What are Florida's rules?
Florida uses the federal names for its Medicare Savings Programs: QMB, SLMB and QI1. They are part of Florida Medicaid, set out in the Economic Self-Sufficiency (ESS) Program Policy Manual, and the Department of Children and Families (DCF) decides eligibility. Each needs Medicare Part A (QMB allows conditional Part A enrollment) and assets no more than three times the SSI resource limit, adjusted each year.
| Program | Countable income (federal poverty level) | What Florida Medicaid pays |
|---|---|---|
| QMB (Qualified Medicare Beneficiary) | Up to 100% | Medicare premiums, deductibles and coinsurance |
| SLMB (Special Low-Income Medicare Beneficiary) | Over 100%, up to 120% | Part B premium |
| QI1 (Qualifying Individual) | Over 120%, up to 135% | Part B premium, only for people not eligible for another Medicaid group except Medically Needy |
Asset limit for all three programs in 2026: $9,950 for one person, $14,910 for a couple. DCF's Appendix A-9.1 lists the exact monthly income amounts for households of one to ten people, effective April 2026. Those amounts are the federal poverty level itself, so they are a little lower than the figures on Medicare.gov, which add back the small general income exclusion DCF subtracts from your income first. This screener doesn't print Florida's amounts; it estimates your income as a share of the federal poverty level, the way the chart is built.
How does DCF count income and savings?
DCF counts income the way Supplemental Security Income does. If your Part B premium is taken out of your Social Security check, add it back: DCF counts your income before that deduction. A small general income exclusion comes off first. Wages get more: after an earned income exclusion, only half of the remaining earnings count. The screener applies those steps, which is why it asks for work earnings separately.
For assets, DCF doesn't count the home that is your principal residence, whatever its value, and it excludes one automobile regardless of value. It can also exclude a home in another state if your spouse or a dependent relative lives there or you intend to return to it, which matters for people who split the year between Florida and somewhere else. A retirement account you already take regular payments from isn't counted as an asset; the payments count as income instead. Bank accounts, CDs, stocks, bonds and other real estate generally count.
Why the Medicare Savings Programs matter so much in Florida: Florida hasn't expanded Medicaid, and MEDS-AD, its full-Medicaid program for aged and disabled people with income up to 88% of the poverty level, doesn't cover people on Medicare unless they are in a nursing home, hospice or home and community-based services. For many Floridians on Medicare with low income, QMB, SLMB or QI is the main state help. See what is MEDS-AD? and Florida Medicaid and Medicare.
Does Extra Help come with it?
Yes. Everyone who qualifies for QMB, SLMB or QI1 is treated as eligible for Extra Help, the federal program that lowers Part D premiums, deductibles and copays, without a separate application. If your income or savings are above the Medicare Savings Program limits, you may still fit Extra Help: in 2026 its income limit is $23,940 a year for one person ($32,460 for a married couple), and its resource limit is $18,090 for one person or $36,100 for a couple, counting burial funds. See Extra Help in Florida and the drug cap estimator.
How do I apply in Florida?
- Make sure you have Medicare Part A. All three programs need Part A; QMB allows conditional enrollment, so you can apply even if you would owe a Part A premium. If you aren't enrolled, sign up through Social Security.
- Apply through ACCESS Florida. Florida uses one application for all its assistance programs. Apply online at MyACCESS, or call DCF's customer call center at (850) 300-4323 (Florida Relay 711) for help.
- Have proof ready. Your Social Security award letter, pension statements (for example from the Florida Retirement System), recent pay stubs, and bank, investment and life insurance statements.
- Watch for the decision. DCF may ask for more documents. QMB has no retroactive coverage, so apply as soon as you think you might qualify.
Help from a Medicare Savings Program alone isn't subject to Medicaid estate recovery under federal law. If you also qualify for full Medicaid, read Florida Medicaid and Medicare and Medicare Savings Programs in Florida. Late-enrollment penalties are covered on the penalty calculator.
Sources
- Florida DCF — Appendix A-9.1, Medicare Savings Programs (MSPs) and Low-Income Subsidy (LIS) financial standards, effective April 2026 (PDF)
- Florida DCF — ESS Program Policy Manual, Chapter 2000, Coverage Groups (QMB 2040.0817, SLMB 2040.0818, QI1 2040.0819, MEDS-AD 2040.0813) (PDF)
- Florida DCF — ESS Program Policy Manual, Chapter 2600, Calculation of Benefits (QMB, SLMB and QI1 eligibility test, 2640.0126) (PDF)
- Florida DCF — ESS Program Policy Manual, Chapter 1600, Assets (home, automobile and retirement funds) (PDF)
- Florida DCF — Public assistance (ACCESS Florida)
- eCFR — 20 CFR 416.1112, Earned income we do not count
- Social Security Act section 1917(b) — Estate recovery (Medicare cost-sharing excluded)
- KFF — Status of state Medicaid expansion decisions
- Medicare.gov — Medicare Savings Programs
- Medicare.gov — Help with drug costs (Extra Help 2026 limits)
- Social Security — Extra Help with Medicare prescription drug costs
Frequently asked questions
Do I qualify for help paying Medicare costs in Florida?
You may, if your countable income is up to 135% of the federal poverty level and your assets are within $9,950 for one person or $14,910 for a couple in 2026. Extra Help with drug costs goes up to 150%. The screener gives an estimate; the Florida Department of Children and Families makes the decision.
Why are DCF's income limits a little lower than Medicare.gov's?
DCF's chart, Appendix A-9.1, lists the federal poverty level amounts themselves. Medicare.gov's figures add the small general income exclusion that is subtracted from your income first. The result is the same: DCF subtracts that exclusion from your income before comparing it with the chart.
Does Florida have an asset limit for Medicare Savings Programs?
Yes. DCF's Appendix A-9.1 sets it at $9,950 for one person and $14,910 for a couple in 2026, the same as the federal standard. The home you live in and one automobile don't count.
Where do I apply in Florida?
Online through ACCESS Florida (MyACCESS), the Department of Children and Families' application for Medicaid and other help. DCF's customer call center is (850) 300-4323, Florida Relay 711. If you qualify for QMB, SLMB or QI, you also get Extra Help with Part D drug costs automatically.
Can I get full Florida Medicaid instead?
Usually not through MEDS-AD: Florida's program for aged and disabled people doesn't cover people on Medicare unless they're in a nursing home, hospice or home and community-based services. Low-income Floridians on Medicare may get full Medicaid through SSI or Medically Needy; DCF checks every program you might fit when you apply.
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