If the cost of Medicare feels out of reach, review assistance before deciding to go without coverage. Different programs help with different bills. Applying for one does not always complete the process for another.
Start with the expense you need help paying
| Program | Main purpose | Where the decision is made |
|---|---|---|
| Medicare Savings Programs | Help with Medicare premiums; some also help with eligible medical cost sharing. | Your state Medicaid agency. |
| Extra Help | Help with Part D premiums and drug cost sharing. | Automatic qualification for some people; Social Security application for others. |
| Medicaid | State-administered health assistance that can coordinate with Medicare. | Your state. |
| Prescription Payment Plan | Spreads covered Part D out-of-pocket bills across the remaining year. | Your Medicare drug plan. This is not a discount program. |
Medicare Savings Programs
QMB can help with premiums and covered Medicare deductibles, coinsurance and copayments. SLMB and QI focus on Part B premiums. QDWI helps certain working people with disabilities pay Part A premiums. States decide eligibility; some use more generous rules than the federal baseline.
QMB also protects you from being billed Medicare cost sharing for Medicare-covered services, subject to any permitted small Medicaid copayment. Show your coverage information and question an unexpected bill rather than assuming it is correct.
Extra Help for prescriptions
Some people qualify automatically through Medicaid, a Medicare Savings Program or SSI. Others apply through Social Security. Extra Help can reduce drug-plan costs and means no Part D late penalty while receiving the benefit. It is not the same as a plan’s advertised extra benefits.
Prepare an application folder
- Medicare information and current insurance notices.
- Current income information and requested resource records.
- Household and marital-status information.
- Recent letters about Medicaid, SSI or existing assistance.
- A list of questions about which income and assets the program counts.
Use the official application process and keep the submission confirmation. Do not post account numbers, Medicare numbers or financial documents in public comments or ordinary website inquiries.
After applying
Read the approval or denial carefully. Confirm when assistance begins, whether a separate drug-plan choice is needed and whether renewal is required. If circumstances change or a renewal request arrives, respond by the stated deadline.
Common question: Should I skip applying because my income seems slightly too high? Not necessarily. State exclusions and resource rules differ. A program’s actual determination is more reliable than a quick comparison to a general chart.
Sources and update notes
Published by My Coverage Relay. Updated September 24, 2026. This guide explains general rules; individual eligibility, plan terms and state protections require a specific review.