North Carolina Medicare Savings Program 2026: Income Limits & How to Apply
North Carolina Medicare Savings Program: MQB Benefits, Limits and How to Apply
North Carolina’s Medicare Savings Programs, commonly called MQB programs, may pay the Medicare Part B premium. MQB-Q may also protect eligible beneficiaries from Medicare-covered deductibles, coinsurance and copayments.
Updated with April 2026 limits and the July 2026 family-planning coverage change
Independent educational resource: This website is not Medicare, NC Medicaid, ePASS, a county Department of Social Services or an insurance company. The county DSS and NC Medicaid make official eligibility decisions. Approval, effective dates, premium adjustments and refunds are not guaranteed.
Quick Answer
North Carolina calls its three main Medicare Savings Programs MQB-Q, MQB-B and MQB-E.
- MQB-Q is North Carolina’s QMB program and may pay Medicare premiums plus Medicare-covered cost-sharing.
- MQB-B is North Carolina’s SLMB program and pays the Medicare Part B premium.
- MQB-E is North Carolina’s QI program and pays the Part B premium, subject to annual renewal and available funding.
Apply online through NC ePASS, by telephone through your county DSS, in person, or by sending a signed paper application to the DSS office serving the county where you live.
For rough 2026 gross-income screening, the upper monthly amounts are $1,350 for one person under MQB-Q, $1,616 under MQB-B and $1,816 under MQB-E. North Carolina uses lower countable-income standards after applying permitted exclusions.
Table of Contents
- North Carolina MQB program names
- Benefits and July 2026 update
- 2026 income and resource limits
- Application options
- Apply online through ePASS
- Apply by telephone
- Paper application and supplements
- Documents to prepare
- What happens after applying
- Coverage and retroactive months
- Free official help
- Renewal and reporting changes
- Denials and hearing rights
- Frequently asked questions
What Is the Medicare Savings Program Called in North Carolina?
North Carolina commonly uses the abbreviation MQB for Medicaid for Qualified Medicare Beneficiaries. The state names differ from the names used on Medicare.gov.
| National Name | North Carolina Name | Main Benefit |
|---|---|---|
| Qualified Medicare Beneficiary | MQB-Q | Medicare premiums and Medicare-covered deductibles, coinsurance and copayments |
| Specified Low-Income Medicare Beneficiary | MQB-B | Medicare Part B premium |
| Qualifying Individual | MQB-E | Medicare Part B premium, subject to annual funding and renewal rules |
When contacting DSS, ask to be screened for MQB-Q, MQB-B and MQB-E. You do not need to select the final category yourself. DSS reviews the application and assigns the correct program when eligibility requirements are met.
For general background, see our guide explaining what a Medicare Savings Program is or browse the Medicare Savings Programs information center.
MWD Is Not the Same as Federal QDWI
North Carolina’s Medicaid for Workers with Disabilities, often called MWD or HCWD, is a broader state Medicaid category for certain working people with disabilities. It is not the same program as the federal Qualified Disabled and Working Individual Medicare Savings Program.
A working person with a disability who lost premium-free Medicare Part A should ask DSS or NC SHIIP specifically about QDWI. Do not assume an MWD application automatically requests QDWI.
What Does North Carolina MQB Pay?
| Program | What It May Pay | Important Rule |
|---|---|---|
| MQB-Q / QMB | Part B premium, Part A premium when owed, and Medicare-covered deductibles, coinsurance and copayments | Provides federal QMB billing protection |
| MQB-B / SLMB | Medicare Part B premium | Does not generally provide QMB’s Medicare cost-sharing protection |
| MQB-E / QI | Medicare Part B premium | Must be renewed for each calendar year and is subject to available funding |
How Much Could Part B Premium Assistance Be Worth?
The standard Medicare Part B premium is $202.90 per month in 2026. If North Carolina pays the full standard premium for 12 covered months, the potential premium assistance equals $2,434.80.
The actual result depends on the approved program, effective date and premium owed. An income-related premium adjustment or late-enrollment penalty may be treated differently.
Review the official 2026 Medicare Part B premium information.
