Quick answers
- What are Oregon's Medicare Savings Program income limits?
- QMB is for income up to 100% of the federal poverty level, SMB up to 120%, the SMF benefit from 120% to 135%, and QDWI up to 200%. ODHS lists the monthly dollar limits, which it updates each March.
- Does Oregon have an asset limit for Medicare Savings Programs?
- Not for QMB, SMB or the SMF benefit. Oregon eliminated their resource limits effective January 1, 2016, and OAR 461-160-0015 excludes all resources for them. QDWI still has a resource limit.
- How do I apply for a Medicare Savings Program in Oregon?
- Apply online at one.oregon.gov (benefits.oregon.gov), call the ONE Customer Service Center at 1-800-699-9075 (TTY 711), or visit a local ODHS office. ODHS says it notifies you of its decision within 45 days.
- Does Oregon recover Medicare Savings Program payments from my estate?
- Oregon's rule OAR 461-135-0835 excludes correctly made payments for Medicare cost sharing on or after January 1, 2010 from estate claims. Other Medicaid benefits can be different, so ask ODHS about your situation.
- Do I also get Extra Help?
- Yes. If you qualify for QMB, SMB or the SMF benefit, you get Extra Help with Part D drug costs automatically, without a separate application.
Medicare Savings Programs (MSPs) are paid for by Medicaid and run by each state. In Oregon, ODHS runs them and uses its own names for two of the four programs: SMB for what most states call SLMB, and the SMF benefit for what most states call QI. The biggest Oregon difference is that QMB, SMB and SMF have no asset test: your savings don't count.
Oregon's four Medicare Savings Programs
| Program (Oregon name) | Income limit | What it pays |
|---|---|---|
| QMB — Qualified Medicare Beneficiary | Up to 100% of the federal poverty level | Part A premium (if you have one), Part B premium, and Medicare deductibles, coinsurance and copays |
| SMB — Specified Low-Income Medicare Beneficiary (SLMB) | Up to 120% | Part B premium |
| SMF benefit — Qualifying Individual (QI) | From 120% to 135% | Part B premium. Enrollment is capped each year by federal funding, and it is not available to people eligible for other Oregon Medicaid |
| QDWI — Qualified Disabled Working Individual | Up to 200% | Part A premium only, for people under 65 who lost premium-free Part A because they went back to work. ODHS notes most Oregonians in this situation use Employed Persons with Disabilities (EPD) instead |
Oregon's rules are OAR 461-135-0730 (requirements for QMB, SMB and SMF) and OAR 461-155-0295 (income standards).
Income limits
The limits are percentages of the federal poverty level. ODHS publishes the monthly dollar amounts for individuals and couples on its Medicare Savings Programs page, and updates them each March (the current table covers March 2026 to February 2027). Use ODHS's table: it is the one that decides your case.
Oregon's dollar amounts are not the same as the national figures shown on Medicare.gov, so always check the ODHS chart. Some income doesn't count, so apply even if you think you are slightly over. See what the Oregon Medicare Savings Program income limits are.
No asset test for QMB, SMB or SMF
ODHS says there are no asset limits for these programs in Oregon. Its transmittal APD-PT-21-041 records that the resource limits for QMB, SMB and SMF were eliminated effective January 1, 2016, and Oregon's resource rule, OAR 461-160-0015, excludes all resources for those three programs. QDWI is the exception: it still has a resource limit. In most states, people with savings above the federal limit ($9,950 single or $14,910 for a couple in 2026, per Medicare.gov) can't qualify. In Oregon, savings, a second car or investments don't stop you from getting QMB, SMB or SMF if your income is within the limit. See does Oregon have an asset limit for Medicare Savings Programs?
What each program pays
QMB
QMB pays your Part B premium ($202.90 a month standard in 2026), your Part A premium if you don't get premium-free Part A, and your Medicare deductibles, coinsurance and copays. OHA says QMB members pay no Part A or Part B deductibles, coinsurance or copays. Many QMB members also have OHP ("QMB + OHP with Limited Drug"); some get an Oregon Health ID only so the state can pay their Medicare cost sharing.
SMB and the SMF benefit
Both pay the Part B premium, which then stops being taken out of your Social Security check. They don't pay deductibles or coinsurance.
QDWI
QDWI pays only the Part A premium, for working people under 65 with disabilities who lost premium-free Part A.
QMB billing protection
If you have QMB, federal law says Medicare providers may not bill you for Medicare deductibles, coinsurance or copays for covered services. This applies whether you have Original Medicare or a Medicare Advantage plan. If you get a bill:
- Tell the office you have QMB. Show your Medicare card and your Oregon Health ID card.
