Help with Medicare Costs

Read below for different ways you may be able to save on a variety of Medicare costs:  

Check if you qualify for any assistance programs:

There are a variety of programs available to help cover your Medicare costs if you have limited income and resources: 

  • Medicare Savings Programs  

    Medicare Savings Programs can help cover your Medicare Part A and Part B deductibles, coinsurance, and premiums.  See the chart below to see if you meet this year’s income and resource guidelines. For additional details about these programs, see Medicare Savings Programs  

  • Extra Help (also known as Low-Income Subsidy)

    Extra Help is a prescription assistance program that allows you to enroll in drug coverage at a reduced (or no) monthly premium and reduced copays, depending on whether your prescription is generic or brand name.  Many people qualify for Extra Help automatically if they are already receiving assistance through Medicaid or a Medicare Savings Program.  But you can still qualify for Extra Help even if you don’t qualify for Medicaid or Medicare Savings Programs. 

    See the chart below to see if you meet this year’s income and resource guidelines  For additional details about prescription assistance, see Extra Help or review our Extra Help brochure .

    Do you qualify for Extra Help or a Medicare Savings Program?
    Do you qualify for Extra Help or a Medicare Savings Program?
    I am single, and… my income is no more than $1,976/month, and… I have no more than $17,600 in resources You qualify for Extra Help 
    I am married, and… my income is no more than $2,664/month, and… I have no more than $35,130 in resources You qualify for Extra Help 
    Do you qualify for Extra Help or a Medicare Savings Program?
    Do you qualify for a Medicare Savings Program?
    I am single, and… my income is no more than $1,781/month, and… I have no more than $9,660 in resources You qualify for a Medicare Savings Program 
    I am married, and… my income is no more than $2,400/month, and… I have no more than $14,470 in resources You qualify for a Medicare Savings Program 

    These programs (Medicare Savings Programs and Extra Help) are available whether you are enrolled in Original Medicare Parts A and B or a Medicare Advantage plan.
     


If you don’t qualify for assistance but you still have high drug costs: 

  • Contact your Medicare drug plan (Part D plan or Medicare Advantage plan) to see how you can apply for a formulary exception (ask your plan to cover a prescription that is not covered) or a tiering exception (ask your plan to provide your prescription at a lower cost-sharing amount).  Sometimes it is also less expensive to order your prescriptions through the drug plan’s mail order pharmacy.     
  • Search online (or talk with your pharmacist) about available discount cards or coupons. Note that not all pharmacies accept all prescription discount cards/coupons.
  • Talk with your doctor. They may have ideas for how to lower your costs, including whether your doctor could switch you to a generic version or provide temporary samples while you figure out a plan.   
  • Reach out to see if there are other assistance programs that could help you:

Make sure to check your Medicare plan (Part D or Medicare Advantage) every year during the Open Enrollment Period from October 15th to December 7th: 

  • Every year, Medicare Advantage and Medicare Part D plans change the terms of their yearly contract, so costs (like premiums & deductibles) and formularies (list of covered prescriptions) change.  This means that whatever plan you are enrolled in this year may not be the most cost-effective plan for you next year.  For details about what to check each year during Open Enrollment, including how to contact your local SHIIP/SMP site, go to our Open Enrollment Period (OEP) page. 

     

Additional Resources

For other tips on how to save money throughout the year, read our quarterly newsletter post â€śSaving Money & Medicare”