Where to start: the two main programs that help with Medicare costs

If your income is low, you may be able to get help paying your Medicare premiums, deductibles, and copays through two federal programs: Medicaid and the Medicare Savings Programs. Medicaid is run by your state and covers people whose income and assets fall below a certain threshold. The Medicare Savings Programs (also called MSPs) are smaller programs that help people with slightly higher incomes pay specific Medicare costs — usually just the Part B premium.

The key difference is that Medicaid covers more, but has stricter income and asset limits that vary by state. Medicare Savings Programs have higher income limits but only cover certain costs. Most people start by checking whether they may have access to for Medicaid first, since it offers the broadest help. If you don't may have access to for Medicaid, you then check the Medicare Savings Programs.

Both programs are administered by your state, not by Medicare itself. This means the income limits, the process process, and what gets covered can differ depending on where you live. You'll need to contact your state Medicaid office or your state health insurance information program (SHIP) to find out what's available to you.

Key Takeaways

  • Medicaid and Medicare Savings Programs are the two main ways to get help with Medicare costs, and both are run by your state.
  • Medicaid covers more costs but has lower income limits; Medicare Savings Programs have higher income limits but cover only specific costs like your Part B premium.
  • You can contact your state Medicaid office directly, or call your State Health Insurance information Program (SHIP) at 1-877-839-2675 to find out which program you may be able to use.
  • You will need to provide proof of income (recent tax return, pay stubs, or benefit statements), proof of citizenship or legal residency, and proof of your Social Security number.
  • Processing times vary by state, but most decisions come within 30 to 60 days of submitting your documents.

Understanding Medicaid and what it covers for Medicare costs

Medicaid is a joint federal and state program that covers low-income people of any age. If you may have access to for Medicaid, it can pay your Medicare Part A and Part B premiums, your deductibles, and your copays. In some states, Medicaid also covers services that Medicare doesn't cover at all, like dental or vision care.

The income limit for Medicaid varies significantly by state. In some states, you can earn up to 138% of the federal poverty level; in others, the limit is lower. For 2024, the federal poverty level for a single person is about $14,600 per year, but your state may set its own limit higher or lower. You also have an asset limit — the amount of money and property you can own and still may have access to. This limit also varies by state, but is often around $2,000 for a single person.

To find out your state's specific income and asset limits, contact your state Medicaid office. You can find the phone number by searching "[your state] Medicaid office" online, or by calling your State Health Insurance information Program (SHIP) at 1-877-839-2675. SHIP staff can tell you whether you likely may have access to and help you understand the next steps.

Medicare Savings Programs: a smaller help for people with slightly higher income

If your income is too high for Medicaid but still low, the Medicare Savings Programs may help. There are three of them: the may have access to Medicare Beneficiary (QMB) program, the Specified Low-Income Medicare Beneficiary (SLMB) program, and the may have access to Individual (QI) program. Each one covers different costs and has different income limits.

The QMB program covers your Part A and Part B premiums, deductibles, and copays. The SLMB program covers only your Part B premium. The QI program also covers only your Part B premium but has the highest income limit of the three. Income limits for these programs are set at 135% to 200% of the federal poverty level, depending on which program you're looking at. For a single person in 2024, this means income limits range from roughly $19,700 to $29,200 per year.

Unlike Medicaid, the Medicare Savings Programs have no asset limit — only income matters. This makes them a good option for people who own a home or have savings but don't earn much. You explore through your state Medicaid office, the same way you would for Medicaid.

How to find your state Medicaid office and start the process

The fastest way to begin is to call your State Health Insurance information Program (SHIP) at 1-877-839-2675. SHIP is a free counseling service in every state, and the staff can tell you over the phone whether you might may have access to for Medicaid or a Medicare Savings Program based on your income. They can also tell you exactly what documents you'll need and where to send them.

If you prefer to contact your state Medicaid office directly, search online for "[your state name] Medicaid office" or "[your state name] Department of Social Services." Most states have a central phone line and a website where you can read the process form. Some states also allow you to start an process online.

