4 Assistance Programs That Could Help Pay Your Medicare Costs

Published by: Medicare Made Clear

Are you living on a low income and need help paying your health care costs? You may qualify for one or more financial assistance programs designed to help pay some Medicare costs.

 

The following financial programs may help cover your Medicare costs if you qualify.

Program Name Program Benefits Eligibility Information

Medicaid

Helps pay some of your Medicare costs not covered by Original Medicare (Parts A & B)

 

May also provide additional coverage that Parts A & B do not

Varies by state.

Medicare Savings Programs*

 

*multiple programs available

Helps pay Medicare Part A & B premiums, deductibles and coinsurance costs. 

Varies by program. 

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

Combines medical, social and long-term care services

 

Covers services that Medicare and Medicaid do.

 

May cover additional health care items or services not covered 

by Medicare.

 

Covers prescription drugs.

Age 55 or older

 

Live in the service area of a PACE organization

 

Need a nursing home-level of care (as certified by your state)

 

Must be able to live safely in your community with assistance from PACE

Extra Help

Helps pay some or all of your Medicare Part D costs

You must be receiving Medicare.

 

Have limited resources and income.

 

Reside in one of the 50 states or the District of Columbia.

1. Medicaid

 

Medicaid is a federal- and state-funded assistance program that is managed by state and local governments. Medicaid may help pay some of the costs Original Medicare does not. Additionally, Medicaid may also provide coverage for other health services and items that Medicare doesn’t.

 

Eligibility requirements and the application process will vary by state. Find out if you qualify for Medicaid.

 

Special Note: If you have both Medicaid and Medicare, you are also eligible for a special kind of Medicare Advantage plan called a Dual Special Needs Plan. Learn more about those here.

 

 

2. Medicare Savings Programs

 

Medicare Savings Programs are Medicare-administered programs for people with limited incomes and resources designed to help pay Medicare costs like premiums, deductibles, copays and coinsurance.

 

Individuals who qualify for a Medicare Savings Program may also qualify for Extra Help, a program that helps pay prescription drug costs. There are four types of Medicare Savings Programs. Each program covers different costs and has different eligibility requirements.

 

Learn more about Medicare Savings Programs in your state.

 

 

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

 

PACE is a joint Medicare and Medicaid program that helps with some medical, social, and long-term care. PACE is for individuals who are at least 55 years or older and who require a nursing-home level of care (as certified by their state) and who can live safely in their community with PACE’s help.

 

PACE provides coverage for the health care services and items Medicare and Medicaid normally do if authorized by the individual’s health care team. PACE may provide additional coverage as well for other items if the team deems them necessary. Finally, PACE will cover your prescription drugs as well, so a stand-alone Part D plan is not necessary.

 

PACE is not available in all states, and what you pay for PACE will depend on your personal financial situation. You can search for PACE programs in your area here.

 

 

4. Extra Help & Other Prescription Drug Assistance Programs

 

Extra Help is a program that helps pay your Medicare Part D premiums, deductibles, co-pays and co-insurances. You may automatically qualify for Extra Help if you have both Medicare and Medicaid or if you have Medicare and receive Supplemental Security Income (SSI). To qualify for Extra Help, you must have limited financial resources below $14,610 for individuals or $29,160 for married couples living together.1 Resources can include things like the contents of your bank accounts (checking, savings and even certificates of deposit), real estate, stocks, bonds, mutual funds, any cash you have (on-hand or not) and IRAs (Individual Retirement Accounts).

 

You can apply online at the Social Security Administration web site and learn more here.

 

If you don’t qualify for Extra Help, State Pharmaceutical Assistance Programs (SPAPs) may be an option. SPAPs also help pay Medicare prescription drug plan premiums or other drug costs. Programs are available in many states and the U.S. Virgin Islands. Coverage and qualification requirements vary by state. Find out if there’s an SPAP program in your state.

 

 

Continue Learning About Medicare Assistance Programs

 

Do your research. Learn what each program covers, its eligibility requirements and how to apply for benefits. And if one of these doesn’t work for you, there may be community-level programs available as well. You can learn about programs in your community by contacting your city, county or state offices for information.

 

 

1 https://www.ssa.gov/pubs/EN-05-10508.pdf

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