The Medicare Savings Program in New York, 2026
The single most under-used benefit I see in the Capital Region. New York pays the Part B premium for anyone on Medicare whose income is under about $2,500 a month, and pays every Medicare copay and deductible for those under about $1,850; it doesn't look at savings, a house or a car. Most people who qualify have never applied, usually because they were told years ago that they earned too much. Here is who qualifies in 2026, what it pays, and exactly how to apply in Albany, Schenectady, Saratoga and Rensselaer counties.
New York's Medicare Savings Program (MSP) pays your Medicare Part B premium ($202.90 a month in 2026) and, at the QMB level, all of Medicare's deductibles, copays and coinsurance too. It is based on income only; New York has no asset test. The 2026 limits, after the standard $20 disregard: QMB up to $1,856 a month for a single person or $2,509 for a couple (138% of the poverty level); QI up to $2,494 single or $3,375 couple (186%). You apply with form DOH-4328 mailed to your county Department of Social Services, or online through NY State of Health; the Medicaid Helpline is 1-800-541-2831. Anyone enrolled in an MSP automatically gets Extra Help with Part D drug costs. I screen for it and help with the form at no charge.
Who qualifies in 2026
| Level | Single, per month | Married couple, per month | What it pays |
|---|---|---|---|
| QMB (Qualified Medicare Beneficiary), up to 138% of poverty | $1,856 | $2,509 | Part B premium, Part A premium if any, and all Medicare deductibles, copays and coinsurance |
| QI (Qualifying Individual), 138% to 186% of poverty | $2,494 | $3,375 | Part B premium only |
Figures include the $20 monthly disregard New York applies to everyone; the Department of Health lists them as $1,836 + $20 and $2,474 + $20. Income is gross: Social Security before the Part B deduction, pensions, wages, interest. No asset test. Limits update each spring.
You must have Medicare Part A (for QI) and live in New York. Citizenship or a qualifying immigration status is required, the same as for Medicaid; New York does not apply a five-year wait to lawfully present immigrants.
What it's worth
- Part B premium: $202.90 a month in 2026, so $2,434.80 a year added back to your Social Security deposit. Both levels pay it.
- QMB adds Medicare's cost-sharing: the $283 Part B deductible, the 20% coinsurance on doctors and outpatient care, the $1,736 Part A hospital deductible. A provider who takes Medicare may not bill a QMB member for any of it, and Medicare Advantage plans must honor it too.
- Extra Help, automatically: any MSP enrollment qualifies you for full Extra Help with Part D, worth the plan premium (up to the regional benchmark), the deductible and most of the copays; see Extra Help.
- Late-enrollment penalties waived: the Part B penalty is not charged while the state pays your premium, and the Part D penalty is waived under Extra Help.
- A Medigap decision changes: with QMB you don't need a Medigap policy to cover the 20%; the state covers it. Many QMB members drop a $300-a-month Medigap premium. With QI you still do.
How to apply
- Get the form. DOH-4328, "Medicare Savings Program Application", from the Department of Health's website (also in Spanish, Russian, Chinese, Arabic, Bengali, Haitian Creole, Italian, Korean and Polish) or from the county office. Two pages: household, income, Medicare number.
- Attach proof. Your Medicare card, photo ID, and proof of income: the Social Security benefit letter (or the new-year COLA letter), pension statements, recent pay stubs. No bank statements are required in New York.
- Mail or bring it to the Medicaid unit of the county where you live (addresses below). Paper applications must go to the county, not to Albany. If your Medicaid is already through NY State of Health, you can apply there instead.
- Wait for the notice. Counties have 45 days to decide. QMB starts the first of the month after approval; QI is retroactive up to three months. The Part B refund arrives from Social Security, sometimes as a lump sum for the months already covered.
- Renew yearly. The county sends a renewal; return it or the coverage lapses. If your income falls later, reapply for the higher level.
Where to send it in the Capital Region
| County | Medicaid unit | Phone |
|---|---|---|
| Albany | Albany County Department of Social Services, 162 Washington Avenue, Albany, NY 12210 | (518) 447-7300; Medicaid appointments (518) 447-4989 |
| Schenectady | Schenectady County Department of Social Services, 797 Broadway, Schenectady, NY 12305 | (518) 388-4470; Medicaid (518) 388-4445 |
| Saratoga | Saratoga County Department of Social Services, 152 West High Street, Ballston Spa, NY 12020 | (518) 884-4140; Medicaid enrollment (518) 884-4148 |
| Rensselaer | Rensselaer County Medicaid Unit, 1600 Seventh Avenue, Troy, NY 12180 | (518) 266-7970 |
Addresses and numbers from each county's website as of September 2026; call before visiting. Statewide Medicaid Helpline: 1-800-541-2831. Free counseling is also available from each county's HIICAP program through the Office for the Aging (1-800-701-0501).
Three situations I see every month
- "I was denied in 2019." New York raised the limits by roughly 50% in 2023 and dropped the asset test. A 2019 denial tells you nothing about 2026; apply again.
