How You Can Get Help Paying Medicare Premiums

• by Christian Worstell
• October 31, 2022
• Reviewed by John Krahnert

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 2023 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 2023 prescription drug costs will be no more than $4.15 for generic drugs and $10.35 for brand-name covered drugs.
  
  
• To qualify for Extra Help, your previous year annual income must be below $20,385 (or $27,465 for married couples living together). You must also not have assets and other financial resources such as stocks, bonds or savings accounts that total more than $15,510 (or $30,905 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 when you visit MyRxPlans.com

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 2022 income and resources meet the following limits:

• $1,153 individual monthly income
• $1,546 married monthly income
• $8,400 in individual resources
• $12,600 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 2022 income and resources meet the following limits:

• $1,379 individual monthly income
• $1,851 married monthly income
• $8,400 in individual resources
• $12,600 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 2022 income and resources meet the following limits:

• $1,1,549426 individual monthly income
• $2,080 married monthly income
• $8,400 in individual resources
• $12,600 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 2022 income and resources must also meet the following limits:

• $4,615 individual monthly income
• $6,189 married monthly income
• $4,000 in individual resources
• $6,000 in resources as a married couple

How much do Medicare premiums cost?

2023 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 $279 per month in 2023. Beneficiaries who paid Medicare taxes for fewer than 30 quarters must pay $506 per month in 2023.
  
  
• 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 $164.90 per month in 2023.
  
  
• 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 $17.60 per month in 2023.²
  
  
• Part D (prescription drug coverage)
  Medicare Part D plans are also sold by private insurers, so premiums can vary.
  
  The average 2022 Part D premium was $47.59 per month.³

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.

About the author

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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