Financial Assistance for Medical Costs

If you need help paying for other Medicare health care costs, you may be eligible for a variety of other assistance programs. There are several different state-run programs such as the Qualified Medicare Beneficiary (QMB) Program, the Specified Low-Income Medicare Beneficiary (SLMB) Program, the Qualifying Individual (QI) Program, and the Qualified Disabled and Working Individuals (QDWI) Program.

If you have Part D and you need help paying for Medicare prescription drug plan costs, such as premiums, deductibles, copayments, and coinsurance, because of limited income and resources, you may be eligible for Medicare’s Extra Help program. If you qualify for Extra Help, you will receive assistance paying your Part D expenses, will have less costs if you enter the coverage gap in your Part D plan, will not be required to pay a late enrollment penalty if you enroll in Medicare after your Initial Enrollment Period, and will be able to switch plans at any time of the year. Qualification requirements for Extra Help may change each year, and are based upon yearly income and resource limits. You automatically qualify for Extra Help if you have Medicare and either have full Medicaid coverage, get help from Medicaid for paying your Part B Premiums with the Medicare Savings Program, or you get Supplemental Security Income (SSI). If you did not qualify automatically and did not receive notice of your qualification in the mail, you can apply for Extra Help anytime by visiting, calling Social Security at 1-800-772-1213, or visiting to find the location of your state’s Medicaid office.  

In addition, Medicaid is a joint federal and state program that covers most medical costs that Original Medicare, Medicare Part D, and Medicare Advantage Plans do not cover. Medicaid programs may have different names in different states, may have different eligibility requirements, and may include different coverage. Many states have recently expanded their Medicaid programs, so people who were not previously eligible may now be able to obtain Medicaid.

Other forms of medical care financial assistance include State Pharmacy Assistance Programs (SPAPs), Pharmaceutical Assistance Programs, and Programs of All-inclusive Care for the Elderly (PACE).

All of the programs listed above vary state-to-state and year-by-year, so you should call or visit your state’s Medicaid office, visit, or call 1-800-MEDICARE to receive specific and updated information.