More Help for You

What if I need help paying my Medicare Health Care costs?

People who have limited income and resources can also seek help in paying their Medicare Health Care costs.

Below are the different programs they can choose depending on their qualification. 

Medicare Savings Programs

If you have limited income and resources, you may be able to get help from your state to pay your Medicare costs if you meet certain conditions.

4 kinds of Medicare Savings Programs:

• Qualified Medicare Beneficiary (QMB) Programs: If you're eligible, the QMB Program helps pay for Part A and/or Part B premiums. Also, Medicare providers aren't allowed to bill you for services and items Medicare covers, including deductibles, coinsurance, and copayments. If you get a bill for these charges, tell your provider or debt collector that you're in QMB Program and can't be charged for items and services Medicare covers. If you've already made payments on a bill for services and items Medicare covers, you have the right to a refund.

Note:  To make sure your provider knows you're in the QMB Program, show both your Medicare and Medicaid or QMB card each time you get care. You can also give your provider a copy of your "Medicare Summary Note" (MSN). 

If your provider won't stop billing you, call at 1-800-MEDICARE; TTY users can call 1-877-486-2048.

• Specified Low-Income Medicare Beneficiary (SLMB) Program: Helps pay Part B premiums only,
• Qualifying Individual (QI) Program: Helps pay Part  B premiums only. Funding benefits are limited, and the applications are granted on a first-come, first-serve basis.
• Qualified Disabled and Working Individuals (QWDI) Programs: Helps pay Part A premiums only. You may qualify for this program if you have a disability and are working.

Important: The names of these programs and how they work may vary by state. Medicare Savings Programs aren't available in Puerto Rico or the U.S. Virgin Islands.

How do I qualify?

To qualify for a Medicare Savings Program, you must have income and resources below a certain limit.

States have different limits and ways of counting your income and resources, so you should check with your state Medicaid office to see if you qualify

Medicaid

Medicaid is a joint federal and state program that helps pay health care costs if you have limited income and resources and meet other requirements. Some people qualify for both Medicare and Medicaid. 

What does Medicaid cover?

• If you have Medicare and full Medicaid coverage, most of your health care costs are covered, You can get a Medicare coverage through Original Medicare or Medicare Advantage Plan.
• If you have Medicare and/or full Medicare coverage, Medicare covers your part D prescription drugs. Medicaid may still cover some drugs that Medicare doesn't cover.
• People with Medicaid may get coverage for services that Medicare doesn't cover or only partially covers, like nursing home care, personal care, transportation to medical services, home-and-community-based services, and dental, vision, and hearing services.

How do I qualify?

• Medicaid programs vary from state to state. They may also have different names, like "Medical Assistance" or "Medi-Cal".
• Each state has different income and resources requirements.
• In most cases, you need to be enrolled in Medicare, if eligible, to get Medicaid.
• Call your Medicaid office for more information.
• Visit Medicare.gov/contacts or call 1-800-MEDICARE

Demonstration plans for people who have both Medicare and Medicaid

Medicare is working with some states and health plans to offer demonstration plans for certain people who have both Medicare ad Medicaid, called Medicare-Medicaid Plans. If you're interested in joining, visit Medicare.gov/plan-compare to see if one is available in your area and if you qualify.

State Pharmacy Assistance Program (SPAPs)

Many states have SPAPs that help certain people pay for prescription drugs based on financial need, age, or medical condition. To find out if there's an SPAP in your state and how it works, call your State Health Insurance Assistance Program (SHIP). 

Pharmaceutical Assistance Programs 

(Patient Assistance Programs)

Many major drug manufacturers offer assistance programs for people with Medicare drug coverage who meet certain requirements. Visit Medicare.gov/pharmaceutical-assistance-program to learn more.

Supplemental Security Income (SSI) Benefits

SSI is a cash benefit paid by Social Security to people with limited income and resources who are blind, 65 or older, or have a disability. SSI benefits aren't the same as Social Security retirement benefits. You may be able to get both SSI benefits and Social Security benefits at the same time if your Social Security benefit is less than the SSI benefit amount, due to limited work history, a history of low-wage work, or both. If you're eligible for SSI, you automatically qualify for Extra Help and are usually eligible for Medicaid.

You can visit benefits.gov/ssa, and use the "Benefit Eligibility Screening Tool" to find out if your eligible for SSI or other benefits. 

Note: People who live in Puerto Rico, the U.S. Virgin Islands, Guam or American Samoa can't get SSI.

Programs for people who live in the U.S. territories

There are programs in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Island, and American Samoa, to help people with limited income and resources pay their Medicare costs. However, programs vary in these areas. To learn more, you can call your Medicaid office or visit Medicare.gov/contacts. You can also call 1-800-MEDICARE to get the phone number, TTY users can call 1-877-486-2048.