Is there help for me if I can’t afford Medicare’s premiums?

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  • Contributor
  • February 28, 2015

Q: Is there help for me if I can’t afford Medicare’s premiums?

A: Yes. Medicare Savings Programs (MSP) pay Medicare Part A and Medicare Part B premiums, deductibles, copays, and coinsurance for enrollees with limited income, and there are also MSPs that help just help to pay Medicare Part B premiums. (For most seniors, Medicare Part A is premium-free.)

To qualify for MSP assistance, a single person must earn less than $1,245 monthly ($1,813 for a couple), although the limits are lower to qualify for the most robust MSP that provides assistance with deductibles, copays, and coinsurance. Eligibility for MSPs is determined by your state Medicaid office.

Medicaid is also available to low-income individuals, including some seniors who are enrolled in Medicare. About 20 percent of Medicare beneficiaries are “dual eligible” for both Medicare and Medicaid. This is especially true of older seniors who need nursing home care and have exhausted their own funding to cover the cost.

Medicare offers “Extra Help” for Medicare enrollees who can’t afford prescription drug programs. In 2015, if you’re a single person earning less than $17,655 annually with financial resources that don’t exceed $13,640, “Extra Help” lowers your plan’s premium substantially and lowers the cost of prescription drugs to a very small amount

Many states offer State Pharmacy Assistance Programs (SPAPs), which help low-income individuals pay for prescription drugs based on their financial situations, on their age and on their medical condition. You can use this Medicare tool to search for SPAPs in your area.

Assistance with prescription drug coverage is available for elderly and disabled people through PACE (Programs of All-Inclusive Care for the Elderly). This Medicare / Medicaid program provides resources that are equivalent to nursing home services but which allow the enrollee to remain at home. PACE covers doctors visits, home care, hospital visits, transportation and home care as well. The fact sheet, “Quick Facts About Programs of All-inclusive Care for the Elderly” will answer your questions about the program.