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Help Paying for Medicare Premiums

If premiums are hard to afford, state and federal programs may cover them. See what you qualify for.

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Quick answer

Seniors who need help paying Medicare premiums can apply for Medicare Savings Programs (QMB, SLMB, QI, QDWI) through their state Medicaid office. These programs cover the Part B premium, and QMB also pays the Part A premium, deductibles, and coinsurance. Income and resource limits apply.

Medicare premiums can take a real bite out of a fixed income. Several programs exist to pay them for you if you qualify.

What programs pay Medicare premiums?

The main help comes from the four Medicare Savings Programs. The Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI) programs pay the Part B premium. The Qualified Medicare Beneficiary (QMB) program pays both the Part A and Part B premiums plus deductibles and coinsurance. The Qualified Disabled and Working Individual (QDWI) program pays the Part A premium for certain working people under 65 with disabilities. All four are run by your state Medicaid agency with income limits updated yearly by CMS.

How premium help boosts your Social Security check

Most seniors have the Medicare Part B premium automatically deducted from their monthly Social Security payment. When a Medicare Savings Program pays that premium for you, the deduction stops and your check goes up by the full premium amount. Over a year that adds up to real money you can put toward rent, food, or other bills. For QMB enrollees, the savings are even larger because deductibles and coinsurance are covered too, eliminating most surprise medical bills.

Talk to someone who can check your eligibility

Income and resource limits change every year and vary by state, so guessing whether you qualify is risky. Several states have raised or eliminated asset limits, meaning seniors turned down before may now be eligible. The simplest step is to call 1-800-MEDIGAP (1-800-633-4427). A licensed benefits specialist will review your situation, tell you which premium-paying programs you likely qualify for, and guide you to the correct state application, all at no cost.

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Frequently asked questions

Who pays my Medicare premium if I qualify?+

Your state Medicaid agency pays the premium directly on your behalf through a Medicare Savings Program. You stop seeing the Part B premium deducted from Social Security, and for QMB the Part A premium and cost-sharing are covered too.

What income do I need to get premium help?+

Income limits are set yearly by CMS as a percentage of the federal poverty level and differ by program and state. QMB has the lowest limit, then SLMB and QI. Because states apply income disregards, it is worth getting screened even if you think you earn too much.

Can I get help with both Part A and Part B premiums?+

Yes, through the QMB program, which pays both Part A and Part B premiums plus deductibles and coinsurance. SLMB and QI pay only the Part B premium. The right program depends on your income.

Does premium help also lower drug costs?+

Yes. Qualifying for any Medicare Savings Program automatically enrolls you in Extra Help, which reduces Part D prescription drug premiums, deductibles, and copays. The two benefits work together to lower your total Medicare costs.

How do I start getting help paying my premiums?+

Call 1-800-MEDIGAP (1-800-633-4427). A licensed specialist will check your eligibility for all premium-paying programs, review related benefits, and walk you through your state's application at no charge.

Talk to a licensed specialist โ€” free.

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