Qualified Medicare Beneficiary (QMB) in Santa Clara County

A directory listing, not an eligibility decision.

UniHealth can identify a possible match, but the responsible program makes the final decision.

What to know

Why it may fit: Your circumstances can be checked against the program’s published guidelines.
What to do next: QMB pays your Medicare premiums, deductibles and copays. You apply through your county, on the Medi-Cal application or a short form. If you get SSI and have Part B, it comes automatically.
Who runs it: Santa Clara County / DHCS

What the program may consider

You have Medicare
QMB income limit, after income that does not count
California 2026 resource rule

How to get it

QMB pays your Medicare premiums, deductibles and copays. You apply through your county, on the Medi-Cal application or a short form. If you get SSI and have Part B, it comes automatically.

Before you start

You need this first Original Medicare. You must have Medicare Part B. You do not need Part A first. The state signs you up for Part A if needed.
Having this helps Supplemental Security Income / State Supplementary Payment (SSI/SSP). If you get SSI and have Part B, the state gives you QMB automatically. You do not need to apply.
Having this helps Aged, Blind and Disabled Federal Poverty Level Medi-Cal. With Medi-Cal, you can sign up for Part B at any time of year. QMB can then start.

How to apply

California's one application for Medi-Cal, CalFresh and cash aid

Online it is BenefitsCal. On paper it is the SAWS 2 PLUS. One application can ask for several programs at once.

The same application can also ask for CalFresh Food, CalWORKs, Extra Help with Medicare drug costs, General Assistance, Aged, Blind and Disabled Federal Poverty Level Medi-Cal and 11 more.

OnlineBenefitsCal websiteApply online for Medi-Cal, CalFresh and cash aid, any time of day.
PhoneMedi-Cal Helpline (state): 1-800-541-5555Questions about Medi-Cal, including QMB that came with SSI.
PhoneHICAP free Medicare counseling: 1-800-434-0222Free, unbiased help with Medicare choices.
PhoneSanta Clara County benefits line: (408) 758-3800Apply or ask questions by phone, 8 a.m. to 5 p.m.
FaxSanta Clara County benefits fax: (408) 295-9248
MailSanta Clara County benefits mail: P.O. Box 11018, San Jose, CA 95103
In personSanta Clara County benefits offices: 1867 Senter Rd, San Jose; 1330 W. Middlefield Rd, Mountain View; 379 Tomkins Ct, Gilroy

You can also use: Short application for QMB, SLMB and QI only (form MC 14 A)

A paper form you mail to your county social services office. The limits printed on it are old. The savings limit is now $130,000 for one person and $195,000 for two. This help is not taken back from your estate.

You can also use: Social Security's Extra Help application

Apply online, by phone, or on paper. Social Security also sends your answers to the state, unless you say no. Your county then mails you forms for help with Medicare costs. Send them back to finish that application.

Getting help

Someone can apply for you

Anyone can help you fill out the application. You can also name a person or an organization to act for you on form MC 382. They can sign your application and renewals, send papers, and ask about your case. You can limit what they may do. They get copies of your letters only if you ask on the form. You can cancel at any time. In Santa Clara County, a name typed into a helper's own app does not count as your signature. Sign in ink, by phone with the county, or through an approved e-signing service.

You can name a person or an organization to act for you: ask for Appointment of Authorized Representative (MC 382).

What happens after you apply

The county gets your application. It first checks records it can see, like your Social Security and Medicare data.
The county
The county may mail you forms to sign and a list of papers to send. Send them by the due date on the letter. They may ask for proof of Medicare Part B, income, and savings. Since 2026, the county must check your savings.
Only if the county needs more from you
The countyA helper can help with this You get 10 days. If you miss it, the county contacts you once more and gives 10 more days.
QMB can start only after you have Medicare Part B. Sign up for Part B at Social Security. If you have Medi-Cal, you can sign up any time of year.
Only if you do not have Part B yet
Social SecurityA helper can help with this
You get a letter that says yes or no. If you used the Medi-Cal application, the county checks full Medi-Cal too.
The countyWithin 45 days of the day you applied.
QMB starts on the first day of the month after the county finds you eligible. It never covers earlier months.
The county
The state mails you a Medi-Cal card. Show it with your Medicare card. It tells doctors not to bill you for Medicare costs.
If you have QMB without full Medi-Cal
The stateOnly you can do this
The state tells Medicare it will pay your premiums. If you have no Part A, the state signs you up and pays for it.
The stateAbout 2 months after the county approves it.
Social Security stops taking the Part B premium from your check. It pays you back for months the state covers. That refund counts as savings in the month you get it.
Social Security
You then get Extra Help with Medicare drug costs automatically. You do not need to apply for it.
Medicare
If you have no Medicare drug coverage, Medicare signs you up for a drug plan. You can pick a different plan. The choice is yours. HICAP gives free, unbiased help. Need medicine before it starts? Ask the pharmacy about LI NET. It is short-term Medicare drug coverage.
Only if you have no Medicare drug coverage
Medicare

What only you can do

Sign the application, or sign form MC 382 so a helper can sign for you.
You choose: help with Medicare costs only, or full Medi-Cal too. Help with Medicare costs is not paid back from your estate. Some full Medi-Cal care after age 55 can be.
Sign up for Medicare Part B at Social Security, if you do not have it.
Give proof of your income, savings, and Medicare when the county asks.
Keep the drug plan Medicare picks, or choose your own. The choice is yours. HICAP gives free, unbiased help.
Tell the county within 10 days about changes, like more income or savings, or a move.
Send back your yearly renewal form and any proof the county asks for.

How long it takes: About 2 to 4 months until the Part B premium stops coming out of your check. QMB does not cover months before it starts.
You are enrolled when: You have a QMB approval letter. Social Security no longer takes the Part B premium from your check. Medicare doctors and hospitals may not bill you for Medicare deductibles or copays. If you have QMB only, you also get a Medi-Cal card to show them.
To keep it: The county checks again each year, including your savings. Send back any renewal form. If your help stops because a form was late, you have 90 days to send it. Keep Medicare Part B, keep living in California, and report changes within 10 days.

Can’t be combined with

Specified Low-Income Medicare Beneficiary (SLMB). You can have only one of QMB, SLMB or QI. The county picks the one that fits your income.
Qualifying Individual (QI). You can have only one of QMB, SLMB or QI. The county picks the one that fits your income.

Coming changes

Starting January 4, 2027: Some people who are not citizens lose Medicare on January 4, 2027. Citizens and green card holders keep it. Without Medicare, QMB ends too.
Starting July 1, 2027: Starting July 1, 2027, the Medi-Cal savings limit drops to $21,000 for one person and $31,000 for a couple. Today it is $130,000 and $195,000. It is not yet known if the new limit applies to QMB.

Choosing a Medicare plan is your decision. UniHealth does not choose, recommend, or enroll anyone in Medicare plans. For free, unbiased help, call HICAP at 1-800-434-0222.