- "I'm just over the line." The line is gross income after a $20 disregard, and the county applies other disregards in some cases. Apply and let the county decide. If you're over for QMB you may still fit QI, and if you're over for both, EPIC (income to $75,000 single / $100,000 couple) still cuts drug costs.
- "I have a Medicare Advantage plan; does this still apply?" Yes. MSP works with any plan. With QMB, the plan's copays are covered by the state as well, and you become eligible for D-SNP plans built for people with both Medicare and Medicaid help; see Medicare and Medicaid together.
MSP, Extra Help and EPIC side by side
New York has three overlapping programs and people mix them up. Help paying for Medicare compares all three on one page; Extra Help is the federal drug-cost program with its own application through Social Security; EPIC is the state drug program for middle incomes.
How I help
A ten-minute screening by phone: your monthly income and household size tell me which level you fit. If you qualify, I fill the DOH-4328 in with you, list the documents your county wants, and follow up if the notice doesn't arrive. There's no fee for any of it, and it doesn't change your Medicare plan or your doctors. Ask for a screening or pick a time for a call.
- Medicare Savings Programs 2026 (NY Department of Health) — QMB $1,836 + $20 / $2,489 + $20; QI $2,474 + $20 / $3,355 + $20; DOH-4328; Helpline 1-800-541-2831; rev. 3/26
- Form DOH-4328, Medicare Savings Program application (NY DOH, PDF)
- Medicare Savings Programs (Medicare.gov) — QMB billing protection; automatic Extra Help
- Help with drug costs, Extra Help 2026 (Medicare.gov) — $18,090 / $36,100 resources; $5.10 / $12.65 copays
- HIICAP notebook, module 9: Medicare Savings Programs (NY State Office for the Aging, 2026)
- Medicare costs 2026 (Medicare.gov) — Part B premium $202.90
- Medical Assistance, Albany County DSS
- Health care assistance, Schenectady County DSS
- Social Services, Saratoga County
- Medicaid, Rensselaer County
I do not offer every plan available in your area. Any information I provide is limited to the plans I do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Assistance Program for information on all of your options. Not connected with or endorsed by the U.S. government, the Social Security Administration or the federal Medicare program.
Common questions
Short answers to what people ask before they call.
What are the Medicare Savings Program income limits in New York for 2026?
After the $20 monthly disregard New York applies to everyone: QMB up to $1,856 a month for a single person or $2,509 for a married couple (138% of the federal poverty level); QI up to $2,494 single or $3,375 couple (186%). Gross income counts, including Social Security before the Part B deduction. There is no asset or resource test in New York. Limits change each spring when the poverty level updates.
How do I apply for the Medicare Savings Program in New York?
Three ways. Mail form DOH-4328 (the Medicare Savings Program application, two pages plus instructions) to the Medicaid unit of the county Department of Social Services where you live; apply online through NY State of Health if your Medicaid is already handled there; or apply in person at the county office. Send proof of income (Social Security award letter, pension statement, pay stubs) and identity. The Medicaid Helpline, 1-800-541-2831, answers questions; I help fill the form in at no charge.
What does QMB pay for?
The Part B premium ($202.90 a month in 2026, so $2,434.80 a year back in your Social Security check), the Part A premium if you pay one, and all Medicare Part A and B deductibles, copays and coinsurance. Providers who take Medicare are not allowed to bill a QMB member for Medicare cost-sharing. QMB starts the month after approval; it is not retroactive.
What does QI pay for?
The Part B premium only. QI is for incomes above the QMB line up to 186% of poverty; you can't have full Medicaid at the same time. QI can be paid retroactively for up to three months before the month you applied, so apply even if you're mid-year. Funding is a yearly federal allotment; New York has not run out in recent years.
Does the Medicare Savings Program count my savings or my house?
No. New York removed the resource test for Medicare Savings Programs; only income is counted. That's different from most states and from the federal Extra Help program, which still has a resource limit ($18,090 single, $36,100 couple in 2026).
If I get MSP, do I get Extra Help for prescriptions too?
Yes, automatically. Enrollment in any Medicare Savings Program qualifies you for full Extra Help with Part D: $0 plan premium up to the benchmark, $0 deductible and copays of at most $5.10 for generics and $12.65 for brand names in 2026, plus a monthly right to change drug plans. You'll get a letter from Medicare; nothing else to file.
Will applying affect my Medicare or my doctors?
No. MSP sits alongside Original Medicare, a Medigap policy or a Medicare Advantage plan; it doesn't change your plan or your doctors. It also isn't counted in a public-charge test. If your income is close to the line, apply anyway: the county makes the determination, some income is disregarded, and a denial costs nothing.
Ten minutes to find out
Your monthly income before deductions and whether you're single or married. I tell you which level you fit, fill in the DOH-4328 with you and say what to send with it. No fee, and it doesn't touch your Medicare.