Medicare Assistance Programs- Updated Eligibility Limits
Updated Eligibility Limits for Medicare Assistance Programs
There are several programs available to cover costs related to Medicare and prescriptions. Eligibility for any of the assistance programs depends on income and resources/assets. Income includes Social Security benefits, pension, job income, IRAs, and annuities. Resources include money in checking or savings accounts, IRAs, stocks, bonds, etc. The income & resource limits for these programs change every year, so if you donβt qualify now, make sure to check back next spring- or if your financial situation changes.
Extra Help (also known as the Low-Income Subsidy)
The Medicare Extra Help program is prescription drug assistance. If you are eligible for βExtra Help,β then your monthly cost (premium) for your drug plan could be a reduced cost or even $0, depending on the drug plan you choose. You will also have reduced copays for your prescriptions, up to $5.10 for generic or $12.65 for brand name drugs in 2026.
Otherwise, edibility is based on meeting income & resource limits. For 2026 these limits are:
- Single person β You are eligible if your income is under $2,015/month and you have under $18,090 in resources
- Married couple β You are eligible if your joint income is under $2,725/month and you have under $36,100 in resources
If you meet these requirements and donβt already have Medicare prescription assistance, you can call the Iowa SHIIP-SMP program and ask for help applying for Extra Help. We have counselors who can assist you in English or in Spanish. You can also apply for the Extra Help program through the Social Security Administration website.
Anyone who receives Medicaid assistance (including the Medicare Savings Program) will be automatically enrolled in Extra Help.
Medicare Savings Programs
Those who qualify for Medicare Savings Programs can receive assistance for Medicare Part A and Part B costs. You can be eligible for both the Extra Help program and a Medicare Savings Program.
SLMB β This program will cover your monthly Medicare Part B premium if you meet these requirements as of April 1, 2026:
- Single person β You are eligible if your income is under $1,816/month and you have under $9,950 in resources
- Married couple β You are eligible if your joint income is under $2,455/month and you have under $14,910 in resources
QMB β This program will cover your Medicare Part A & B deductibles, premiums, and copays if you meet these requirements as of April 1, 2026:
- Single person β You are eligible if your income is under $1,350/month and have under $9,950 in resources
- Married couple β You are eligible if your income is under $1,824/month and have under $14,910 in resources
If you meet these requirements and donβt already have assistance through a Medicare Savings Program, you can call the Iowa SHIIP-SMP program and ask for help applying. We have counselors who can assist you in English or in Spanish. You can also apply through the Iowa Health & Human Services website.
For More Information
- Visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) for more information about Medicare.
- Visit ssa.gov to learn more about the Extra Help program.
- For local help understanding your Medicare coverage and eligibility, call SHIIP-SMP at: 1-800-351-4664.