New for July 2026: MQB-Q and MQB-B family-planning coverage
Effective under NC Medicaid Direct, people enrolled in MQB-Q or MQB-B now also receive Family Planning Program coverage. Covered services may include contraception, health screenings, testing and treatment for sexually transmitted infections, related laboratory services, HPV vaccines and sterilization procedures.
MQB-E beneficiaries who receive only Part B premium assistance are not included in this added family-planning coverage. This separate benefit does not change the rule that MQB-B generally pays only the Part B premium for ordinary Medicare costs.
Read the official NC Medicaid July 2026 family-planning update.
QMB Billing Protection
Medicare providers and suppliers generally may not bill an active QMB beneficiary for Medicare Part A or Part B deductibles, coinsurance or copayments on Medicare-covered services and items.
If you receive an improper bill:
- Confirm that MQB-Q was active on the date of service.
- Compare the bill with the Medicare Summary Notice.
- Show the provider proof of QMB or Medicaid status.
- Ask the billing office to verify eligibility and remove prohibited cost-sharing.
- Contact NC SHIIP or 1-800-MEDICARE if billing continues.
See our detailed QMB Medicare Savings Program guide.
North Carolina Medicare Savings Program Limits for 2026
Two sets of numbers can appear in Medicare Savings Program information:
- Practical gross-income screening figures include the standard $20 general income exclusion.
- North Carolina’s official countable-income standards show the amount after applicable exclusions are applied.
Report gross income as requested. Do not subtract the $20 yourself unless the application specifically tells you to do so. DSS calculates countable income.
Practical Gross-Income Screening
| Program | Individual Monthly Screening | Couple Monthly Screening | Resource Limit |
|---|---|---|---|
| MQB-Q / QMB | Up to $1,350 | Up to $1,824 | $9,950 individual / $14,910 couple |
| MQB-B / SLMB | Up to $1,616 if not MQB-Q | Up to $2,184 if not MQB-Q | $9,950 individual / $14,910 couple |
| MQB-E / QI | Up to $1,816 if not MQB-Q or MQB-B | Up to $2,455 if not MQB-Q or MQB-B | $9,950 individual / $14,910 couple |
Official North Carolina Countable-Income Standards
The following state standards are effective April 1, 2026:
| Program | Individual Countable Income | Couple Countable Income |
|---|---|---|
| MQB-Q | Up to $1,330 | Up to $1,804 |
| MQB-B | $1,330.01 to $1,596 | $1,804.01 to $2,164 |
| MQB-E | $1,596.01 to $1,796 | $2,164.01 to $2,435 |
Why the numbers differ: Medicare.gov’s screening figures already include the standard $20 general income exclusion. North Carolina’s state chart shows countable-income levels before that screening adjustment is added back.
Review the official federal 2026 Medicare Savings Program limits.
Our related guides explain MSP income-limit calculations and Medicare Savings Program resource limits.
What Resources May Count?
DSS may ask about:
- Checking and savings accounts
- Certificates of deposit
- Cash
- Stocks, bonds and mutual funds
- Retirement and investment accounts
- Life-insurance cash value
- Burial funds or funeral contracts
- Trusts, promissory notes or similar arrangements
- Real estate other than the principal home
The principal home, one vehicle, household goods and certain burial property may be excluded. Report what the application or DSS requests and allow the eligibility worker to apply the exclusions.
How to Apply for MQB in North Carolina
North Carolina accepts Medical Assistance applications through several routes.
| Application Route | What to Do |
|---|---|
| Online | Apply through NC ePASS and select Medical Assistance |
| Telephone | Call the DSS office serving your county and ask to submit a Medical Assistance application by phone |
| Paper | Complete DHB-5200 and send it to the local county DSS |
| In person | Visit the local DSS office; calling ahead may reduce waiting |
| Email, fax or drop box | Use the method and current address or number confirmed by the county DSS office |
On North Carolina applications, Medicaid may be called Medical Assistance. Clearly report Medicare enrollment and state that you want to be screened for MQB.
Option 1: Apply Online Through NC ePASS
Use the official NC ePASS portal. An NCID account is required to begin the online application.
Step 1: Start a Medical Assistance Application
Select the option to apply and choose Medical Assistance or Medicaid. The portal may not display a large button labeled Medicare Savings Program.
