Tips, resources to get help with Medicare costs

Dear Savvy Senior: Does Medicare offer financial assistance for struggling seniors? My mom lives primarily on her Social Security survivor benefit and is having a hard time paying her Medicare costs. — Need Assistance

Dear Need Assistance: There are several financial assistance programs that can help Medicare beneficiaries who are struggling to pay their out-of-pocket health care costs.

Here’s what’s available, along with the eligibility requirements and how to apply.

Medicare Savings Programs

Let’s start with a program that helps pay premiums and out-of-pocket costs for Medicare Parts A and B. It’s called the Medicare Savings Program, and it has several benefit levels for people based on income and asset level. At its most generous, the program will pay your Parts A and B premiums and pretty much all your Medicare deductibles, coinsurance and copayments.

To qualify for a Medicare Savings Program, 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 $1,715 a month for individuals (or $2,320 for married couples). Everything counts toward income, including payouts from 401(k) plans, pensions, Social Security and help from family members.

Medicare also allows states to impose an asset test, which can be as little as $9,430 per individual ($14,130 for married couples). This does not count your house, car or personal belongings but does include retirement savings and bank accounts.

But some states have made their Medicare Savings Programs a lot more generous, with much higher income limits and in some cases no asset tests. And the program may be called something else in your state. To find out if you qualify or to apply, contact your state Medicaid program. Visit Medicaid.gov or call 800-633-4227 for contact information.

Medication assistance

For help with Medicare Part D prescription drug plan costs, there is another low-income subsidy program called Extra Help. To receive it, your mom will need to apply through her Social Security office.

Depending on your mother’s income level, this program will pay part or all of her Part D prescription drug plan’s monthly premiums, annual deductibles and prescription copayments. In 2025, individuals with a yearly income below $23,475 ($31,725 for a married couple) and assets under $17,600 ($35,130 for a married couple) can qualify for Extra Help.

If she’s eligible to be in a Medicare Savings Program, she will automatically qualify for Extra Help. But because the requirements are slightly different, even if she doesn’t qualify for a Medicare Savings Program for Part B, she might be able to get Extra Help for Part D. For more information or to apply, visit SSA.gov or call 800-772-1213.

Other programs

Depending on your mom’s income level, needs and location there are many other financial assistance programs that can help such as Medicaid, SSI (supplemental security income), PACE (Program of All-inclusive Care for the Elderly), SNAP (Supplemental Nutrition Assistance Program), LIHEAP (Low-Income Home Energy Assistance Program) and many others.

To find out which assistance programs she may be eligible for, and learn how to apply for them, go to BenefitsCheckUp.org. This is a free, confidential website designed for people 55 and older that contains more than 2,500 programs.

It’s also possible to get help in person at one of the 87 benefits enrollment centers scattered across 38 states. Visit NCOA.org to locate a benefits center in your area or call 800-794-6559.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org.