Financial Assistance Programs
Navigating Medicare costs can feel overwhelming, but you don’t have to face them alone. From Medicaid and Extra Help to state-level assistance programs and hospital charity care, there are multiple resources designed to reduce your premiums, copays, and out-of-pocket expenses. Understanding which programs you qualify for, and how they work alongside Medicare, can mean the difference between financial stress and peace of mind.
Medicaid
What it covers:
- Pays your Medicare Part B premium and, in many states, your Part A premium (if you have one), deductibles, coinsurance, and copays.
- May also cover long-term care, in-home assistance, transportation and other services beyond Medicare’s scope.
How to apply:
- Visit your state’s Medicaid website (find yours at https://www.medicaid.gov/about-us/where-can-people-get-help-medicaid-chip# ).
- Complete the online application or download a paper form.
- Provide proof of income, assets, citizenship/immigration status, and Medicare entitlement.
Extra Help (Low-Income Subsidy/LIS)
What it covers:
- Pays all or part of your Medicare Part D (prescription drug) monthly premium, annual deductible, and lowers copayments for covered drugs.
How to apply:
- Income eligibility can be found here: https://www.medicare.gov/basics/costs/help/drug-costs
- Apply online at Social Security: https://www.ssa.gov/benefits/medicare/prescriptionhelp
- Or call SSA at 1-800-772-1213 (TTY 1-800-325-0778).
- You’ll need proof of income and resources (bank statements, etc.).
Medicare Savings Programs (MSPs)
There are four levels of MSPs—each helps pay your Part A and/or Part B costs:
| Program | Covers… |
|---|---|
| Qualified Medicare Beneficiary (QMB) | Part A & B premiums, deductibles, coinsurance, copays |
| Specified Low-Income Medicare Beneficiary (SLMB) | Part B premium only |
| Qualifying Individual (QI) | Part B premium only; funded federal dollars, first-come basis |
| Qualified Disabled and Working Individuals (QDWI) | Part A premium only |
How to apply:
- Income eligibility can be found here: https://www.medicare.gov/basics/costs/help/medicare-savings-programs
- Use your state Medicaid application (https://www.medicaid.gov/about-us/where-can-people-get-help-medicaid-chip#).
- Indicate which MSP you’re seeking and include Medicare card proof plus financial documentation.
EPIC (Elderly Pharmaceutical Insurance Coverage)
(New York State residents only)
What it covers:
- Pays a portion of your Part D drug plan premiums, copays and Late Enrollment Penalty (LEP), if you have one.
How to apply:
- Income eligibility can be found here: https://www.health.ny.gov/health_care/epic/eligibility.htm
- Online at NYSOFA: https://www.health.ny.gov/health_care/epic/application_contact.htm
- Or call 1-800-332-3742.
- Submit proof of NY residency, over 65, and income.
Hospital Financial Assistance & Charity Care
What it covers:
- Many hospitals offer sliding-scale discounts or charity care for unpaid Part A and possibly Part B coinsurance, deductibles, and other hospital-related bills.
How to apply:
- Contact your hospital’s Billing or Patient Financial Services department—ask for their Financial Assistance Program.
- Complete their application (often available on the hospital’s website).
- Provide income statements and Medicare EOBs (Explanation of Benefits).
Next Steps:
- Review eligibility: Compare income, asset limits, and program benefits.
- Gather documentation: Social Security award letter, Medicare card, pay stubs, bank statements.
- Apply early: Many programs have processing times—start at least 60 days before you need help.
- Reach out to us: Once you receive your program approval, reach out. There may be plans you qualify for with additional benefits.
Every dollar you save on premiums, deductibles, and prescriptions frees you up to enjoy the retirement you’ve worked so hard for. Whether you’re exploring Medicaid, Extra Help, an MSP, EPIC, or hospital financial aid, starting the application process early is key.
Once you’re approved for any of these programs, reach out to us. You may qualify for an alternative insurance plan with enhanced benefits.
