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Get Help Paying for Medicare Premiums, Deductibles, Copays

You could be eligible for financial assistance


spinner image medicare and finances a laptop opened up showing the medicare website with a button on it that says help along with symbols of money a piggy bank a calculator displaying the word cost and money
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Medicare covers most of your health care expenses after you turn 65, but it isn’t free. You’ll still have some out-of-pocket costs for Medicare Part APart B and Part D prescription drug coverage.

Fortunately, several programs provide financial assistance to people with limited resources or who have certain conditions. They can help pay Medicare premiums, deductibles, copayments and prescription drug costs.

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Reducing your costs for Parts A and B

State-run Medicare Savings Programs can help people with low incomes pay Part A and Part B premiums and out-of-pocket costs and provide some help with their drug costs.

To be eligible, your income — and sometimes your savings — must be below certain limits, which vary by state. These limits are generally higher than those required to qualify for Medicaid, and some states don’t count your savings.

Medicare Savings Programs come in four types, each with different details and eligibility requirements. Income limits are slightly higher in Alaska and Hawaii.

The Qualified Medicare Beneficiary Program helps pay for Part A and Part B premiums, deductibles, coinsurance and copayments. You also automatically qualify for the Part D Extra Help program and pay no more than $4.30 in 2023 for each drug your plan covers.

2023 gross monthly income and asset limits:

  • Individual. $1,235 income, less than $9,090 assets.
  • Couples. $1,663 income, less than $13,630 assets.

The Specified Low-Income Medicare Beneficiary Program pays Part B premiums and provides Extra Help with Part D costs. You’ll pay no more than $10.35 in 2023 for each drug your plan covers.

2023 gross monthly income and asset limits:

  • Individual. $1,478 income, less than $9,090 assets. 
  • Couples. $1,992 income, less than $13,630 assets.

The Qualifying Individual Program pays Part B premiums and provides Extra Help with Part D costs. You’ll pay no more than $10.35 in 2023 for each drug your plan covers. States approve applications on a first-come, first-served basis.

2023 gross monthly income and asset limits:

  • Individual. $1,660 income, less than $9,090 assets.
  • Couples. $2,239 income, less than $13,630 assets.

The Qualified Disabled Working Individual Program is for people with disabilities who have returned to work, lost Social Security disability benefits and don’t qualify for premium-free Part A because they’re working again. It also helps pay for Part A premiums.  

2023 gross monthly income and asset limits:

  • Individual. $4,945 income, less than $4,000 assets.  
  • Couples. $6,659 income, less than $6,000 assets.  
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For more information about the assets and income that are included in the calculation, see the Medicare Rights Center’s financial eligibility guidelines.

To learn if you qualify

Contact your state Medicaid program or your State Health Insurance Assistance Program (SHIP) to find out if you’re eligible. Application requirements vary by state. If you apply for the federal Extra Help program to help with prescription drug costs, your application is automatically forwarded to your state to determine eligibility for a Medicare Savings Program.

Puerto Rico and the U.S. Virgin Islands don’t have Medicare Savings Programs, but their Medicaid programs may be able to assist you financially. See Medicaid.pr.gov in Puerto Rico and Medical Assistance Program in the U.S. Virgin Islands.

Making Part D more affordable

If you need assistance paying premiums, deductibles and copayments for Part D prescription drug plans, find out if you’re eligible for federal Extra Help.

You’ll get Extra Help automatically if you have full Medicaid coverage, if you qualify for certain Medicare Savings Programs or if you’re receiving Supplemental Security Income benefits from Social Security.

If you don’t automatically get Extra Help, you can apply for it. To qualify in 2023, your assets must be less than $33,240 if married and living with your spouse or $16,660 if you’re unmarried or not living with a spouse. Keep in mind, Extra Help defines assets differently than Medicare Savings Programs.

For more information about eligibility, see the Social Security Administration’s Understanding the Extra Help With Your Medicare Prescription Drug Plan. Also see the Extra Help page at Medicare.gov.

If you qualify for Extra Help, you’ll also need to enroll in a Part D prescription plan. If you don’t choose a plan, Medicare will enroll you in one automatically. Check the Medicare Plan Finder to find a plan that covers your medications.

6 steps to apply for Part D Extra Help

1. Gather the following documents:

  • Bank statements and tax returns.
  • IRA or 401(k) account balances.
  • Statements for annuities, pensions, Railroad Retirement Board benefits or veterans’ benefits.

Go to the Apply for Medicare Part D Extra Help program page at SocialSecurity.gov.

2. Click Start application. You’ll see the Extra Help welcome page with information about the program and eligibility. Click Find Out If You Qualify for more information about criteria. When you’re ready to apply, click Apply Now.

3. Read the information on the next screen that explains how to complete the online application. When you’re done, click Next.

4. Answer the series of personal questions. Click Next.

5. Your answers to the previous questions are early steps in determining your eligibility for the program. If you qualify so far, you’ll be asked to apply. Click Apply Now.

6. Enter your name, Social Security number, date of birth and whether you worked this year and last year. You’ll need to supply information about your spouse, such as whether he or she wants to apply for Extra Help, too.

You’ll then be asked about your income and assets, which will help determine if you’re eligible for the program.  

If you need help completing the application, contact Social Security at 800-772-1213 or your State Health Insurance Assistance Program. The Social Security Administration provides instructions in several languages for filling out the application. You can review your completed application before you submit it.

Medicare will send you a notice identifying your level of Extra Help assistance. You may get full or partial assistance depending on your income and assets and whether you have Medicaid coverage or receive aid from a Medicare Savings Program.

Once you’ve enrolled in Extra Help, Medicare will notify your Part D plan. If you fill a prescription and the credit isn’t applied, show the pharmacist the Medicare approval letter.

More people will qualify in 2024

The income limits to qualify for full Extra Help will increase next year, thanks to the Inflation Reduction Act. Those who meet present income caps for partial Extra Help will receive full benefits.

If you don’t qualify for Extra Help or want to supplement its benefits, you may be eligible for a state pharmaceutical assistance program (SPAP) that can help with your prescription costs. Each program works differently.

To find out more about the assistance program in your state, you can call 800-MEDICARE or contact your State Health Insurance Assistance Program.

Video: Is Financial Assistance Available for Medicare?

This story, originally published Jan. 28, 2022, was updated with 2023 information and revised.

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