Medicare Additional Resources
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Medicare Extra Help or Low-income subsidy
Medicare Extra Help is a federal program that provides financial assistance to low-income Medicare beneficiaries to help pay for their prescription drug costs (also known as Part D). This program is also known as the "Low-Income Subsidy" (LIS).
To be eligible for Medicare Extra Help, an individual must meet the following criteria:
Must be entitled to Medicare Part A (Hospital Insurance) and enrolled in Medicare Part B (Medical Insurance)
Beneficiaries who are eligible for Medicare Extra Help can receive:
Reduced monthly premium for their Medicare Part D plan.
Reduced copayments for their prescription drugs.
Coverage for the gap in coverage (also known as the "donut hole") under their Medicare Part D plan.
If you think you may be eligible for Medicare Extra Help, you can apply through your local Social Security office or by calling 1-800-MEDICARE (1-800-633-4227).
Medicare Savings Program
The Medicare Savings Program (MSP) is a state-administered program designed to help low-income individuals pay for their Medicare premiums and out-of-pocket costs. The MSP is not a separate health insurance program, but rather a program that provides financial assistance to those who are already enrolled in Medicare.
There are four types of Medicare Savings Programs, each with its own eligibility requirements:
Qualified Medicare Beneficiary (QMB):
This program pays for Medicare Part A and Part B premiums, deductibles, coinsurance, and copayments. To be eligible, you must have Medicare Part A and have income at or below 100% of the federal poverty level (FPL) and limited resources.
Qualified Individual (QI) Program:
This program pays for Medicare Part B premiums. To be eligible, you must have Medicare Part A, have income between 120% and 135% of the FPL, and limited resources.
Specified Low-Income Medicare Beneficiary (SLMB):
This program pays for Medicare Part B premiums. To be eligible, you must have Medicare Part A, have income between 100% and 120% of the FPL, and limited resources.
Qualified Disabled and Working Individuals (QDWI) Program:
This program helps individuals who have lost their premium-free Medicare Part A due to work, but who are still disabled and working. To be eligible, you must be disabled, have lost your premium-free Medicare Part A due to work, and have income at or below 200% of the FPL and limited resources.
To apply for the Medicare Savings Program, you should contact your state's Medicaid agency. They can provide you with information about eligibility and the application process.