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 2019 Medicare premiums you can expect to pay.

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The Medicare Extra Help program can help you pay Part D premiums

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 2019 prescription drug costs will be no more than $3.40 for generic drugs and $8.50 for brand-name covered drugs.

  • To qualify for Extra Help, your annual income must be below $18,210 (or $24,690 for couples) in 2018. You must also not have assets and other financial resources such as stocks, bonds or savings accounts that total more than $14,100 (or $28,150 for couples).

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

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 2018 income and resources meet the following limits:

  • $1,032 individual monthly income
  • $1,392 married monthly income
  • $7,560 in individual resources
  • $11,340 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 2018 income and resources meet the following limits:

  • $1,234 individual monthly income
  • $1,666 married monthly income
  • $7,560 in individual resources
  • $11,340 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 2018 income and resources meet the following limits:

  • $1,386 individual monthly income
  • $1,872 married monthly income
  • $7,560 in individual resources
  • $11,340 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 2018 income and resources must also meet the following limits:

  • $4,132 individual monthly income
  • $5,572 married monthly income
  • $4,000 in individual resources
  • $6,000 in resources as a married couple

How much do Medicare premiums cost?

2019 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 $240 per month in 2019. Beneficiaries who paid Medicare taxes for fewer than 30 quarters must pay $437 per month in 2019.

  • 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 $135.50 per month in 2019.

  • 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 has been estimated at $28 per month in 2019.1

  • Part D (prescription drug coverage)
    Medicare Part D plans are also sold by private insurers, so premiums can vary. The average 2019 Part D premium is expected to be $32.50.1

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 in your area, speak with a licensed insurance agent by calling TTY Users: 711, 24 hours a day, 7 days a week.

 

1 CMS. Medicare Advantage premiums continue to decline while plan choices and benefits increase in 2019. (Sep. 28, 2018). Retrieved from www.cms.gov/newsroom/press-releases/medicare-advantage-premiums-continue-decline-while-plan-choices-and-benefits-increase-2019.

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