses the standard federal names for all three levels: the Qualified Medicare Beneficiary (QMB) program, the Specified Low-Income Medicare Beneficiary (SLMB) program, and the Qualifying Individual (QI) program.. Whatever the name, one application covers all three; the office places you at the highest level you qualify for.

North Dakota Medicare Savings Program Income and Asset Limits

The federal floors for a single person in 2026 are $1,350 a month for QMB, $1,616 for SLMB and $1,816 for QI, each including a $20 disregard. North Dakota’s figures: Federal (QMB $1,350 / SLMB $1,616 / QI $1,816 single; $1,824 / $2,184 / $2,455 couple).

Assets: Federal ($9,950 single / $14,910 couple). The home, one vehicle, household goods and burial funds up to $1,500 do not count.

North Dakota applies Supplemental Security Income (SSI) income methodology to the Medicare Savings Programs, and the state’s manual is explicit that the more restrictive 209(b) rules it uses elsewhere in Medicaid may not be applied here.

That means Social Security benefits, pensions, wages, and most other regular money coming in are counted, while certain items SSI ignores — including a portion of earnings and a small general disregard — are set aside before the comparison is made. If a married couple lives together, both spouses’ income is counted, even when only one of them has Medicare.

North Dakota treats the three levels differently, and this surprises families. QMB is never retroactive: coverage starts the month after the month the state approves the case, so the months while the application was pending are not paid. SLMB and QI can be backdated to cover months before the application was filed, provided the person met every eligibility rule in each of those months and had Medicare then.

The exact number of months North Dakota allows for that backdating is UNVERIFIED here; confirm it with ND HHS.

The QMB Billing Protection Most People Never Use

Federal law forbids any provider who accepts Medicare from billing a QMB enrollee for Medicare deductibles, coinsurance or copays. If a bill arrives, the enrollee does not owe it. Show the QMB card, cite the rule, and if it continues report it to 1-800-MEDICARE or the North Dakota SHIP. This one protection is worth more than the premium for anyone with regular hospital or specialist care.

North Dakota Medicare Savings Program and Part D Extra Help

Approval for QMB, SLMB, or QI in North Dakota automatically makes the person “deemed” eligible for the Medicare Part D Extra Help subsidy, also called the Low-Income Subsidy. No second application is needed — the state reports the approval, Social Security is notified, and Medicare mails a letter confirming the lower drug costs. If the person is not already in a Part D plan, Medicare may enroll them in one.

Anyone who does not receive that letter should call the ND SHIC counselors listed below rather than reapplying.

North Dakota Prescription Help Beyond Medicare

North Dakota does not operate a true state pharmaceutical assistance program (SPAP) that pays for seniors’ drugs. — North Dakota runs its own drug-cost program for seniors alongside Extra Help. Ask The application is decided by North Dakota Health and Human Services (ND HHS) Medicaid — not by Medicare and not by the Social Security Administration. or the SHIP whether you qualify for both.

How to Apply for the North Dakota Medicare Savings Program

Where: The application is decided by North Dakota Health and Human Services (ND HHS) Medicaid — not by Medicare and not by the Social Security Administration. — application. Free help: North Dakota’s State Health Insurance Assistance Program is called SHIC — State Health Insurance Counseling, sometimes written Senior Health Insurance Counseling — and it is housed at the North Dakota Insurance Department, 600 East Boulevard Avenue, Department 401, Bismarck, ND 58505..

Bring the Medicare card, proof of all income, and — in states with an asset test — bank statements. A decision usually takes a few weeks; the Part B premium refund appears as a larger Social Security deposit once the change reaches Social Security.

Who Typically Qualifies for the North Dakota Medicare Savings Program

A widow living on one Social Security check. A retired couple whose combined income is modest once one pension stopped. A person under 65 on Medicare through disability. Anyone who receives Supplemental Security Income already qualifies at the top level. Homeowners qualify as easily as renters, because the home is never counted, and in the states without an asset test savings are not counted either.

The North Dakota Medicare Savings Program Calendar

New federal poverty guidelines are published in January or February; states adopt the new North Dakota medicare savings program limits in the weeks after, usually by March or April. A person who was just over the limit in December may be under it in April without their income changing. The Part B premium itself changes each January, so the value of the program rises with it. QI funding is allocated by calendar year and can run out; apply early rather than late.

If the North Dakota Medicare Savings Program Application Is Denied

The denial notice states the reason and the deadline to ask for a hearing. The three fixable reasons are missing proof of income, income counted that should have been excluded, and — in asset-test states — a burial fund or life insurance that should not have been counted. Fix the reason and reapply; nothing prevents a second application. The state SHIP will review a denial for free.

The North Dakota Medicare Savings Program Versus Full Medicaid

The program pays Medicare costs; it does not make you a Medicaid patient. You keep your doctors, your Medicare card and your plan. Full Medicaid, with its lower income limit, adds coverage Medicare does not have — long-term care above all. Many people qualify for the North Dakota medicare savings program first and for full Medicaid only later, when care needs and costs rise. The two applications go to the same office.

What to Do Next

If you qualify for a North Dakota medicare savings program, apply before you shop for plans: the premium help changes which Medigap or Advantage plan makes sense. Your SHIP counselor can do both in one visit.

Official Sources

• North Dakota Medicare Savings Programs: https://www.hhs.nd.gov/healthcare/medicaid is the single best starting point on a North Dakota .gov site, because it is the agency that actually decides these applications and it links onward to the “Ways to Apply” page and the Self-Service Portal. For the plain-language description of what each level pays, the state’s own handout is https://www.hhs.nd.gov/sites/www/files/documents/fact-sheet-medicare-premium-assistance-program.pdf. Caseworkers and advocates who want the governing rules can read policy manual section 510-05-60 at https://www.nd.gov/dhs/policymanuals/51005/510_05_60_05.htm.
• The application is decided by North Dakota Health and Human Services (ND HHS) Medicaid — not by Medicare and not by the Social Security Administration.: https://www.hhs.nd.gov/healthcare/medicaid/apply is the official “Ways to Apply” page listing every method. The online application is filed through the ND HHS Self-Service Portal at https://applyforhelp.nd.gov, where the applicant signs in with a North Dakota Login or creates one. The state’s public fact sheet describing the program sits at https://www.hhs.nd.gov/sites/www/files/documents/fact-sheet-medicare-premium-assistance-program.pdf. The specific paper form number North Dakota assigns to the Medicare Savings Program application is UNVERIFIED; request the correct form from the Customer Support Center.
• Medicaid.gov spousal impoverishment standards: medicaid.gov
• Medicare.gov Medicare Savings Programs: medicare.gov

This North Dakota medicare savings program guide was checked against the state Medicaid agency, CMS and the statute cited above in September 2026. Figures reset on their own calendars (most on January 1); if a number here disagrees with a notice you received, the notice wins — and please tell us. This page is general information, not legal, financial or medical advice.

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