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Get help covering your Medicare costs

If you think you will have trouble paying your Medicare premiums or if you’re afraid you can’t afford the presciptions you need after you turn 65, there are a number of programs out there that could help.

Financial assistance: Income vs Assets

Qualifying for a Medicare Savings Program depends on your income and assets. So what counts as an asset?

Counts as an asset

The amount of money you have in the bank

Stocks

Bonds

Real estate you own, but don’t live in

Certificates of Deposit (CDs), Mutual Funds, and

other investments through a financial institution

Doesn't count as an asset

The house you live in

One vehicle, like a car or motorcycle*

One vehicle, like a car or motorcycle*

Household items like computers and TVs

Life insurance with a cash value below $1,500

Buriel funds**

*If you have more than one vehicle, the others may be counted as an asset.

**Up to $1,500 per person

Medicare Savings Programs

If you meet the requirements, there are 4 state programs that can help you pay for your Medicare premiums. You may even qualify for help paying for your Medicare Part A and Medicare Part B deductibles, coinsurance, and copayments. The 4 Medicare Savings Programs are:

Qualified Medicare Beneficiary Program (QMB) - Helps people with limited income pay for Medicare Part A premiums, Medicare Part B premiums, deductibles, copayments, and coinsurance.

Requirements:

- Assets cannot exceed $7,860 for individuals and $11,800 for couples.

- Income cannot exceed $1,084/month for individuals and a combined $1,457/month for couples.

Specified Low-Income Medicare Beneficiary Program (SLMB) - Helps pay for Medicare Part B premiums only

Requirements:

- Assets cannot exceed $7,860 for individuals and $11,800 for couples.

- Income cannot exceed $1,296/month for individuals and a combined $1,744/month for couples.. 

Qualified Individual Program (QI) - Pays for Medicare part B premiums. Applications for this assistance program are limited and operate on a first come, first-serve basis.

Requirements:

- Assets cannot exceed $7,860 for individuals and $11,800 for couples.

- Income cannot exceed $1,456/month for individuals and a combined $1,960/month for couples.

Qualified Disabled and Working Individuals Program (QDWI) - Pays for Medicare part A premiums only and people under the age of 65 who meet certain criteria can also apply for this program.

Requirements:

- Assets cannot exceed $4,000 for individulas and $6,000 for couples.

- Income cannot exceed $4,339/month for individuals and a combined $5,833/month for couples.

Learn more about Medicare Savings Programs

Extra Help for prescriptions

Nobody should have to worry about not being able to pay for their prescriptions. The Extra Help program is a federally funded program that helps people pay for their Medicare Part D premiums, copayments, deductibles, and coinsurance. If you qualify for either the QMD, SLMB, or QI programs above, then you automatically qualify for the Extra Help program.

Learn more about how to get help paying for Medicare Part D

Medicaid

Medicaid is a joint federal and state program that helps people with limited income and resources pay for medical expenses. It also overs some services that aren’t covered by all Medicare coverage options like nursing home care and personal care services. You can also have both Medicare and Medicaid, which could cover all your bases when it comes to out-pocket costs.

To find out if your eligible for Medicaid, call your State Medicaid program.

PACE

Programs of All-Inclusive Care for the Elderly (PACE) is a Medicare and Medicaid program that helps people meet their health care needs close to home, instead of at a nursing home or another facility.

PACE can help you get care at home, or nearby in your community like:

- Adult day primary care (including doctor and recreational therapy nursing services)

- Dentistry

- Emergency services

- Home care

- Hospital care

- Laboratory/x-ray services

- Meals

- Medical specialty services

- Nursing home care

- Nutritional counseling

- Occupational therapy

- Physical therapy

- Prescription drugs

- Preventive care

There’s no deductible or copay for any service that’s approved by your PACE team. What’s more, if you qualify for Medicare, you won’t pay a monthly premium for PACE services either.

Find PACE plans near you.

Children’s Health Insurance Program

The Children’s Health Insurance Program (CHIP) provides comprehensive health insurance coverage for children under the age of 19 – regardless of household income. If you’re caring for a child of that age, this program can help you cover the costs.

Learn more about CHIP

Talk to a licensed Medicare advisor

To enroll in a Highmark plan or learn more call
1-844-614-0343 (TTY users call 711)
8 a.m. - 8 p.m. ET, Monday to Friday
9 a.m. - 5 p.m. ET, Saturday 

 

Looking for more help?

To enroll in a Highmark plan or learn more call
1-844-614-0343 (TTY users call 711)
8 a.m. - 8 p.m. ET, Monday to Friday
9 a.m. - 5 p.m. ET, Saturday