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Qualifying for the Medicare Savings Program or Extra Help

If you are unable to afford Medicare there are benefits such as the Medicare Savings Programs (MSP) that could help. Medicare Savings Programs (MSPs) are Medicaid-administered benefits that help cover Medicare premiums and out-of-pocket costs, such as deductibles and coinsurance. These programs are available for those on Medicare with limited incomes and resources who do not qualify to be fully enrolled in Medicaid.

How to get help with Part A & B costs?

Qualified participants need to meet certain income and resource levels and have Medicare Part A to qualify. If requirements are met, Medicare and state Medicaid programs work together to provide assistance through the Medicare Savings Programs.

There are four different Medicare Savings Programs. Each program has a different income and resource eligibility limit. Even if not eligible for Medicaid, qualification can be met for one of these programs to help cover Medicare costs.

Four Medicare Savings Programs

The programs are listed below, along with what each program pays for and the income and resource level limits that must be met to qualify. Some states may have even higher income or resource limits for these programs or they may eliminate resource limits entirely.

Get help with Part D Prescription Drug Costs

Get help paying for Medicare drug costs with a program called Extra Help (also called Part D low-income subsidy or LIS). Extra Help is a Federal program that helps people with limited income and resources pay for their Part D premiums and drug costs.

Most people who qualify for Extra Help will pay:

  • No premiums,

  • No deductibles, and

  • No more than $8.35 in 2020 for each drug their plan covers.

The amount of Extra Help received depends on income and resources. If qualified for Extra Help, it possible to join a Medicare Part D plan at any time and not have to pay a penalty, even if enrollment is late.

Plus, people who receive Extra Help can change Part D plans at any time – as often as once per month. Learn about switching plans.

Qualifying for Extra Help with Medicare Costs

There are different levels of Extra Help available, depending on income and assets. People with a lower income and fewer assets get more help with their Medicare drug plan costs.

The resource amount includes $1,500 in savings that you can use as a burial fund. Couples can have $3,000 for the burial savings.

You may not qualify for Extra Help with costs if your income or assets are over these limits. Remember you can apply for help even if you are slightly over the limit you need to qualify.

If you think you qualify for Extra Help, take the BenefitsCheckUp questionnaire to find all of your options. It is free and confidential. Find out your options.

Out-of-Pocket Costs with Extra Help

Related Content

Part D Low Income Subsidy (LIS/Extra Help)
The Part D Low Income Subsidy (LIS/Extra Help) program helps pay for a portion of Part D prescription drug plan costs, including Part D premiums.
How to Reduce Prescription Drug Costs
There are several other programs that can help reduce prescription costs. Save money on Medicare by comparing plans and using these tips .
Make Sense of Medicare Costs
Medicare covers a wide range of medical services. But Medicare is not free – it does not cover everything.

Age Well Planner is an educational website created by nonprofit the National Council on Aging (NCOA). We provide information, resources, and referrals on topics such as: Benefits, Income, and Medicare.

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