How You Can Get Help Paying Medicare Premiums

Medicare costs can add up. In addition to out-of-pocket costs like deductibles and coinsurance, there are also Medicare premiums that must be paid to maintain coverage.

In this guide, we detail several ways that you can get help paying Medicare premiums, and we detail the 2021 Medicare premiums you can expect to pay.

Do you qualify for the Medicare Extra Help Program?

Medicare Extra Help, also known as the Medicare Part D Low-Income Subsidy, is a federal program that can help with Medicare Part D prescription drug plan premiums.

• If you qualify for Medicare Extra Help, your 2021 prescription drug costs will be no more than $3.70 for generic drugs and $9.20 for brand-name covered drugs.
  
  
• To qualify for Extra Help, your annual income must be below $19,140 (or $25,860 for married couples living together) in 2020. You must also not have assets and other financial resources such as stocks, bonds or savings accounts that total more than $14,610 (or $29,160 for couples).

Your home, a car, a burial plot, furniture and other household items do not count as applicable financial resources.

Before you can apply for Extra Help, you must belong to a Medicare Part D drug plan.

You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online in as little as 10 minutes when you visit MyRxPlans.com.¹

How to apply for the Medicare Extra Help program

In order to apply for the Medicare Extra Help program, you need to fill out the Application for Extra Help with Medicare Prescription Drug Plan Costs (Form SSA-1020).

You can either apply online, call (1-800-772-1213 (TTY (1-800-325-0778) or apply at your local Social Security office. 

Applying for the Medicare Low-Income Subsidy

Some people receive the Medicare Low-Income Subsidy automatically. These include people who:

• Are enrolled in both Medicare and Medicaid (known as “dual eligible”)
• Receive Supplemental Security Income (SSI)
• Qualify for a Medicare Savings Program.

If you qualify for automatic enrollment, you do not need to apply for the program.

Those who do not qualify for automatic enrollment must first apply to Social Security and then apply for the Medicare Low-Income Subsidy in one of the following three ways:

• Contact your local State Health Insurance Assistance Program (SHIP)
  These assistance programs receive funding from the federal government to provide free local health insurance counseling and assistance to people with Medicare.
  
  SHIP representatives can also help you complete applications to programs like the Medicare Low-Income Subsidy.
  
  To get in contact with your State Health Insurance Assistance Program, call 877-839-2675.
  
  
• Apply through the Social Security Administration
  The Social Security Administration may assist you in applying for the Medicare Low-Income Subsidy.
  
  You may be able to apply online, over the phone or in person at your local Social Security office.
  
  
• Apply online through the National Council on Aging
  The National Council on Aging website features an online application for the Medicare Low-Income Subsidy (www.benefitscheckup.org/medicare-rx-extra-help-application).
  
  When you apply online, the application is then sent directly to the Social Security Administration.   

4 kinds of Medicare Savings Programs that can help with Medicare premiums

Medicare Savings Programs can help beneficiaries cover the cost of premiums for Medicare Part A (hospital insurance) and Part B (medical insurance). Medicare Savings Programs can also help with paying Medicare deductibles, coinsurance and copayments.

There are four Medicare Savings Programs:

Qualified Medicare Beneficiary Program (QMB)

This program helps pay for Medicare Part A and Part B premiums. If you qualify for this program, you automatically qualify for Medicare Extra Help.

You may qualify for the QMB if your 2020 income and resources meet the following limits:

• $1,084 individual monthly income
• $1,457 married monthly income
• $7,860 in individual resources
• $11,800 in resources as a married couple

Specified Low-Income Medicare Beneficiary Program (SLMB)

If you earn just a little too much to qualify for the QMB program, you may qualify for the Specified Low-Income Medicare Beneficiary program. This program helps pay Medicare Part B premiums and qualifies you for Medicare Extra Help.

You may qualify for the SLMB if your 2020 income and resources meet the following limits:

• $1,296 individual monthly income
• $1,744 married monthly income
• $7,860 in individual resources
• $11,800 in resources as a married couple

Qualifying Individual Program (QI)

Those who do not qualify for either the QMB or SLMB programs may still be eligible for the Qualifying Individual Program, which pays for Medicare Part B premiums and qualifies you for Medicare Extra Help.

You must apply for QI benefits every year, and applications are reviewed on a first-come, first-served basis. You can’t get QI benefits if you qualify for Medicaid.

You may qualify for QI benefits if your 2020 income and resources meet the following limits:

• $1,456 individual monthly income
• $1,960 married monthly income
• $7,860 in individual resources
• $11,800 in resources as a married couple

Qualified Disabled and Working Individuals Program (QDWI)
This program is a little different than the others in that it only pays for Medicare Part A premiums. You may qualify for QDWI benefits if any of the following apply:

• You lost your premium-free Part A benefits because you returned to work
• You are under 65, disabled and currently working
• You are not getting state medical assistance

To qualify for QDWI benefits, your 2020 income and resources must also meet the following limits:

• $4,339 individual monthly income
• $5,833 married monthly income
• $4,000 in individual resources
• $6,000 in resources as a married couple

How much do Medicare premiums cost?

2021 Medicare premiums are as follows:

• Part A
  Most beneficiaries who receive Part A do not have to pay a premium for their Part A coverage. If you worked and paid Medicare taxes for at least 40 quarters (10 years), you will receive premium-free Part A coverage.
  
  Beneficiaries who worked and paid Medicare taxes for between 30 and 39 quarters will pay a Part A premium of $259 per month in 2021. Beneficiaries who paid Medicare taxes for fewer than 30 quarters must pay $471 per month in 2021.
  
  
• Part B
  The Part B premium is based on your income, with higher-earning individuals having to pay more (called the Medicare IRMAA).
  
  The standard premium most people will pay for Medicare Part B is $148.50 per month in 2021.
  
  
• Part C (Medicare Advantage)
  Medicare Advantage plans are sold by private insurance companies, so premiums will vary from one plan to the next. Some Medicare Advantage plans feature $0 premiums, though $0 premium plans are not available in all locations.
  
  The average Medicare Advantage plan premium that includes prescription drug coverage is $33.57 per month in 2021.²
  
  
• Part D (prescription drug coverage)
  Medicare Part D plans are also sold by private insurers, so premiums can vary.
  
  The average 2021 Part D premium is $41.64 per month.²

Read additional medicare costs guides to learn more about Medicare costs and how they will affect you.

Additional ways to save on Medicare

There are even more ways to save money on your Medicare costs, including joining a Medicare Advantage plan that may offer the benefits you need at a price you can afford.

To compare Medicare Advantage plans available where you live, call to speak with a licensed insurance agent today.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!

¹ 10-minute claim is based solely on the time to complete the e-application if you have your Medicare card and other pertinent information available when you apply. The time to shop for plans, compare rates, and estimate drug costs is not factored into the claim. Application time could be longer. Actual time to enroll will depend on the consumer and their plan comparison needs.

² MedicareAdvantage.com's The Best States for Medicare in 2021 report. (Oct. 27, 2020).

About the author

Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.

His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.

Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. He currently lives in Raleigh, NC.

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