Medicare Savings Programs in New York

New York absorbed SLMB. Because its QMB limit already reaches $1,856 a month, the income band SLMB exists to cover federally — between 100% and 120% of the poverty guideline — sits entirely inside New York's QMB band. Someone who would be an SLMB case in most states is a QMB case here, which pays more: QMB covers deductibles, coinsurance and copayments, and SLMB does not.

The practical effect is that being screened against the federal SLMB limit of $1,616 understates what New York offers by a wide margin, and searching the state's site for SLMB returns nothing.

New York applies no resource limit to the savings programmes. That is worth stating precisely, because the state does apply a resource limit to full Medicaid for dual eligibles — $33,038 for one person — and the two are easy to conflate. A person with savings well above that figure can still qualify for QMB in New York, because QMB is not full Medicaid.

This is the part a state agency page cannot tell you, because it has only its own figures. We hold all 51.

• Income. New York’s QMB limit of $1,856 is the 7th highest of the 46 jurisdictions publishing a comparable figure, at 137% of the federal screening limit. The highest is the District of Columbia at $4,010; most states sit at $1,350 or the bare $1,330 beneath it.
• Resources. New York is one of 12 jurisdictions applying no resource test. The others are Alabama, Connecticut, Delaware, Louisiana, Maine, Massachusetts, Mississippi, New Mexico, Oregon, Vermont and Washington.

The full table of all 51 carries every figure with the agency page it came from.

All three programmes carry full Extra Help for Part D automatically — federal regulation treats anyone eligible for QMB, SLMB or QI as a full-subsidy individual, with no separate application. And the Part D late enrollment penalty, which is otherwise permanent, is not charged while someone is subsidy-eligible. Qualifying in New York therefore stops a penalty being charged for as long as the eligibility lasts — a waiver for that period rather than a cancellation, since a later gap in coverage without Extra Help can bring one back.

Applications go to your local Department of Social Services, or online through NY State of Health — not to Medicare, and not to this site. The form is DOH-4328. Medicaid Helpline 1-800-541-2831. Applying for Extra Help through Social Security also starts a savings-programme application with the state unless you ask it not to. Free, unbiased help is available from a State Health Insurance Assistance Program counsellor at shiphelp.org.