Medicare Financial Assistance Programs

Learn how programs like Extra Help, Medicare Savings Programs, and Medicaid coordination may help reduce Medicare premiums, deductibles, and prescription drug costs.

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Understanding Medicare Financial Assistance

Medicare costs can include premiums, deductibles, and copayments that vary depending on the type of coverage a person has. For individuals with limited income or resources, several federal and state programs may help reduce these expenses.

Understanding the different types of Medicare financial assistance programs can help beneficiaries determine whether they qualify for additional support with Medicare costs. These programs may help pay Medicare premiums, lower prescription drug costs, or assist with other out-of-pocket medical expenses.

Some programs are administered through Medicare, while others are coordinated through state Medicaid offices.

Types of Medicare Financial Assistance Programs

Several programs may help eligible individuals manage Medicare expenses, including:

• Extra Help (Low-Income Subsidy) — Helps reduce Medicare Part D prescription drug costs
• Medicare Savings Programs (MSP) — May help pay Medicare Part B premiums and other cost sharing
• Medicaid coordination — Provides additional coverage for individuals who qualify for both Medicare and Medicaid
• State Pharmaceutical Assistance Programs (SPAP) — State programs that help with prescription drug expenses in certain areas

Eligibility requirements vary depending on income, resources, and household size.

Extra Help (Low-Income Subsidy)

The Extra Help program, also called the Low-Income Subsidy (LIS), helps individuals with limited income pay for Medicare Part D prescription drug coverage.

Extra Help may reduce:

• Monthly Part D premiums
• Prescription drug copayments
• Deductibles and coverage gaps

Individuals may qualify automatically if they already receive certain forms of assistance, such as Medicaid or Supplemental Security Income (SSI). Others may apply through the Social Security Administration.

Learn more about Prescription Drug Coverage (Part D) to understand how drug plans work alongside Extra Help.

Medicare Savings Programs (MSP)

Medicare Savings Programs are state-administered programs that help pay certain Medicare costs for individuals with limited income.

Depending on eligibility, these programs may help pay:

• Medicare Part B premiums
• Deductibles and coinsurance
• Other Medicare cost-sharing expenses

There are several types of Medicare Savings Programs, including:

• Qualified Medicare Beneficiary (QMB)
• Specified Low-Income Medicare Beneficiary (SLMB)
• Qualifying Individual (QI)

Each program has different income guidelines and levels of assistance.

Medicaid and Medicare Coordination

Some individuals qualify for both Medicare and Medicaid, sometimes referred to as being “dual eligible.”

When Medicare and Medicaid are coordinated together:

• Medicare remains the primary health insurance
• Medicaid may help pay certain premiums or out-of-pocket costs
• Additional services may be covered depending on state rules

This coordination can significantly reduce the overall cost of healthcare coverage.

State Pharmaceutical Assistance Programs

Some states offer State Pharmaceutical Assistance Programs (SPAPs) that help residents afford prescription medications.

These programs vary by state and may assist with:

• Prescription drug copayments
• Medicare Part D premiums
• Coverage during the Part D coverage gap

Availability and eligibility requirements depend on the state where a person resides.

Understanding Eligibility for Assistance Programs

Eligibility for Medicare financial assistance programs depends on several factors, including:

• Household income
• Financial resources
• Current Medicare enrollment status
• State-specific eligibility guidelines

Individuals who believe they may qualify for assistance can apply through:

• Social Security Administration
• State Medicaid offices
• Local assistance programs or counseling services

Request Information About Medicare Financial Assistance

If you have questions about Medicare financial assistance programs or would like help understanding available options, our office can help explain how these programs work and how they may apply to your situation.

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This website and the Medicare 101 educational series are not affiliated with or endorsed by the U.S. government or the federal Medicare program.

There is no cost for a Medicare coverage review.

Frequently Asked Questions

What is the Extra Help program for Medicare?

The Extra Help program, also called the Low-Income Subsidy, helps individuals with limited income reduce the cost of Medicare Part D prescription drug coverage.

Who qualifies for Medicare Savings Programs?

Medicare Savings Programs are designed for individuals with limited income and resources who may need help paying Medicare premiums and other out-of-pocket costs.

Can Medicaid help with Medicare costs?

Yes. Individuals who qualify for both Medicare and Medicaid may receive assistance paying Medicare premiums, deductibles, or other medical expenses depending on their eligibility.

How do I apply for Medicare financial assistance?

Applications for Medicare financial assistance programs can be submitted through the Social Security Administration or through a state Medicaid office depending on the program.

This information is based on publicly available guidance from the Centers for Medicare & Medicaid Services.