Financial Assistance Programs

Medicare Assistance Programs provide financial assistance to eligible low-income individuals who need support in paying for medical expenses. The aim of these programs is to ensure that everyone, regardless of their income, has access to high-quality healthcare services.

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Extra Help

One of the most popular Medicare Assistance Programs is Extra Help, also known as the Low-Income Subsidy. This program provides assistance in paying for prescription drugs that are covered under Medicare Part D. Extra Help offers discounts on monthly premiums, deductibles, and co-payments, making prescription medication more affordable for eligible individuals.

How Do I Qualify?

Income: For individuals in 2023, the income limit for Extra Help will be $21,720 per year. For couples, the income limit will be $29,140 per year. These limits will enable a significant number of individuals to qualify for the Extra Help program, providing you with the financial assistance you need to pay for your prescription drug coverage.

Resources: For individuals in 2023, the resource limit will be $14,790. For couples, the resource limit will be $29,520. The resource limit includes assets such as savings and investments, but it does not include your primary residence or personal belongings.

You must be enrolled in Medicare Part A and Part B

Those who qualify for financial aid can save a significant amount of money per year, with the cost of generic drugs averaging $4.15 or less, and brand-name drugs averaging $10.35 or less in 2023.

Kindly get in touch with us to know more about this program and to determine which drug coverage plan will suit you best once you are enrolled.

Medicare Savings Programs

These programs assist individuals with limited income and resources in paying their Medicare premiums.

QMB Program (Qualified Medicare Beneficiary)

This program covers premiums for Part A and Part B, as well as deductibles, coinsurance, and copayments. Eligible individuals with a monthly income of $1,235 or less, and married couples with a combined income of $1,663 or less, can apply. There are also resource limits for potential beneficiaries, with a maximum of $9,090 for individuals and $13,630 for married couples.

SLMB Program (Specified Low-Income Medicare Beneficiary)

This program covers the Part B premium for those who meet certain income and resource limits. To qualify, an individual must earn no more than $1,478 per month, while a married couple must earn no more than $1,992 per month. In addition, there is a resource limit of $9,090 for individuals and $13,630 for married couples.

QI Program (Qualifying Individual)

Part B premium coverage is provided for those with a monthly income of $1,660 for individuals and $2,239 for married couples. In addition, there are resource limits set at $9,090 for individuals and $13,630 for married couples.

QDWI Program (Qualified Disabled and Working Individuals)

To be eligible for the QDWI program, individuals must meet certain income and disability criteria. They must be under the age of 65, have a disability but are able to work, and have limited income and resources. In addition, they must be eligible for Medicare Part A and not be receiving benefits under the Medicaid program or any other government assistance program.

Contact our office today to learn how to qualify for these programs.

Spend Down

The program, often referred to as Excess Income or Surplus Income, is designed for individuals with a slightly higher income than the monthly limit to qualify for Medicaid. It is particularly beneficial to those with costly medical bills.

How It Works

Suppose an individual’s monthly income is $1,050, exceeding the maximum Medicaid benefit of $950. This implies that they are $100 above the ceiling to receive Medicaid assistance. The Spend Down period, which is typically six months, implies that the excess income must be multiplied by six to arrive at the Spend Down amount of $600. Comparable to a deductible, the individual must fulfill this Spend Down amount on medical services before Medicaid pays for medical costs again.

It’s important to note that Medicaid will not provide payment for the bills used to fulfill the Spend Down amount, and the individual receiving those bills will bear the responsibility for them. However, once the Spend Down requirement is reached, Medicaid will take care of all future medical bills for the remainder of that specific time period (usually six months). After that, the Spend Down resets, and the individual will have to meet the expenses again.

Call our qualified Medicare agent today to determine what programs you may be eligible for and how to apply for assistance.

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We are not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact or 1-800-MEDICARE to get information on all of your options.