Tennessee Medicare Savings Programs: QMB, SLMB, QI, and QDWI

Tennessee’s Medicare Savings Programs are four TennCare-run programs that help people with limited income pay for Medicare. Depending on which tier you qualify for, the state covers your Medicare Part B premium (currently $202.90 a month in 2026), your Part A premium if you owe one, and in the top tier your Medicare deductibles, coinsurance, and copays as well.¹ To qualify for any of the four, you must live in Tennessee, be a U.S. citizen or eligible non-citizen, and be entitled to Medicare Part A.²

What Each of the Four Programs Pays

Qualified Medicare Beneficiary (QMB)

QMB is the most generous tier. It pays Part A premiums (if you owe one), Part B premiums, and all deductibles, coinsurance, and copays for Medicare-covered services.³⁴⁵

Specified Low-Income Medicare Beneficiary (SLMB)

SLMB pays the Part B premium only. It does not cover deductibles, coinsurance, or copays. If you had previously declined Part B, being approved for SLMB automatically enrolls you in Part B.²

Qualifying Individual (QI)

QI also pays only the Part B premium, but for people with slightly higher income than SLMB allows. Two catches: you can’t be enrolled in any other category of Medicaid at the same time, and QI runs on a capped federal appropriation, so enrollment can close for the year once Tennessee’s allocation is used up.⁶

Qualified Disabled and Working Individual (QDWI)

QDWI is a narrow program for people under 65 who lost premium-free Part A because they went back to work. It pays only the Part A premium. Income limits are higher than the other tiers, but the resource limit is much lower.⁷

2026 Income and Resource Limits

Tennessee uses the federal limits and applies a standard $20 monthly disregard to unearned income. The state has not dropped the asset test for any tier.⁸ For 2026:⁹

QMB (up to 100% of the federal poverty level): $1,350 a month for an individual, $1,824 for a couple. Resources capped at $9,950 individual, $14,910 couple.
SLMB (100% to 120% FPL): $1,616 individual, $2,184 couple. Same resource limits as QMB.
QI (120% to 135% FPL): $1,816 individual, $2,455 couple. Same resource limits.
QDWI (up to 200% FPL): $5,405 individual, $7,299 couple. Resources capped at $4,000 individual, $6,000 couple.³

Resource limits don’t count $1,500 set aside for burial. If you work, Tennessee further excludes the first $65 of earned income and half of what remains. A separate cost-of-living adjustment deduction keeps people from losing eligibility in the window between Social Security’s January raise and the release of updated poverty levels.² If your income looks a little high on paper, apply anyway. The deductions can bring you under the limit.

Extra Help With Prescription Drugs Comes With It

Approval for QMB, SLMB, or QI automatically qualifies you for Medicare’s Part D Extra Help, also called the Low-Income Subsidy. In 2026, Extra Help caps your out-of-pocket cost at $12.65 per covered prescription.³ The Social Security Administration has estimated the benefit’s annual value at about $5,700.¹⁰ If you weren’t already in a Part D plan, Extra Help also waives any late enrollment penalty you’d otherwise owe.

How to Apply

Tennessee uses the same application for Medicare Savings Programs that it uses for all other TennCare coverage. There is no separate MSP form. You can apply through any of these channels:¹¹

Online at TennCareConnect.TN.gov. The portal lets you apply, upload documents, check status, and report changes. Plan on 30 to 60 minutes.
By phone at 855-259-0701. For hearing or speech impairments, the Tennessee Relay Service is 800-848-0298.
By paper. Print the application from the TennCare site and mail it to TennCare Connect, P.O. Box 305240, Nashville, TN 37230-5240, or fax it to 855-315-0669.
In person at a local Department of Human Services office.¹²

Have Social Security numbers and birth dates for everyone on the application, income documentation like pay stubs and bank statements, information on any existing health insurance, and details about assets such as vehicles and property. If something is missing, send the application anyway. TennCare will write back asking for the specific items it needs.¹²

Federal rules give the state 45 days from receipt of a complete application to make an eligibility decision.¹³ QMB coverage starts on the first day of the month after TennCare has everything it needs. SLMB and QI can be backdated up to three months before the application date if you were eligible then.

Renewing Each Year

MSP coverage has to be renewed every year. TennCare first tries to verify eligibility automatically from federal data like tax records. If it can’t, a renewal packet comes in the mail. Review the pre-filled information, note any changes, sign, and return it. The deadline is generally 40 days from the date on the letter.¹⁴

Miss the deadline and coverage ends. You then have a 90-day reconsideration window from your last day of coverage to submit the information and potentially have coverage restored without starting a fresh application.¹⁴ Renewals can be done online, by phone, by mail, by fax, or in person. The renewal instructions tell MSP members who need help to call the Tennessee SHIP helpline at 877-801-0044 and ask for assistance with the TennCare renewal packet for Medicare cost-sharing.¹⁵

Free Help With Your Application

Tennessee’s State Health Insurance Assistance Program (TN SHIP), run through the Tennessee Commission on Aging and Disability, provides free one-on-one counseling for Medicare beneficiaries. Counselors meet in person or by phone, can work with a family member or friend you authorize, and offer translation services in more than 20 languages.¹⁶ Reach TN SHIP at 877-801-0044 (TTY: 800-848-0299) or by email at dda.ship@tn.gov. If you get voicemail, counselors typically return calls within two business days.¹⁷

If You Have Both Medicare and TennCare: A 2026 Deadline

Many MSP recipients also qualify for a Dual Eligible Special Needs Plan (D-SNP), a Medicare Advantage plan built for people with both Medicare and Medicaid. D-SNPs often add dental, vision, hearing, food, and transportation benefits beyond Original Medicare.¹⁸

Starting January 1, 2027, Tennessee will require your D-SNP and your TennCare Medicaid plan to be with the same company. If they don’t match by December 31, 2026, you’ll be disenrolled from your D-SNP and moved back to Original Medicare. A special enrollment period runs from June 1 through October 31, 2026, so you can align the two plans. The TN SHIP helpline (877-801-0044) can walk you through your options.¹⁸

1
CMS. 2026 Medicare Parts B Premiums and Deductibles
2
TennCare. Specified Low-Income Medicare Beneficiary Policy Manual
3
Medicare.gov. Medicare Savings Programs
4
CMS. Prohibition on Billing Qualified Medicare Beneficiaries
5
CMS. Qualified Medicare Beneficiary Program
6
KFF. Eligibility for Medicare Savings Programs for Qualifying Individuals
7
TennCare. TennCare Eligibility Reference Guide
8
TennCare. Qualifying Individuals Policy Manual
9
SSA. Medicare Savings Programs Income and Resource Limits
10
NCOA. What Are Medicare Savings Programs
11
TennCare. How Do I Apply for TennCare
12
TennCare. TennCare Paper Application
13
Center for Medicare Advocacy. Medicare Savings Programs
14
TennCare. TennCare Redetermination
15
TennCare. Renewal Packet Instructions
16
FTAAAD. SHIP Program
17
SHIP Help. Tennessee SHIP
18
TennCare. Dual Eligible Special Needs Plan