- Ask them to bill correctly. The provider should bill Medicare and the state, not you.
- Get help if it continues. Call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048). Medicare can confirm your QMB status to the provider.
How to apply in Oregon
- Gather documents. Your Medicare card and proof of income (Social Security, pension, wages). For QMB, SMB and SMF there is no asset test.
- Apply. Online at one.oregon.gov (also reached at benefits.oregon.gov), by calling the ONE Customer Service Center at 1-800-699-9075 (TTY 711) to get a mailed application, or at a local ODHS office. ODHS's Aging and People with Disabilities line, 1-855-673-2372, can also connect you with local offices. The same application covers OHP.
- Or start with Extra Help. Medicare.gov says that when you apply for Extra Help with Social Security, your information is also sent to the state to start a Medicare Savings Program application, unless you opt out.
- Wait for the decision. ODHS says it notifies you within 45 days. More detail: how to apply for a Medicare Savings Program in Oregon.
- Check your Social Security check. Once the state starts paying your Part B premium, it is no longer deducted. It can take a few months, and premiums deducted in the meantime are usually refunded.
Estate recovery and Medicare Savings Programs
Medicaid programs can make claims against the estates of some people who received benefits. Oregon's rule on limits to estate claims, OAR 461-135-0835, says that all correctly made payments on or after January 1, 2010 for Medicare cost sharing are excluded from a claim. Other Medicaid benefits, such as long-term care, follow different rules, so ask ODHS how they apply to you.
Medicare Savings Programs and Extra Help
If you qualify for QMB, SMB or the SMF benefit, you get Extra Help with Part D drug costs automatically. Because Oregon's QMB, SMB and SMF have no asset test and Extra Help does, applying for an MSP can be the easier way to get Extra Help if your savings are above Extra Help's limit. See Extra Help in Oregon.
Related guides
- The Oregon Health Plan and Medicare
- Medicare and OHP together (dual eligible)
- Medicare costs in Oregon
- Does Oregon estate recovery apply to Medicare Savings Programs?
If you'd like help understanding how an MSP fits with your Medicare plan choices, you can request a call from a licensed insurance agent.
Sources
- Oregon Department of Human Services — Medicare Savings Programs (programs, limits, no asset limits, how to apply)
- ODHS transmittal APD-PT-21-041 (December 6, 2021) — QMB, SMB and SMF resource limits eliminated January 1, 2016
- OAR 461-160-0015, Resources; general information (resources excluded for QMB, SMB and SMF) (ODHS rules)
- OAR 461-135-0835, Limits on estate claims (ODHS rules)
- Oregon Health Authority — OHP and Medicare (QMB members)
- Medicare.gov — Medicare Savings Programs (2026 national limits; QMB billing protection)
- CMS — Qualified Medicare Beneficiary program and billing prohibition
Every question in this guide
- Will Oregon take my house if I get help paying for Medicare?
- Does Oregon have an asset limit for Medicare Savings Programs?
- How do I apply for a Medicare Savings Program in Oregon?
- How do I get Extra Help paying for prescription drugs in Oregon?
- What are the Oregon Medicare Savings Program income limits?
Frequently asked questions
What is QMB and who qualifies in Oregon?
QMB (Qualified Medicare Beneficiary) is the Medicare Savings Program with the most help. It pays your Part A premium if you have one, your Part B premium ($202.90 a month in 2026), and Medicare deductibles, coinsurance and copays. In Oregon it is for people with Medicare and income up to 100% of the federal poverty level, with no asset limit.
Do I have to apply separately for Extra Help if I qualify for a Medicare Savings Program?
No. People enrolled in QMB, SMB or the SMF benefit get Extra Help (the Part D Low-Income Subsidy) automatically. Medicare mails a notice.
Can a doctor bill me for Medicare copays if I have QMB?
No. Federal law bars Medicare providers from billing people with QMB for Medicare deductibles, coinsurance and copays, including in Medicare Advantage plans. If you get a bill, tell the provider you have QMB and show your Medicare and Oregon Health ID cards; if it continues, call 1-800-MEDICARE.
What is the SMF benefit in Oregon?
SMF is Oregon's name for the Qualifying Individual (QI) program. It pays the Part B premium for people with income between 120% and 135% of the federal poverty level. Federal funding is limited each year, so ODHS must stop enrolling people if the cap is reached, and it isn't available to people who qualify for other Oregon Medicaid.
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