What are North Carolina's rules?
North Carolina calls its Medicare Savings Programs MQB: MQB-Q (QMB), MQB-B (SLMB) and MQB-E (QI). They are part of NC Medicaid and are set out in the Aged, Blind and Disabled Medicaid Manual. Your county Department of Social Services (DSS) decides eligibility. North Carolina uses the federal minimum income levels and keeps an asset test at the federal standard.
| Program | Countable income (federal poverty level) | What NC Medicaid pays |
|---|---|---|
| MQB-Q (Qualified Medicare Beneficiary) | Up to 100% | Part B premium, any Part A premium, Medicare deductibles and coinsurance |
| MQB-B (Specified Low-Income Medicare Beneficiary) | Over 100%, up to 120% | Part B premium |
| MQB-E (Qualifying Individual) | Over 120%, up to 135% | Part B premium, only for people not eligible for other NC Medicaid |
Resource limit for all three programs: $9,950 for one person, $14,910 for a couple. NC Medicaid's chart MA-2252 lists the exact monthly income amounts for one to eight people, effective April 1, 2026. This screener doesn't print those amounts; it estimates your income as a share of the federal poverty level, the way the chart is built.
How does North Carolina count income and savings?
The county counts income the way Supplemental Security Income does. If your Part B premium is taken out of your Social Security check, add it back: the county counts your income before that deduction. A small general income exclusion comes off first. Wages get more: after a work-expense exclusion, only half of the remaining earnings count (NC Medicaid manual MA-2260). The screener applies those steps, which is why it asks for work earnings separately.
Two more North Carolina rules: the county compares your income to the limit for your family size (you, your spouse and dependent children under 18 at home), and for MQB-Q it ignores the January Social Security cost-of-living increase until the new limits start in April. For resources, the county counts what you have at the first moment of the month. It doesn't count the home you live in, household goods, one vehicle used for transportation, burial spaces or irrevocable burial contracts, or retirement accounts you can't withdraw in a lump sum. Bank accounts, CDs, stocks, bonds and other real estate generally count.
Does Extra Help come with it?
Yes. Everyone who qualifies for MQB-Q, MQB-B or MQB-E 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 MQB 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 North Carolina and the drug cap estimator.
How do I apply in North Carolina?
- Make sure you have Medicare. MQB-Q needs Part A and Part B; MQB-B and MQB-E need Part A. If you aren't enrolled, sign up through Social Security; NC Medicaid can pay the Part A premium for MQB-Q members who don't get premium-free Part A.
- Apply with NC Medicaid. Apply online through ePASS (you'll need an NCID), or with your county DSS in person, by phone, by mail, email or fax.
- Have proof ready. Your Social Security award letter, pension statements (for example from the North Carolina Retirement Systems), recent pay stubs, and bank, investment and life insurance statements.
- Watch for the decision. The processing standard is 45 days. MQB-Q starts the first day of the month after the decision, with no retroactive months; MQB-B and MQB-E can go back up to three months if you qualified then.
Help from MQB alone isn't subject to estate recovery under federal law. If you also qualify for full NC Medicaid, read NC Medicaid and Medicare and Medicare Savings Programs in North Carolina. Late-enrollment penalties are covered on the penalty calculator.
Sources
- NC Medicaid — MA-2252, Non-MAGI Medicaid Income/Reserve Limits, effective April 1, 2026 (PDF)
- NC Medicaid — MA-2260, Financial Eligibility Regulations (income exclusions, family size budgeting) (PDF)
- NC Medicaid — MA-2230, Financial Resources (PDF)
- NC Medicaid — MA-2130, Qualified Medicare Beneficiaries - Q (PDF)
- NC Medicaid — MA-2160, Qualified Individual 1 (MQB-E) (PDF)
- NC Medicaid — How to apply for NC Medicaid
- 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 North Carolina?
You may, if your countable income is up to 135% of the federal poverty level and your countable resources are within the MQB limit of $9,950 for one person or $14,910 for a couple. Extra Help with drug costs goes up to 150%. The screener above gives an estimate; your county DSS makes the decision.
Does North Carolina have an asset limit for Medicare Savings Programs?
Yes. NC Medicaid's chart MA-2252 sets the MQB reserve limit at $9,950 for one person and $14,910 for a couple, the federal standard. The home you live in and one vehicle used for transportation don't count.
Why does the screener ask for work earnings separately?
Because North Carolina counts wages more gently than other income. After a small general exclusion, the county subtracts a work-expense exclusion and then half of the remaining earnings (NC Medicaid manual MA-2260), so working people can qualify with higher gross pay.
Where do I apply in North Carolina?
Online through ePASS, or with your county Department of Social Services in person, by phone, mail, email or fax. The NC Medicaid Contact Center, 1-888-245-0179, can help you find your DSS. If you qualify for MQB, you also get Extra Help with Part D drug costs automatically.
My savings are over the limit. Is there any other help?
Possibly. Extra Help, which Social Security runs, has a higher resource limit of $18,090 for one person or $36,100 for a couple in 2026, counting money set aside for burial. The screener checks it for you.
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