Step 2: Report Medicare Coverage
Enter:
- Medicare number
- Part A and Part B enrollment
- Medicare effective dates when requested
- Other health-insurance information
When a comments field is available, write: “I have Medicare and want to be screened for MQB-Q, MQB-B and MQB-E.”
Step 3: Enter Household and Income Information
Report all requested household members and income sources, including Social Security, Railroad Retirement, pensions, wages, self-employment, annuities and other regular payments.
Use gross amounts before deductions unless the field specifically asks for a net amount.
Step 4: Report Resources
Complete all account, investment, insurance, property and burial-fund questions presented by ePASS. Include jointly owned resources and explain ownership when needed.
Step 5: Upload Available Proof
Upload readable, complete copies. A cropped bank screenshot that hides the account owner, statement date or balance may not be accepted.
Step 6: Submit and Keep Confirmation
Review names, Medicare information, income figures, resource balances and mailing address. Save the confirmation number or submission page.
Continue checking ePASS, regular mail and telephone messages for DSS requests.
Apply Through NC ePASS
Choose Medical Assistance and clearly report your Medicare coverage.
Option 2: Apply by Telephone
North Carolina allows Medical Assistance applications to be completed by telephone through the local county DSS office.
- Use the official county DSS directory.
- Call the office serving the county where you live.
- Say that you have Medicare and want to apply for MQB-Q, MQB-B and MQB-E.
- Complete the application questions during the call.
- Ask how the required signature will be completed.
- Return any mailed signature page promptly.
- Write down the application date, worker’s name and confirmation information.
Telephone signature warning: A telephone application still requires a valid signature. North Carolina may mail a signature page. Failure to return it can cause the application to be denied.
The NC Medicaid Contact Center at 1-888-245-0179 can provide general assistance and help locate the correct county. It is open Monday through Friday from 8 a.m. to 5 p.m., excluding state holidays. TTY users may call 711 or use RelayNC.
Option 3: Apply With a Paper Form
The official NC Medicaid application page currently links:
DHB-5200
Application for Health Coverage & Help Paying Costs
Download the official DHB-5200 application.
Complete the form, report Medicare coverage, write “MQB or Medicare Savings Program” in an appropriate comments area, sign it and send it to your county DSS office.
Do Not Wait for Every Document
A signed application can establish the filing date even when some proof is still being gathered. North Carolina requires at least identifying information for an applicant, a mailing address and a valid signature.
DSS may contact you for missing information after the application is filed. Respond by the deadline in the notice.
DSS May Request Appendix D
DHB-5200 does not contain every detailed non-MAGI resource question that may be required for an aged, blind or disabled Medicaid category.
DSS may request Appendix D for income and resources or another county-approved verification form. Complete any supplement requested by DSS.
Appendix E and Prior Medical Bills
DHB-5200 asks whether help is needed for medical bills from the previous three months. DSS may request Appendix E for prior medical bills.
Checking that box does not guarantee retroactive MQB coverage. MQB-Q, MQB-B and MQB-E have different effective-date rules.
Where to Send the Paper Application
North Carolina does not use one statewide mailing address for every MQB application.
Send the application to the Department of Social Services serving the county where you live. Use the county directory to confirm the current:
- Mailing address
- Email address, when accepted
- Fax number, when accepted
- Drop-box location
- Walk-in hours
Keep a complete copy and proof of mailing, fax, email or delivery. Never send your only Medicare card, Social Security card or original financial document.
Documents and Information to Prepare
| Information Type | Examples to Prepare |
|---|---|
| Medicare and identity | Medicare card, Social Security number, legal name, date of birth, identification and North Carolina address |
| Income | Social Security record, pension statement, Railroad Retirement statement, pay stubs, self-employment records and annuity documentation |
| Resources | Complete bank statements, certificates of deposit, investments, retirement accounts, life insurance, property and burial arrangements |
| Other coverage | Medicare Advantage, Medigap, employer coverage, TRICARE or other health-insurance information |
| Representation | Power of attorney, guardianship or authorized-representative documentation when applicable |
Provide complete statement pages. Do not black out deposits or transfers that DSS may need to review.
What Happens After You Apply?
The county DSS verifies Medicare enrollment, residence, income, resources and other eligibility information.