You can also visit Medicare.gov and use their "Find Care Providers" tool to locate your state Medicaid office, or call Medicare directly at 1-800-MEDICARE (1-800-633-4227) and ask them to connect you with your state program.

What documents you'll need to gather before you explore

Most states ask for the same basic documents. You'll need proof of your income from the past month or two — this can be a recent pay stub, a Social Security benefit statement, a pension statement, or your most recent tax return. If you have no income, you may need a letter from your bank or a statement showing you have no income.

You'll also need proof of citizenship or legal residency. A birth certificate, passport, or naturalization papers all work. You must provide your Social Security number, so have that ready. Some states ask for proof of your current address, such as a utility bill or lease.

If you're explore for Medicaid (not just a Medicare Savings Program), you may also need to list your assets — bank accounts, investments, property you own. The Medicare Savings Programs don't require this, but Medicaid does. Call your state office or SHIP before you explore to confirm exactly what they need; requirements can vary slightly.

The process process and what happens after you submit

You can explore by mail, phone, in person, or online, depending on your state. If you're explore by mail, send your completed form and documents to the address listed on the form — usually your state Medicaid office. Keep a copy of everything you send.

After you submit your process, your state will review it and send you a notice in the mail. This notice will say whether you were found to be within the income and asset limits, and if so, which program you may have access to for. Processing times vary by state, but most decisions come within 30 to 60 days. Some states are faster; others may take longer if they need more information from you.

If your state asks for more information, respond as quickly as you can. If you don't respond within the important date they give you (usually 10 to 30 days), your process may be denied. If that happens, you can reapply or ask for a hearing to appeal the decision.

Once you're approved, your coverage usually starts on the first day of the month after your approval, or sometimes the month you applied. Your state will send you a new Medicare card or a letter explaining your coverage. From that point on, when you see a doctor or go to the hospital, show your Medicare card as usual — the program will handle the payment to Medicare on your behalf.

What to do if your income or situation changes

If your income increases after you're approved, you may lose coverage. Most states allow you to earn a small amount more without losing benefits, but the rules vary. If you get a raise, a new job, or a change in benefits, contact your state Medicaid office to report the change. They'll tell you whether you still may have access to.

If your income decreases — for example, if you retire or lose a job — you may become may be able to access for a different program or for more help. Report this change as well, because it could increase your benefits. Your state will usually ask you to report changes within 10 days, though some states are more flexible.

You'll also need to recertify your coverage periodically, usually once a year. Your state will send you a form in the mail asking you to confirm your income and household information. Fill it out and return it by the important date, or your coverage may end.

Frequently Asked Questions

Can I have both Medicaid and Medicare at the same time?

Yes. If you may have access to for Medicaid, you keep your Medicare coverage and add Medicaid on top of it. Medicaid then helps pay the costs that Medicare doesn't cover. You'll have both cards and use them together when you see a doctor.

What if I'm not a U.S. citizen?

You may still may have access to if you are a lawful permanent resident (green card holder) or have certain other legal immigration statuses. Undocumented immigrants generally do not may have access to for Medicaid or Medicare Savings Programs, though some states offer limited emergency coverage. Call your state Medicaid office or SHIP to ask about your specific situation.

How much money can I have in the bank and still may have access to for Medicaid?

Asset limits vary by state, but are often around $2,000 for a single person and $3,000 for a couple. Your home and one car usually don't count toward this limit. Call your state Medicaid office to find out the exact limit where you live.

What if I'm denied — can I appeal?

Yes. If your state denies your process, the notice will explain why and tell you how to request a hearing. You usually have 30 to 60 days to ask for an appeal. At the hearing, you can present new information or explain why you think the decision was wrong. Many people win on appeal.

Do I have to pay anything to use Medicaid or Medicare Savings Programs?

No. These are free programs funded by federal and state taxes. No one should ask you to pay a fee to explore or to use the coverage. If someone does, it's a scam.