Original Medicare (Part A and Part B) helps make healthcare more affordable to those who are at least 65 years old, or certain younger people with disabilities or diseases.
However, there are still out-of-pocket costs associated with Medicare, such as premiums, deductibles, coinsurance and more.
You may qualify for certain government and private programs that offer help paying for these costs.
These programs include:
Take a look at some of these programs and find out if you’re eligible.
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A Medicare Savings Program (MSP) is a federally funded program that helps pay for Medicare costs including premiums, deductibles, copayments and coinsurance.
These programs, also called Medicare Buy-In programs or Medicare Premium Payment Programs, are administered by the individual states in which they are offered and are available to people with limited income and resources.
There are four types of Medicare Savings Programs, each with its own qualifications and benefits. All help cover Medicare premiums and the associated out-of-pocket costs.
This program helps pay Medicare Part A and Part B premiums. It may also help pay for deductibles, coinsurance and copayments.
If you qualify for QMB, you are automatically qualified for the Extra Help program. Extra Help offers additional assistance in paying for Medicare Part D prescription drug coverage.
2021 Monthly Income Limits*
Individuals: $1,472
Married couples: $1,472
This program reduces Medicare Part B premiums. Those who qualify for SLMB, are also automatically qualified for Extra Help.
2021 Monthly Income Limits*
Individuals: $1,308
Married couples: $1,762
This program helps cover Part B premiums. Applications must be submitted every year, and are accepted on a first-come, first-serve basis.
You can’t use QI benefits if you qualify for Medicaid. However, those who meet the criteria for QI also qualify for Extra Help.
2021 Monthly Income Limits*
Individuals: $1,469
Married couples: $1,980
This program lowers Part A premiums.
To qualify, you must meet one of the following criteria:
2021 Monthly Income Limits*
Individuals: $4,379
Married couples: $5,892
To apply for a Medicare Savings Program, call your State Medicaid Program.
Before you do, be sure you can answer “yes” to each of these three questions:
This program helps lower the costs of Medicare Part D prescription drugs. It may also lower Part D premiums, deductibles and copayments.
Those who provide proof that they qualify for Extra Help should not pay more than $3.95 for covered generic drugs or $9.85 for covered brand name drugs in 2022.
You may qualify for Extra Help in 2021 if you have up to $19,320 in annual income as an individual, or $26,130 in annual income for married couples.
You may automatically qualify for Extra Help if you already have full Medicaid coverage, if you get Supplemental Security Income (SSI) benefits from the Social Security Administration, or if you get help paying your Medicare Part B premiums from a Medicare Savings Program.
Medicaid is a government assistance program available to those with limited incomes. It can be used alongside Medicare to help pay for health care expenses that aren’t covered by Original Medicare, such as personal and nursing home care services.
Medicaid eligibility requirements vary by state. Check with your state’s Medicaid program to find out more.
Programs of All-inclusive Care for the Elderly, also referred to as PACE, is a state assistance program for seniors. This program works with Medicare, Medicaid or both to provide community-based care. PACE also offers Medicare Part D prescription drug coverage, adult day care, dentistry, transportation, nursing home care and hospital care.
To qualify for PACE, you must:
Pharmaceutical Assistance Programs are offered by some pharmaceutical companies. These programs help offset some of the cost of prescription drugs.
Eligibility requirements vary between insurance companies. To find out if you qualify, check out the pharmaceutical assistance program page on Medicare.gov.
This federal program offers cash benefits to seniors and disabled adults and children. The benefits can be used to pay for basic living expenses.
You must meet certain income restrictions to qualify. For more information, visit the SSA.gov website or your local Social Security office.
If you live in certain U.S. territories and meet income limitations, you may be able to get financial assistance to help pay for Medicare.
U.S. territories include:
You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.
You can call to speak with a licensed insurance agent who can help you compare Medicare Advantage plans and Medicare prescription drug plans that may be available where you live.
You can also compare plans online for free, with no obligation to enroll.
Speak with a licensed insurance agent
*Monthly income limits are higher in Alaska and Hawaii. You may still qualify for benefits if your income is higher than these limits.
Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.
Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.
Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.
A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.
If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.
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