Processing Standard
The policy standard for MQB-Q, MQB-B and MQB-E applications is generally 45 days. Missing documents, an unsigned telephone application or difficulty verifying Medicare can delay the decision.
The broader NC Medicaid application page notes that disability-based applications can take up to 90 days. MQB cases ordinarily use the 45-day standard unless another disability determination is required.
Watch for Verification Requests
Check:
- Postal mail
- The ePASS account
- Telephone calls and voicemail
- Email or text notifications linked to the case
Submit requested documents before the deadline and keep transmission proof.
When Will the Part B Deduction Stop?
Approval does not always change the Social Security payment immediately. North Carolina must send eligibility information to federal Medicare systems.
Keep the approval notice and compare:
- The approved MQB category
- The effective date
- Future Social Security or Railroad Retirement payments
- Medicare premium bills
- Any later premium adjustment or reimbursement notice
Contact DSS when deductions continue beyond the period explained in the approval notice. Do not immediately file a duplicate application unless instructed.
Coverage Dates and Prior-Month Assistance
| Program | North Carolina Timing Rule |
|---|---|
| MQB-Q | Begins on the first day of the month after DSS approves or disposes the case. MQB-Q is not retroactive. |
| MQB-B | May cover the application month and up to three prior months when all eligibility conditions were met and conflicting coverage rules do not apply. |
| MQB-E | May cover up to three prior months, but never a month before January of the current calendar year. |
Eligibility must be established for every earlier month. A request for previous-month help does not guarantee reimbursement.
Extra Help With Prescription Costs
People approved for MQB-Q, MQB-B or MQB-E generally qualify automatically for Medicare Part D Extra Help.
Extra Help may reduce Part D premiums, deductibles and prescription cost-sharing. In 2026, qualifying MSP beneficiaries generally pay no more than $12.65 for each covered drug, and some people pay less.
Review the official Medicare Extra Help information.
Can an Extra Help Application Start an MQB Review?
When someone applies for Extra Help through Social Security, Social Security generally sends application data to the state to begin an MSP review unless the applicant opts out.
Do not rely only on that transfer when prompt premium assistance is needed. Apply directly through ePASS or county DSS and clearly request MQB.
Where to Get Free Help in North Carolina
| Help Needed | Official Resource |
|---|---|
| Apply online | NC ePASS |
| Application instructions | NC Medicaid How to Apply |
| County office, telephone application or paper submission | Local DSS directory |
| NC Medicaid general assistance | 1-888-245-0179, Monday-Friday 8 a.m.-5 p.m. |
| Free Medicare counseling | NC SHIIP: 1-855-408-1212 |
| Medicare or QMB billing problem | 1-800-MEDICARE or 1-800-633-4227 |
| Medicare TTY | 1-877-486-2048 |
| Social Security Extra Help | 1-800-772-1213, TTY 1-800-325-0778 |
NC SHIIP offers free, unbiased Medicare counseling Monday through Friday from 8 a.m. to 5 p.m. Counselors are available in every North Carolina county and do not sell or endorse insurance products.
How to Renew North Carolina MQB
MQB eligibility is reviewed periodically. MQB-E must be evaluated for each calendar year because it is the state’s QI category and funding is limited.
Depending on the renewal notice and county options, a renewal may be completed through enhanced ePASS, mail, telephone, in person, fax or email.
Keep your address, telephone number and email current. A missed renewal notice can cause premium assistance to end.
See our Medicare Savings Program renewal guide.
What to Do if DSS Denies the Application
Read the notice before filing another application.
Check whether the decision involved:
- An unsigned telephone application
- Income calculated above the standard
- Resources calculated above the limit
- A resource classified incorrectly
- Missing Appendix D or another supplement
- Missing bank, pension or Medicare proof
- A missed verification deadline
- Review under the wrong Medicaid category
Contact the county and ask whether missing or incorrect information can be corrected. If you disagree with the final decision, follow the hearing instructions and deadline printed on the eligibility notice.
Do not assume that a telephone call or new application automatically requests a hearing or preserves the deadline.
Use our guide on what to do when a Medicare Savings Program application is denied.
Does MQB Mean Full Medicaid?
