Assistance programs may help with health care costs

2:04 PM, Aug. 26, 2013  |  Comments
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Dear Savvy Senior,

Are there any programs that you know of that help seniors with their Medicare expenses? I'm 67 and live primarily on my Social Security, and I am having a hard time paying my Medicare premiums, deductibles, co-pays and prescription drug costs.

Need some help

Dear Need,

There are several financial assistance programs that can help Medicare beneficiaries who are having a tough time paying their out-of-pocket health care costs. Here's what's offered, along with the eligibility requirements and how to apply.

Medicare savings

Let's start with a program that helps lower-income Medicare beneficiaries pay premiums and out-of-pocket costs for Medicare Parts A and B. It's called the Medicare Savings Program (MSP), and it has several different benefit levels for people with different financial resources. At its most generous, the program will pay your Part B premium and pretty much all your Medicare deductibles and coinsurance. At its least generous, the program will pay just your Part B premium.

To qualify for a MSP, the minimum standard set by Medicare is an income under 135 percent of the federal poverty level, which at the moment works out to around $1,313 a month for individuals.


Medicare also allows states to impose an asset test, which can be as little as $7,080 per individual, not counting your house or car but counting retirement savings and bank accounts.

But some states have made their MSP programs a lot more generous, with much higher income limits, and in some cases, no asset tests at all. And, the program may be called something else in your state. To find out if you qualify or to apply, contact your local Medicaid office: Call 800-633-4227 for contact information.

Medication assistance

For help with your Medicare prescription drug plan costs, there is a completely separate program called Extra Help. To get it, you'll need to apply through your local Social Security office.

Depending on exactly how low your income is, the program will pay all or part of your Part D prescription drug plan premium and deductible, a hefty chunk of your copay, and totally eliminate the doughnut hole coverage gap. In 2013, individuals with an income below $1,436 a month, and assets under $13,300 can qualify for Extra Help.

If you're eligible to be in a Medicare Savings Program, you will automatically qualify for Extra Help. But because the requirements are slightly different, even if you don't qualify for a Medicare Savings Program for Part B, you might be able to get Extra Help for Part D.


Get help

To help you find out if you're eligible for these programs, use the National Council on Aging web-based tool at

You'll need to fill out an online questionnaire that asks things like your date of birth, zip code, expenses, income, assets and a few other things. Once completed, you'll get a report detailing which programs you may qualify for, along with downloadable application forms and, in the case of Extra Help, it allows you to complete your entire application online. The program even knows the specific MSP eligibility rules in your state.

If you don't have Internet access, contact your State Health Insurance Assistance Program (SHIP), who provides free one-on-one Medicare counseling in person or over the phone. To locate your local SHIP, call the eldercare locator at 800-677-1116.

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