Where to Get Help Paying Your Medicare Costs
There are several financial assistance programs that can help lower-income Medicare beneficiaries who are having a difficult time paying their out-of-pocket health care costs. Here is what is available, along with the eligibility requirements and how to apply.
Medicare Savings Programs
The Medicare Savings Program (MSP) helps pay premiums and out-of-pocket costs for Medicare Parts A and B. It has several different benefit levels for people based on their income and assets. For those eligible for the highest level of assistance, the program will pay your Part A and B premiums and most of your Medicare deductibles, coinsurance and copayments. At a minimum, the program will pay only your Part B premium.
The minimum standard set by Medicare to qualify for the MSP is an income under 135% of the federal poverty level, which at the moment works out to approximately $1,426 a month for individuals (or $1,923 for married couples). Payouts from 401(k) plans, pensions, Social Security and help from family members count toward income for purposes of eligibility.
Medicare also allows states to impose an asset test, which may require the maximum assets of an individual to be as low as $7,730 for eligibility ($11,600 for married couples), excluding your house and car, but counting retirement savings and bank accounts.
Some states have made their MSP programs more generous, with much higher income limits and, in some cases, no asset test at all. The program may be called something other than MSP in your state. To find out whether you qualify or to apply, contact your state Medicaid program. Visit Medicare.gov/contacts or call 800-633-4227 for contact information.
Extra Help with Medication
For help with Medicare (Part D) prescription drug plan costs, there is a separate program called Extra Help. To get it, you will need to apply through your local Social Security office.
Depending on your income, this program may pay all or part of your Part D prescription drug plan's monthly premiums, annual deductibles and prescription co-payments. In 2019, individuals with an annual income below $18,735 ($25,365 for a married couple) and assets under $14,390 ($28,720 for a married couple) may qualify for Extra Help.
If you are eligible to participate in a Medicare Savings Program, you will automatically qualify for Extra Help. But because the requirements are slightly different, even if you do not qualify for a Medicare Savings Program for Part A or B, you might be able to get Extra Help for Part D. For more information or to apply, visit SSA.gov/extrahelp or call Social Security at 800-772-1213.
Other Assistance Programs
Depending on your income level, needs and location, there may be many other financial assistance programs that can help such as 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 find out what types of assistance programs you may be eligible for and to learn how to apply for them, go to BenefitsCheckUp.org. This is a free, confidential tool designed for people age 55 and older that contains more than 2,500 programs.
It is also possible to get help in person at one of the 87 locations of Benefits Enrollment Centers scattered across the U.S. Call 888-268-6706 or visit NCOA.org/centerforbenefits/becs to locate a center in your area. Some centers also offer assistance over the phone.
Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.