How To Reduce or Eliminate Your Medicare Insurance Premiums

Who does not pay Medicare Part B and Part D premiums

You may not owe premiums for Medicare Part B (medical insurance) or Part D (prescription drug coverage) if your income falls below certain thresholds. The income limits change each year and depend on your filing status — whether you file taxes as single, married filing jointly, or married filing separately. If your income is low enough, you can have your premiums reduced to zero, or the government may pay them on your behalf through a program called Medicaid.

Part A (hospital insurance) has no monthly premium for most people because you or your spouse paid Medicare taxes while working. If you did not work long enough to may have access to, you may still owe a Part A premium, but that premium can also be reduced or waived based on income.

The key is understanding which program you might may have access to for and how income is measured. Income limits are not the same across all programs, and some programs count income differently than the IRS does.

Key Takeaways

Medicaid can pay your Medicare premiums if your income and assets are below your state's limits, which vary by state and change yearly.
The Medicare Savings Programs (QMB, SLMB, and QI) help pay Part B premiums and cost-sharing for people with income between 100% and 200% of the federal poverty level.
Your state Medicaid office determines whether you meet the income and asset rules; you must contact them directly to learn your state's thresholds.
Some people may have access to for both Medicaid and Medicare; when you do, Medicaid typically pays Medicare premiums first before covering other costs.
Income limits reset each year on January 1, so you may may have access to one year but not the next, or vice versa.

Medicaid and the Medicare Savings Programs

If your income is very low, Medicaid — a joint federal and state program — can pay your Medicare premiums, deductibles, and copayments. Medicaid is run by your state, so income and asset limits differ. Some states are more generous than others. In most states, if you are over 65 and your income is below 100% of the federal poverty level (about $1,300 per month for a single person in 2024, though this varies), you may may have access to.

The Medicare Savings Programs are three separate Medicaid programs designed specifically to help people pay Medicare costs. They are called QMB (may have access to Medicare Beneficiary), SLMB (Specified Low-Income Medicare Beneficiary), and QI (may have access to Individual). Each has different income limits. QMB covers people with income up to 100% of poverty; SLMB covers up to 120% of poverty; QI covers up to 135% of poverty. These programs pay your Part B premium and sometimes your deductibles and copayments, but they do not cover Part D (drug) premiums.

To find out whether you may have access to for Medicaid or a Medicare Savings Program in your state, contact your state Medicaid office. You can locate it through the Centers for Medicare & Medicaid Services (CMS) website or by calling 1-800-MEDICARE.

How to report your income and explore

When you explore for Medicaid or a Medicare Savings Program, you will need to report your income from the past month or the past year, depending on your state's rules. Income includes Social Security, pensions, wages, interest, and dividends. Some types of income are not counted — for example, Supplemental Security Income (SSI) is excluded in most states, and some states exclude a portion of your unearned income.

You will also report your assets — savings, checking accounts, stocks, and property. Most states set an asset limit of $2,000 for a single person and $3,000 for a married couple, though some states have higher limits. Your home and one vehicle are usually not counted as assets.

explore through your state Medicaid office, either by mail, phone, or online. Many states now allow you to start the process on their website. Bring or send proof of income (recent pay stubs, tax returns, or a Social Security statement), proof of citizenship or legal residency, and proof of your Medicare enrollment. Processing typically takes two to four weeks.

What happens if your income changes during the year

If your income drops during the year, you may become newly may be able to access for Medicaid or a Medicare Savings Program. You can explore at any time; you do not have to wait for an annual enrollment period. If you are already enrolled and your income rises above the limit, your coverage will end, usually at the end of the month in which you reported the change.

Income limits reset on January 1 each year. If you did not may have access to last year, your income may fall within the new limit this year, or vice versa. It is worth checking your may be able to access each January, especially if your income is close to the cutoff.

Report income changes to your state Medicaid office as soon as you know about them. Delaying the report can result in overpayments that you may have to repay later.

Dual may be able to access: when you have both Medicare and Medicaid

If you may have access to for both Medicare and Medicaid, you are called dual may be able to access. Medicaid becomes your secondary payer, meaning it covers costs that Medicare does not pay. In most cases, Medicaid pays your Medicare premiums first, then covers deductibles, copayments, and coinsurance up to the limits set by your state.

Dual may be able to access people often have lower out-of-pocket costs than people with Medicare alone. Some states also offer special Medicare Advantage plans designed for dual may be able to access people, which may include additional benefits like dental or vision coverage. Ask your state Medicaid office whether such plans are available in your area.

Income limits by state and year

Income limits for Medicaid and Medicare Savings Programs are set by each state and updated every January. Because limits vary widely, you cannot assume you do not may have access to based on what you heard about another state or another person's situation.

The federal poverty level for 2024 is approximately $1,300 per month for a single person and $1,750 for a married couple, but your state may use a higher or lower percentage of poverty as its threshold. Some states also use a "medically needy" pathway, which allows you to may have access to if your medical expenses are high enough to bring your income below the limit after those expenses are deducted.

The only way to know your state's current limits is to contact your state Medicaid office or call 1-800-MEDICARE and ask to be transferred to your state's program. Do not rely on information from last year or from a website that does not list the current year.

Other ways to lower your Medicare costs

If your income is too high for Medicaid or the Medicare Savings Programs, you may still reduce your costs through other routes. If you have limited income and resources, you may may have access to for the Low-Income Subsidy (LIS), which helps pay Part D premiums and cost-sharing. LIS has higher income limits than Medicaid — up to 150% of poverty in most cases — and is administered by Social Security.

You can also reduce costs by choosing a Medicare Advantage plan (Part C) instead of Original Medicare plus a Medigap policy. Medicare Advantage plans often have lower or zero premiums and may include dental, vision, or hearing benefits. However, they usually have higher copayments and require you to use in-network providers. Compare plans during the annual open enrollment period (October 15 to December 7) to see which option costs less for your situation.

Frequently Asked Questions

Does my home count as an asset when I explore for Medicaid?

No. Your primary residence is not counted as an asset for Medicaid purposes, no matter how much it is worth. One vehicle is also excluded. Other real estate, rental property, and investment accounts do count toward your asset limit.

Can I get Medicaid to pay my Medicare premiums if I am still working?

Yes, if your income is low enough. Medicaid does not have a work requirement for people over 65. Your total income — including wages, Social Security, and any other sources — must fall below your state's limit. Contact your state Medicaid office to report your current income and see whether you may have access to.

What if I am denied Medicaid but think the decision is wrong?

You have the right to appeal. Your state Medicaid office will send you a notice explaining why you were denied and how to request a hearing. You typically have 30 to 60 days to file an appeal. Bring any new documents or information that supports your case, such as updated income statements or proof of expenses.

Do I have to reapply for Medicaid every year?

Requirements vary by state. Some states require annual renewal; others use "continuous may be able to access" and only ask you to report changes in income or household size. When you are approved, your state will tell you when to renew. Mark the date on your calendar so you do not miss the important date.

Can Medicaid pay my Part D premium if I already have a drug plan?

Yes. If you are enrolled in a Part D plan and then become may be able to access for Medicaid, Medicaid can pay your Part D premium going forward. You do not have to switch plans. However, if Medicaid ends, you will be responsible for the premium again, so keep track of any income changes that might affect your may be able to access.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.