Medicare Savings Programs and Extra Help

What these programs are

Medicare Savings Programs are Medicaid-administered programs that may help pay Medicare premiums and, for some beneficiaries, deductibles, copayments, and coinsurance.

Extra Help, also called the Part D Low-Income Subsidy, helps eligible Medicare beneficiaries pay prescription drug plan costs. It can work alongside an MSP.

Who may qualify

People with Medicare and limited income may qualify. Some states also look at countable resources, while others have more generous rules or no asset test for certain help.

Eligibility can depend on household size, marital status, Medicaid status, and whether the applicant already receives SSI or another public benefit.

• QMB generally offers the broadest Medicare cost-sharing protection.
• SLMB and QI generally focus on the Part B premium.
• Extra Help focuses on Part D drug plan costs.
• A state Medicaid agency usually handles MSP applications.

What to gather

• Medicare card and current plan information.
• Social Security, pension, wage, and other income proof.
• Bank or resource information if your state requires it.
• Prescription drug list and pharmacy receipts.
• Recent Medicare Summary Notices or medical bills.

Where to verify and apply

Use Medicare.gov to understand the MSP categories, Social Security to apply for Extra Help, and SHIP for free counseling before switching plans or responding to an insurance pitch.

What varies locally

• State Medicaid agencies administer MSP applications.
• Some states have different resource rules or expanded income limits.
• Part D plan premiums, covered drugs, pharmacy networks, and formularies change by plan and year.
• Open enrollment timing matters for plan changes, but Extra Help and MSP applications may be available outside annual enrollment.

Next steps

• Call SHIP or your state Medicaid office and ask which MSP application applies.
• Apply for Extra Help through Social Security if prescription costs are a problem.
• Use Medicare Plan Compare with your exact medications and pharmacies.
• Keep a copy of any approval letter and show it if a provider bills you incorrectly.