Where to Find Help Making Medicare More Affordable

Medicare coverage can be helpful for millions of Americans, but certain Medicare premiums and other out-of-pocket costs can make it hard for some people to afford Medicare.

If you can’t afford Medicare because of costs such as Medicare deductibles, copayments and other expenses, there are some options that may be able to help you save some money.

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Medicare Savings Programs

Medicare Savings Programs (MSPs) are federally funded programs that help people with limited income and resources pay for costs such as Medicare premiums, deductibles, copayments and coinsurance.

There are four types of Medicare Savings Programs.

The dollar amounts listed may increase in 2020. You should still apply if your income and financial resources are in the ranges listed or a bit higher.

  • Qualified Medicare Beneficiary Program (QMB)
    In 2019, this program is available for single people making less than $1,061 per month or a couple making less than $1,430 per month.

    This is the most comprehensive of all Medicare Savings Programs, offering help for both Medicare Part A and Part B premiums, along with copayments, coinsurance and deductibles.

    If you qualify for a QMB, you automatically qualify for Medicare Part D Extra Help (see “Extra Help” below).

  • Specified Low Income Medicare Beneficiary Program (SLMB)
    You can qualify for this program as a single person with an income of less than $1,269 per month or a couple making less than $1,711 per month in 2019.

    The program helps pay Part B premiums and includes automatic eligibility for Part D Extra Help.

  • Qualified Individual Program (QI)
    To qualify for a QI program in 2019, you must have a monthly income of less than $1,426 as an individual or $1,923 as a couple.

    The program includes help with Part B premiums and provides eligibility for Part D Extra Help.

  • Qualified Disabled and Working Individuals Program (QDWI)
    This program is designed for disabled people who returned to work and lost their premium-free Medicare Part A coverage upon doing so.

    The 2019 income eligibility limits for this program are $4,249 per month as an individual and $5,722 per month for a couple. A QDWI program helps pay for Part A premiums.

Some Medicare Savings Programs may also provide help paying for Medicare Advantage (Part C) premiums.

Medicare Extra Help

A Medicare beneficiary who cannot afford to purchase a Part D plan (Medicare prescription drug coverage) may be eligible for Extra Help.

Extra Help reduces or eliminates the Part D plan premiums and deductibles. The program can also reduce the prescription drug costs that beneficiaries are required to pay.

The program is available for single people enrolled in Medicare making less than $18,735 per year as an individual in 2019, with financial resources not exceeding $14,390 per year.

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

Enroll in Medicare Part D at MyRxPlans.com

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State Pharmacy Assistance Programs (SPAP)

These state-run programs help people with low incomes pay for prescription drugs.

Eligibility is based on age, medical condition and financial status. Programs vary by state.

Programs of All-Inclusive Care for the Elderly (PACE)

These programs provide nursing home services to elderly and disabled people in their own homes.

PACE can also cover doctor appointments, home care, hospital visits, transportation and home care.

Medicare-Medicaid dual eligibility

A number of Medicare beneficiaries are also eligible for Medicaid. When a person is “dual eligible,” Medicaid helps cover health care costs not picked up by Medicare. Medicare pays first, Medicaid second.

Medicare financial help for people in U.S. territories

There are various programs that help people in U.S. territories with limited income and resources pay for Medicare. These territories include Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands and American Samoa.

Beneficiaries in these areas are encouraged to contact their local Medicaid office to learn more about available programs.  

Medicare Advantage plans and Medicare Supplement Insurance

While the programs above can help you afford Medicare, there are two additional ways to help you potentially save money on some Medicare costs.

Medicare Advantage plans (Medicare Part C) offer all of the same benefits as Medicare Part A and Part B, and some Medicare Advantage plans may offer a number of benefits not found in Original Medicare. Many Medicare Advantage plans may even feature $0 premiums.

As a different type of option, Medicare Supplement Insurance plans offer a way to save money by helping to cover some Medicare out-of-pocket costs such as deductibles and coinsurance.

These are just some of the ways you can save money on your Medicare costs. Learn about even more ways to save money on Medicare costs and obtain the health care coverage you deserve.

Can I find an affordable Medicare Advantage plan?

Some Medicare Advantage plans could help you save money on health care services that aren’t covered by Original Medicare.

To compare plans in your area and to find out which ones may be easier for you to afford, call today to speak with a licensed insurance agent.


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