I'm living solely on Social Security of $1,400 monthly and can't afford my Medicare premiums and copays. What assistance programs might help someone in my situation?
Answered by 28 licensed agents
A person of this income level may qualify for Medicaid, which is a separate agency from Medicare, administered by individual States, for low-income folks. Apply through Department of Health and Human Services in your state. If you qualify for Medicaid, it can go along with your Medicare. This is referred to as dual-eligible (Medicare & Medicaid). Dual eligible individuals qualify for additional benefits. There is another program for low-income folks called Extra Help for Prescription Drug Costs. The income brackets for this program are slightly higher than those for Medicaid. Some folks qualify for Medicare, Medicaid and Extra Help for Prescription Drug Costs. If necessary, I'm able to guide folks in applying for Medicaid and/or Extra Help. Additionally, I offer benefit reviews at no charge, to see if I can offer you more benefits or lower premiums or both.
I'm living solely on Social Security of $1,400 monthly and can't afford my Medicare premiums and copays. What assistance programs might help someone in my situation? You might be eligible for medicaid which can qualify for Medicare Saving Programs(MSP) like Qualified Medicare Beneficiary (QMB) Program or other MSP which can with premiums and other cost sharing
Medicaid eligibility starts at $1761/mo with a limit of $9660 in assets. There is also a $20 standard disregard for coverage. If you are under these figures in earning/assets, you are eligible for medicaid, which pays your part B $185 premium among other benefits. Typically, dual eligible Medicare, medicaid HMO special needs plans have no copays. Many offer monthly credit card benefits to use on housing, utility and grocery expenses.
You can apply for your State Medicaid assistance, known as the Medicare Savings Program. Each state calls it something different. In Alabama it is Alabama Medicaid, and I believe in Tennessee it’s called TennCare. They set the income limits for you to qualify and it changes yearly. In Alabama it pays your part B premium currently in 2025.
You can apply for your state Medicaid assistance program, visit your local Medicaid office. You can also apply for the extra help program offered by the Social Security Administration that can lower prescription drug costs.
Low-income subsidy by the state you live in or apply for state Medicaid at that income. You can apply for this online at SSA.gov under the Medicare tab dropdown that says Low-income part D extra help
There are multiple assistance programs for individuals with lower income. I assist people with applying for the Medicare Savings Program. If they qualify then they would no longer be responsible for paying their Part B premium. I also help people with applying for Low Income Subsidy (LIS) also called Extra Help. If approved this would allow them to refill their prescriptions at a lower cost and in some cases pay $0 for all prescriptions. I'd also help with applying for Medicaid. If they qualify and are approved, their copays would be lowered if not reduced to $0 for a visit no matter the kind of visit.
Since I only have an Arizona insurance license, I can only tell you about my state. Therefore, you are currently making too much to qualify for Medicaid. You can also contact “SHIP” or the State Health Insurance Program (Google it) to see if you may qualify for other types of assistance? There are also non-profit organizations to whom you can appeal. If you know of a social worker, that is yet another source of information to help you, too. See if there is an organization of social workers who can recommend someone who is willing to advise you. Lastly, if you can't afford the Medicare premiums, you may have signed up for a Medigap or Medicare Supplement plan, all of which have a monthly premium. So, during the upcoming fall Annual Open Enrollment period: October 15 - Dec. 7, pick up a (free of premium) Medicare Advantage plan which is government- subsidized. That becomes effective on January 1st of the following year.
Contact a local Medicare broker to Check your state EXTRA Help programs. There are resources and programs you are able to apply for that are Income based and may pay your Medicare premiums, penalties, RX copays and much more.
As a Medicare broker to my clients, I help apply for these resources and also can guide where to and how to apply.
We have several options we can explore. LIS, QMB, a Medicare Advantage part B give back. Lets provide a full look at your situation and see what fits best in your situation.
You should definitely apply for "Extra Help" through SSA.Gov
It takes about 15-20 minutes to fill out the application online, and the Federal Government will determine if you qualify for it depending on your answers.
If they approve you, your Medicare Part B premium is paid for you by the Federal government, and you also obtain medicines at an extremely low cost.
There are state programs that can help you with Medicare expenses. You can contact the Medicaid office in your area.
Here are some types of help
QMB Qualified Medicare Beneficiary, if your income is less than $1,275 for 2025 you can get assistance with Part A and B Premiums, deductibles and co-pays.
SLMB Specified low income Medicare Beneficiary, if your income is less than $1,526 for 2025, it helps with Part B Premium.
QI Qualifying individual, if your income is less than $1,715 for 2025, it helps with Part B premium, first come, first served.
Several assistance programs can help with Medicare costs for those with limited income, particularly those receiving only Social Security. Medicare Savings Programs (MSPs) can help pay for Part A and/or Part B premiums, deductibles, and copayments. The "Extra Help" program can assist with Part D (prescription drug coverage) costs. Additionally, Medi-Cal (California's Medicaid program) may offer further assistance with medical costs.
Many programs can assist you in achieving your goals of having a zero-dollar cost for your Medicare Part B premium and a zero-dollar or low-cost option for your prescriptions. You need to have a dedicated insurance agent that can help you and manage the care and the programs for you.
Dependent on your state then you should be receiving help with your part D prescription drug coverage and possibly reach a subsidy level through the state to cover your part B premium.
You can look into Medicaid assistance. You need to apply with the Department of Children and Family. As a broker this is a process I assist my clients with.
Sure, the Extra help would be ideal to help pay copayments, coinsurance & premiums for low income people on fixed incomes. Simply type in Extra Help in the Medicare.gov search box & it will show you exactly how the program works & how you qualify!
Medicaid is the best option. At that income level, you may not qualify for FULL benefits, however you could possibly qualify for partial. Partial may cover your Part B Premium for you. Also, look into your states Agency on Aging and apply for Extra Help aka LIS.
You should qualify for assistance based on your income. Since I do not know enough about your situation, I suggest you contact Medicaid to see if you are dual eligible for both Medicare and Medicaid.
You should apply through your state for something called Medicare Savings Programs. Based on your income and resources you might qualify for one of 4 different programs. For example. Someone making less than $1585 a month and has less than $9660 in resources might qualify for the Specified Low Income Medicare Beneficiary (SLMB) program which helps pay for Medicare Part B premium and also provides you with Extra Help which pays for your prescription drugs.
Although, the actual amount may vary by state, I would contact your local Medicaid office for assistance. Then I would follow up with your Medicare Plan to see what different plans may be available for members at your income level. Don't forget to contact your agent or broker. You shouldn't have to go it alone.
