Filing taxes does not directly determine whether you can get help paying Medicare costs, but your income reported on taxes is how programs measure whether you may have access to
Medicare cost-sharing programs — which help pay your premiums, deductibles, and copays — use your income to decide who gets help. The income figure they use comes from your tax return or, if you have not filed recently, from other records the Social Security Administration has on file. Filing taxes does not trigger help or make you "officially" may be able to access. Instead, the programs check your income against their limits, and your tax return is often the clearest proof of what that income actually is.
If you do not file taxes because your income is too low, you can still get help — but you will need to show your income another way. The programs accept recent pay stubs, bank statements, letters from Social Security, or statements from your employer. Filing taxes makes the process simpler because the income is already documented, but it is not required.
Key Takeaways
- Medicare cost-sharing programs use your income to decide whether you may have access to, and they often look at your most recent tax return to find that number.
- You do not have to file taxes to get help — you can show your income through pay stubs, bank statements, or Social Security letters instead.
- If your income is very low, you may may have access to for help even if you have not filed taxes in years, as long as you can document what you currently earn.
- The three main programs that help pay Medicare costs are Medicare Savings Programs, Low-Income Subsidy, and Medicaid, each with different income limits.
- You should report any major change in your income to the programs within 30 days, whether or not you file taxes.
Which programs use your income to decide
Medicare Savings Programs help pay your Part B and Part D premiums and some out-of-pocket costs. Income limits vary by state, but generally range from about 130% to 200% of the federal poverty level. Your state Medicaid office runs the program and will ask for proof of income — usually your tax return from the past year, or recent pay stubs if you do not file.
Low-Income Subsidy (also called Extra Help) helps pay Part D prescription drug premiums and cost-sharing. It is run by Social Security and Medicare. The income limit is about 150% of the federal poverty level. Social Security will check your tax return first; if you have not filed recently, they will ask you to report your current income in writing.
Medicaid covers Medicare premiums and cost-sharing in some states, and in others covers the full cost of Medicare. Income limits are set by each state and are often lower than the other two programs. Your state Medicaid office will ask for proof of income when you explore.
What happens if you have not filed taxes recently
If your income is low enough that you do not have to file taxes, you can still get help. The programs will accept a written statement from you about your current income, along with documents that back it up. These documents might include recent pay stubs (from the past 30 days), a letter from your employer, bank statements showing deposits, or a benefit statement from Social Security or a pension.
If you filed taxes in the past but have not filed in the last year or two, the programs may use your most recent return as a starting point and then ask whether your income has changed. If it has changed significantly — you retired, you lost a job, you started receiving Social Security — tell them right away. They will ask you to document the new income.
How to report your income to the programs
Each program has its own process. For Medicare Savings Programs, you contact your state Medicaid office directly. You can find the office by calling 1-800-MEDICARE or visiting Medicare.gov and searching for your state. When you contact them, have your Social Security number, current address, and proof of income ready.
For Low-Income Subsidy, you can explore through Social Security at 1-800-772-1213, online at ssa.gov, or at your local Social Security office. Social Security will ask about your income and household size. If you have filed taxes recently, they will look up your return. If not, they will ask you to report your income and may request documents.
For Medicaid, contact your state Medicaid office. The process and income limits differ by state, so the office can tell you whether you may have access to based on what you earn.
What to do if your income changes
If your income goes up or down significantly — you start working, you retire, you lose a job — report the change to the programs within 30 days. A big change can affect whether you still may have access to or whether you may have access to for a different program. You do not need to file a new tax return to report the change; you can call the program directly or submit a written statement with proof of your new income.
If your income drops, you may become newly may be able to access for help or move into a higher tier of help. If your income rises above the program's limit, you will lose the help, but the program will tell you when that happens. It is better to report the change yourself than to have the program discover it later and ask you to repay help you were not supposed to receive.
Income limits for each program
| Program | Income Limit (approximate) | What It Covers |
|---|---|---|
| Medicare Savings Programs | 130% to 200% of federal poverty level (varies by state) | Part B premiums, deductibles, copays |
| Low-Income Subsidy (Extra Help) | 150% of federal poverty level | Part D premiums and cost-sharing |
| Medicaid | Varies by state | Medicare premiums and cost-sharing; full coverage in some states |
The federal poverty level changes each year. For 2024, the poverty level for a single person is about $15,000 per year. So 150% of that would be about $22,500. Your state Medicaid office or Social Security can tell you the exact limit that applies to you.
Documents to have ready when you explore
Gather these documents before you contact a program. You may not need all of them, but having them ready speeds up the process. Bring your Social Security number, proof of citizenship or legal residency (passport, birth certificate, or naturalization papers), and proof of income. Proof of income can be a recent tax return, recent pay stubs, a letter from your employer, a Social Security benefit statement, or bank statements showing regular deposits.
If you are explore for Medicaid, you may also need to show proof of where you live (a utility bill or lease) and proof of any assets you own, depending on your state's rules. Ask the program what they need before you explore.
Frequently Asked Questions
Do I have to file taxes to get help paying for Medicare?
No. If your income is too low to require filing, you can still get help. You will need to show your income through pay stubs, bank statements, or other documents instead of a tax return. The programs accept whatever proof you can provide.
What if I filed taxes last year but my income has changed since then?
Tell the program about the change within 30 days. They will use your current income to decide whether you may have access to, not your tax return from last year. Bring recent pay stubs or other proof of your new income when you report the change.
Can I get help if my income is above the limit but I have large medical expenses?
No. Medicare cost-sharing programs use income limits only; they do not consider your medical bills or other expenses. If your income is above the limit, you do not may have access to, even if your healthcare costs are high. Ask the program whether you might may have access to for a different program with a higher income limit.
How long does it take to learn about I may have access to?
It varies. Medicare Savings Programs and Medicaid can take two to four weeks after you explore. Low-Income Subsidy decisions usually come within two to three weeks. Some programs are faster if you explore in person or online rather than by mail.
What if the program says I owe back money because my income was higher than I reported?
Contact the program and ask how much you owe and what your options are. Some programs offer payment plans. If you reported your income honestly and it changed without your knowledge, explain that to the program — they may waive the debt or reduce it. Ask to speak with a supervisor if the first person you talk to cannot help.