For help with prescription drug costs:
Medicare’s Extra Help program can assist people who have trouble paying their prescription drug costs. The program helps cover the costs of your Medicare drug plan, plus ensures you have no coverage gap, no late enrollment penalty, and can switch plans at any time.
You may qualify for Extra Help in 2018 if you are single, your annual income is less than $18,210, and you have less than $14,100 in savings. (Your savings, or "countable resources" as they're sometimes called, include assets like the money in your checking or savings account, stocks and bonds, mutual funds, and IRAs.) For married people living together (with no dependents), the 2018 limit for annual income is $24,690, and for savings, $28,150.
Note that these limits may be different if you have dependents living with you, or you live and work in Alaska or Hawaii.
You’ll automatically qualify for Extra Help if you have full Medicaid coverage, if Medicaid helps pay your Medicare Part B premium, or you get Supplemental Security Income (SSI) benefits. If you don’t automatically qualify but meet the other requirements, you can apply for Extra Help online at socialsecurity.gov/i1020 or by calling Social Security at 1-800-772-1213.
State Pharmacy Assistance Programs (SPAPs)
Some states offer SPAPs that can help you with prescription drug costs. Eligibility is often based on financial need, age, or medical condition. Contact your State Health Insurance Assistance Program (SHIP) for more information. Find your SHIP contact here.
Pharmaceutical Assistance Programs or Patient Assistance Programs
Many drug manufacturers offer Pharmaceutical Assistance Programs to people with the costs of Medicare drug coverage. If you meet certain requirements, you may be able to receive your prescriptions at no cost or at a reduced rate. For more information, visit Medicare.gov/pharmaceutical-assistance-program.
For assistance with healthcare costs:
MEDICARE SAVINGS PROGRAMS
There are four types of programs designed to help people with modest incomes and savings, each with different financial limits and covering different costs. They are:
Qualified Medicare Beneficiary (QMB) Program
The QMB Program helps pay your Part A and/or Part B premiums. It also prohibits health care providers from billing you directly for Medicare deductibles, coinsurance, and copayments. You won’t be charged over a certain amount for Part D-covered prescription drugs, and you’ll automatically get Extra Help.
Specified Low-income Medicare Beneficiary (SLMB) Program
This program only helps cover the Part B premium.
Qualifying Individual (QI) Program
This also only helps cover Part B premiums, and you must apply each year for benefits. QI benefits are awarded on a first-come, first-served basis.
Qualified Disabled and Working Individuals (QDWI) Program
The QDWI Program helps pay Part A premiums, and you may qualify if you have a disability and are currently working.
To see if you qualify for a Medicare Savings Program, check with your state to find out income and resource limits. You can find your state’s contact information here.
Medicaid is a joint federal and state health insurance program for low-income people or for those with high medical expenses relative to their income and savings (termed "medically needy"). This assistance program covers children, the aged, blind, and/or disabled and other people who are eligible to receive federally assisted income maintenance payments.
Each state has different Medicaid requirements. Call your state’s Medicaid office, or 1-800-MEDICARE to see if you qualify.
Programs of All-Inclusive Care for the Elderly (PACE)
A Medicare and Medicaid program, PACE is available in many states for people who need nursing home-level care. PACE’s assistance allows them to remain in their community by covering home care, transportation to doctor visits, hospital stays, prescription drugs, and more. Contact your Medicaid office to see if there’s a PACE program near you.
Supplemental Security Income (SSI) Benefits
SSI is available to people with limited income who are also disabled, blind, or 65 and older. The Benefit Eligibility Screening Tool at benefits.gov/ssa can help you determine if you’re eligible for SSI benefits, or you can call Social Security at 1-800-772-1213.