Medicare Cost Assistance Options
There are cost assistance options for Medicare Part A, Part B, and Part D for members who qualify. This includes Medicare Savings Programs for Part A and for Part B, a Low-Income Subsidy also called “Extra Help” for Part D, plus other assistance types. This includes Medicare Savings Programs for Part A and for Part B, a Low-Income Subsidy also called “Extra Help” for Part D, plus other assistance types.
Here is a list of Medicare Cost Assistance options based on income and other criteria:
- Medicare Savings Programs. These are income-based state-based assistance programs for Original Medicare (Part A and Part B).
- Low-Income Subsidy (Also called LIS or Extra Help). This is a subsidy based on income that lowers the cost of Part D drug coverage by 25%, 50%, 75%, or even 100%.
- Medicaid. If you qualify for cost assistance on Medicare you may also qualify for Medicaid based on income in your state. Visit Medicare.gov/contacts, or call 1-800-MEDICARE.
- Pharmacy Assistance Programs. Some states have pharmacy assistance programs that help cover the cost of certain types of drugs. For example, a state may provide extra assistance on drug costs based on income for those living with HIV or AIDs. Visit Medicare.gov/pharmaceutical-assistance-program/#state-programs.
- Patient Assistance Programs. Pharmaceutical Assistance Programs (also called Patient Assistance Programs) are offered by many drug manufacturers. Visit Medicare.gov/pharmaceutical-assistance-program.
- Program of All-Inclusive Care for the Elderly (PACE). A state-based Medicare-Medicaid program that provides in-community nursing care and all Medicare and Medicaid-covered services to those who meet certain criteria. You can find PACE options in your county via our website.
- Supplemental Security Income (SSI). This is a cash benefit paid by Social Security to people with limited income and resources who are blind, 65 or older, or have a disability. If you qualify for SSI, you automatically qualify for Extra Help. Visit benefits.gov/ssa.
- Programs for people in U.S. territories. There are specific assistance options in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa that are designed to help people with limited income and resources with Medicare costs. Visit Medicare.gov/contacts, or call 1-800-MEDICARE.
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More Facts on Medicare
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Most people are not automatically enrolled in Medicare Part A and Part B and have to sign up during their Initial Enrollment Period. The following are exceptions: If you’re already getting benefits from Social Security or the Railroad Retirement Board (RRB). If you’re under 65 and have a disability. If you have ALS (amyotrophic lateral sclerosis, also called Lou Gehrig’s disease). Meanwhile, Puerto Rico, has special rules for Medicare Enrollment.
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Medicare Advantage plans in certain states and counties may include the Medicare Give Back Benefit. When you enroll in a Medicare Advantage plan that offers the Part B Give Back Benefit, the plan’s carrier will reimburse you for a portion of your monthly Part B premium via your Social Security check.