The West Virginia 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 West Virginia Medicaid, not by Medicare, and roughly one in three people who qualify never apply. This West Virginia medicare savings program guide gives the 2026 limits as West Virginia 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 West Virginia’s own rules; they reset each spring when the new guidelines take effect.
In This West Virginia Medicare Savings Program Guide:
West Virginia Medicare Savings Program at a Glance (2026)
| 2026 income limits (single) | Federal (QMB $1,350 / SLMB $1,616 / QI $1,816 single; $1,824 / $2,184 / $2,455 couple) |
| 2026 asset test | Federal ($9,950 single / $14,910 couple) |
| What West Virginia calls the levels | West Virginia groups the three Medicare Savings Programs together under the umbrella name “Medicare Premium Assistance Programs.” Inside that umbrella the state keeps the familiar federal labels: QMB (Qualified Medicare Beneficiary), SLMB (Specified Low-Income Medicare Beneficiary, sometimes written “SLIMB” in older state policy manuals), and QI-1 (Qualified Individual). |
| Part B premium it can pay | $202.90 per month in 2026 |
| State prescription program | West Virginia does not run a state pharmaceutical assistance program that pays for drugs the way some northeastern states do. |
| Where to apply | The application is handled by the West Virginia Department of Human Services (DoHS), Bureau for Family Assistance, which runs eligibility for Medicaid and the Medicare Premium Assistance Programs — not by Medicare or the Social Security Administration. |
The Three Levels of the West Virginia 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.
West Virginia labels: West Virginia groups the three Medicare Savings Programs together under the umbrella name “Medicare Premium Assistance Programs.” Inside that umbrella the state keeps the familiar federal labels: QMB (Qualified Medicare Beneficiary), SLMB (Specified Low-Income Medicare Beneficiary, sometimes written “SLIMB” in older state policy manuals), and QI-1 (Qualified Individual).. Whatever the name, one application covers all three; the office places you at the highest level you qualify for.
West Virginia 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. West Virginia’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.
West Virginia counts income using the SSI-based rules the state applies to its aged, blind, and disabled coverage groups, so the worker looks at gross monthly income before the Medicare Part B premium is taken out, then applies the standard disregards those rules allow for a portion of unearned and earned income. Some income is not counted at all, including certain needs-based assistance and specified excluded payments.
A spouse who lives in the home is generally included in the household and that spouse’s income is counted too. Exact figures come from the verified data file.
West Virginia’s Income Maintenance Manual is explicit that QMB is not paid retroactively — QMB coverage begins prospectively after the application is approved, so a family should not expect the state to reimburse Medicare cost-sharing already paid before that start date.
SLMB and QI-1 are treated differently: state policy allows the Part B premium benefit to be backdated, and when the buy-in is completed the Social Security Administration refunds premiums the person already paid. How many prior months the state will cover is UNVERIFIED here and should be confirmed with the county DoHS worker.
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 West Virginia SHIP. This one protection is worth more than the premium for anyone with regular hospital or specialist care.
West Virginia Medicare Savings Program and Part D Extra Help
Enrolling in any West Virginia Medicare Savings Program automatically makes the person “deemed” eligible for the Medicare Part D Low-Income Subsidy, better known as Extra Help, which lowers Part D premiums and prescription costs. No separate Extra Help application to the Social Security Administration is needed — the state reports the MSP enrollment to Medicare, and CMS mails a notice confirming the person is covered.
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Families sometimes file an Extra Help application anyway, which is harmless but unnecessary once the MSP is approved. WV SHIP counselors can confirm that the deeming actually posted.
West Virginia Prescription Help Beyond Medicare
West Virginia does not run a state pharmaceutical assistance program that pays for drugs the way some northeastern states do. — West Virginia runs its own drug-cost program for seniors alongside Extra Help. Ask The application is handled by the West Virginia Department of Human Services (DoHS), Bureau for Family Assistance, which runs eligibility for Medicaid and the Medicare Premium Assistance Programs — not by Medicare or the Social Security Administration. or the SHIP whether you qualify for both.
How to Apply for the West Virginia Medicare Savings Program
Where: The application is handled by the West Virginia Department of Human Services (DoHS), Bureau for Family Assistance, which runs eligibility for Medicaid and the Medicare Premium Assistance Programs — not by Medicare or the Social Security Administration. — application. Free help: Free, unbiased, confidential help is available from the West Virginia State Health Insurance Assistance Program (WV SHIP), administered by the West Virginia Bureau of Senior Services in Charleston..
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 West Virginia 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 West Virginia Medicare Savings Program Calendar
New federal poverty guidelines are published in January or February; states adopt the new West Virginia 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 West Virginia 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 West Virginia 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 West Virginia 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 West Virginia 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
- West Virginia Medicare Savings Programs
- The application is handled by the West Virginia Department of Human Services (DoHS), Bureau for Family Assistance, which runs eligibility for Medicaid and the Medicare Premium Assistance Programs — not by Medicare or the Social Security Administration.
- Medicaid.gov spousal impoverishment standards: medicaid.gov
- Medicare.gov Medicare Savings Programs: medicare.gov
This West Virginia 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.