How to Get Help with Your Medicare Costs
Programs and Tips to Lower Your Out-of-Pocket Medicare Expenses
Dear Savvy Senior,
Does Medicare offer any financial assistance for struggling seniors? My mom lives primarily on her Social Security survivor benefit and is having a hard time paying her Medicare costs.
–Need Assistance
Dear Need,
There are actually several different financial assistance programs that can help Medicare beneficiaries who are having a difficult time paying their out-of-pocket health care costs. Here’s what’s available, along with the eligibility requirements and how to apply.
Medicare Savings Programs
Let’s start with a program that helps pay premiums and out-of-pocket costs for Medicare Parts A and B. It’s called the “Medicare Savings Program,” and it has several different benefit levels for people based on their income and asset level. At its most generous the program will pay your Part A and B premiums and pretty much all your Medicare deductibles, coinsurance and copayments. At its least generous the program will pay just your Part B premium.
To qualify for a Medicare Savings Program, the minimum standard set by Medicare is an income under 135 percent of the federal poverty level, which at the moment works out to around $1,715 a month for individuals (or $2,320 for married couples). Everything counts towards income, including payouts from 401(k) plans, pensions, Social Security, and help from family members.
Medicare also allows states to impose an asset test, which can be as little as $9,430 per individual ($14,130 for married couples), not counting your house, car or personal belongs, but counting retirement savings and bank accounts.
But some states have made their Medicare Savings Programs a lot more generous, with much higher income limits and in some cases no asset tests at all. And the program may be called something else in your state. To find out if you qualify or to apply, contact your state Medicaid program. Visit Medicaid.gov or call all 800-633-4227 for contact information.
Medication Assistance
For help with Medicare (Part D) prescription drug plan costs, there is another completely separate low-income subsidy program she may be eligible for called “Extra Help.” To get it, your mom will need to apply through her Social Security office.
Depending on your mother’s income level, this program will pay part or all of her Part D prescription drug plan’s monthly premiums, annual deductibles and prescription co-payments. In 2025, individuals with a yearly income below $23,475 ($31,725 for a married couple), and assets under $17,600 ($35,130 for a married couple) can qualify for Extra Help.
If she’s eligible to be in a Medicare Savings Program, she will automatically qualify for Extra Help. But because the requirements are slightly different, even if she doesn’t qualify for a Medicare Savings Program for Part B, she might be able to get Extra Help for Part D. For more information or to apply, visit SSA.gov/medicare/part-d-extra-help or call Social Security at 800-772-1213.
Other Programs
Depending on your mom’s income level, needs and location there are many other financial assistance programs that can help like Medicaid, SSI (Supplemental Security Income), PACE (Program of All-inclusive Care for the Elderly), SNAP (Supplemental Nutrition Assistance Program), (LIHEAP) Low Income Home Energy Assistance Program and many others.
To help you find out what types of assistance programs she may be eligible for, and learn how to apply for them, go to BenefitsCheckUp.org. This is a free, confidential website designed for people age 55 and older that contains more than 2,500 programs.
It’s also possible to get help in person at one of the 87 Benefits Enrollment Centers scattered across 38 states. Visit NCOA.org/article/meet-our-benefits-enrollment-centers locate a center in your area. Or call their helpline at 800-794-6559.