Not always. MQB-B and MQB-E primarily provide Medicare premium assistance. MQB-Q provides Medicare premium and cost-sharing assistance, but the beneficiary may or may not qualify for a broader full-benefit Medicaid category.
The July 2026 family-planning addition for MQB-Q and MQB-B is a specific NC Medicaid Direct benefit and does not automatically convert every MQB beneficiary to full Medicaid.
Our MSP versus Medicaid guide explains the distinction.
North Carolina and Georgia Use Different Application Systems
The federal program categories are similar, but each state uses its own terminology and application process.
North Carolina uses MQB terminology, ePASS and county DSS offices. Georgia uses Georgia Gateway, Form 700 and county DFCS offices.
Read the previous state guide: Georgia Medicare Savings Program 2026 benefits, limits and application instructions.
Final North Carolina MQB Application Checklist
- ☐ Used NC ePASS, telephone, paper or an approved county submission method
- ☐ Clearly requested MQB-Q, MQB-B and MQB-E screening
- ☐ Reported Medicare Part A and Part B information
- ☐ Reported gross income as requested
- ☐ Reported applicant and spouse resources when applicable
- ☐ Signed the application or returned the telephone signature page
- ☐ Included readable copies of available documents
- ☐ Completed Appendix D or Appendix E when requested
- ☐ Confirmed the correct county DSS submission details
- ☐ Kept the confirmation, mailing, email, fax or delivery receipt
- ☐ Started checking ePASS, postal mail and voicemail for DSS notices
North Carolina Medicare Savings Program FAQs
What is the Medicare Savings Program called in North Carolina?
North Carolina generally calls the programs MQB. QMB is MQB-Q, SLMB is MQB-B and QI is MQB-E.
Where do I apply online?
Apply through NC ePASS. Select Medical Assistance, report Medicare coverage and clearly request MQB screening.
Can I apply by telephone?
Yes. Call the DSS office serving your county. Complete the questions and return any signature page mailed by DSS.
Which paper application should I use?
The current NC Medicaid application page links DHB-5200, Application for Health Coverage and Help Paying Costs.
Why might DSS request Appendix D?
Appendix D collects detailed income and resource information for non-MAGI Medicaid categories. DHB-5200 may not contain every account or property question needed for an MQB decision.
What are the 2026 gross-income screening amounts?
The practical monthly screening amounts are $1,350 individual and $1,824 couple for MQB-Q, $1,616 and $2,184 for MQB-B, and $1,816 and $2,455 for MQB-E. DSS calculates countable income.
Do MQB-Q and MQB-B include family-planning services?
As of July 2026, NC Medicaid Direct gives MQB-Q and MQB-B beneficiaries Family Planning Program coverage. MQB-E is not included in this added benefit.
Can MQB cover earlier months?
MQB-Q is not retroactive. MQB-B may cover up to three prior months. MQB-E may also cover up to three prior months but not a month before January of the current year.
How long does an MQB application take?
The general policy standard is 45 days. Missing verification, an unsigned application or unresolved Medicare information can cause delays.
Does MQB-Q protect me from Medicare copays?
Yes. Providers generally may not bill an active QMB beneficiary for Medicare Part A or Part B deductibles, coinsurance or copayments on Medicare-covered services.
Does MQB approval include Extra Help?
MQB-Q, MQB-B and MQB-E recipients generally qualify automatically for Medicare Part D Extra Help.
Does MQB need to be renewed?
Yes. North Carolina periodically reviews eligibility. MQB-E is reevaluated for each calendar year and remains subject to available funding.
Is North Carolina MWD the same as QDWI?
No. MWD or HCWD is a separate North Carolina Medicaid category. Ask DSS or SHIIP specifically about federal QDWI when you are working, disabled and paying a Part A premium.
What should I do after a denial?
Read the notice, contact county DSS about corrections and follow the hearing instructions and deadline printed on the notice if you disagree.
Apply Through the Method That Works for You
You do not need to understand every MQB calculation before applying. Report your Medicare, income, resources and household information accurately, submit a valid signature and respond promptly to DSS requests.
Apply online through ePASS, call the county DSS office, visit in person or send the paper application through a county-approved method.
Use an Official North Carolina Application Route
Applying is free. County DSS makes the official eligibility decision.
