What QMB Plus pays in Oklahoma
- Part B premium. OHCA pays it through the Part B buy-in (OAC 317:35-1-2). The standard premium is $202.90 a month in 2026.
- Part A premium, if you owe one. Most people get Part A without a premium. If you don't, OHCA's Part A buy-in pays it for QMBP members.
- Medicare cost sharing. Deductibles (the 2026 Part B deductible is $283), coinsurance and copays for Medicare-covered care.
- Extra Help. You get Extra Help with Part D drug costs automatically. See what Extra Help is.
How QMB compares with SLMB and QI-1
| Program | Pays | 2026 income limit, one person |
|---|---|---|
| QMB Plus (QMBP) | Part A and B premiums, deductibles, coinsurance | $1,350 |
| SLMB | Part B premium | $1,616 |
| QI-1 | Part B premium, if you don't qualify for full SoonerCare | $1,816 |
The limits come from OKDHS Appendix C-1 (July 1, 2026) and match the federal amounts. See Oklahoma's income limits for couples and how income is counted.
Oklahoma details worth knowing
- It can start before you apply. OHCA's certification rule (OAC 317:35-7-60) lets QMB Plus coverage begin as early as the third month before the month you apply, if you were eligible then. The state takes over your Part B premium the month after you are approved.
- You stay in regular SoonerCare. OHCA's SoonerSelect rule (OAC 317:55-3-1) excludes people with Medicare and Medicare Savings Program members from SoonerSelect managed care plans.
- Billing protection. CMS says Medicare providers can't bill QMB members for Medicare cost sharing, even if they don't take SoonerCare.
How to get QMB
Apply with Oklahoma Human Services by calling (405) 522-5050, at a Human Services Center or online at OKDHSLive.org. Read how to apply in Oklahoma, whether Oklahoma can recover QMB costs from your estate and the Medicare Savings Programs guide. For help fitting QMB with a Medicare plan from the companies they work with, you can request a call from a licensed insurance agent.
Sources
- OHCA — OAC 317:35-7-40, Eligibility as Qualified Medicare Beneficiary Plus
- OHCA — OAC 317:35-1-2, Definitions (Part A and Part B buy-in)
- OHCA — OAC 317:35-7-60, Certification for SoonerCare
- OHCA — OAC 317:30-3-25, Crossovers (deductibles, coinsurance, and copays)
- OHCA — OAC 317:55-3-1, SoonerSelect mandatory, voluntary and excluded populations
- Oklahoma Human Services — Help With Medicare Part A and B Premiums
- OKDHS — Appendix C-1 (7/1/2026), Schedules VI, VII, VII.A
- CMS — Qualified Medicare Beneficiary Program
More questions in this guide
- Will Oklahoma take my house if I get help paying my Medicare premiums?
- How do I apply for a Medicare Savings Program in Oklahoma?
- What are the Medicare Savings Program income limits in Oklahoma?
- What is Extra Help for Medicare drug costs and how do I apply?
Part of the guide: Medicare Savings Programs in Oklahoma · All questions
Frequently asked questions
Why does Oklahoma call it QMB Plus?
OHCA's rules use the name Qualified Medicare Beneficiary Plus (QMBP). Under OAC 317:35-7-40, a person who meets the QMBP limits and all other SoonerCare conditions is eligible for SoonerCare medical services, and OKDHS says QMB covers other medical services as well as Medicare costs.
Can a doctor bill me if I have QMB?
No, not for Medicare-covered services. CMS says providers may not bill people in the QMB program for Medicare deductibles, coinsurance or copays. If you get a bill, show your Medicare and SoonerCare cards and call 1-800-MEDICARE.
Do I have to renew QMB?
Yes. OHCA's rule assigns QMB Plus a 12-month certification period, and OKDHS reviews your eligibility again at the end of it.
Can I have QMB and a Medicare Advantage plan?
Yes. OHCA's crossover rule (OAC 317:30-3-25) says SoonerCare pays Medicare deductibles, coinsurance and copays under Part A, Part B and Part C (Medicare Advantage), following the state plan's payment method.
Medicare in your Oklahoma county
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