Your comprehensive national guide to Medicare Savings Programs, Extra Help, financial assistance, and cost-reduction resources.
Medicare provides essential health coverage to tens of millions of Americans, but many seniors and individuals with disabilities still struggle with premiums, deductibles, prescription costs, and out-of-pocket expenses.
That’s where Medicare assistance programs come in.
Whether you’re looking for help paying Medicare premiums, lowering prescription drug costs, or finding resources to reduce hospital and medical bills, this guide will explain every national Medicare assistance option available in 2025—including who qualifies, how to apply, and why millions of eligible Americans still aren’t taking advantage of these programs.
This article serves as the national pillar for Medicare savings resources.
If you need state-specific information, be sure to read your state’s dedicated guide as income limits and program administration vary.
What Are Medicare Assistance Programs?
Medicare assistance programs are federal and state-supported initiatives that help low- and moderate-income individuals reduce the cost of:
- Medicare Part A premiums
- Medicare Part B premiums
- Medicare deductibles
- Medicare copayments and coinsurance
- Medicare Part D prescription drug costs
- Medicare Advantage (Part C) out-of-pocket expenses
- Supplemental coverage for certain high-risk or low-income enrollees
While Medicare itself is federal, many assistance programs are administered at the state level, making eligibility and income limits different depending on where you live.
The main categories of Medicare financial assistance include:
- Medicare Savings Programs (MSPs)
- Extra Help (Low-Income Subsidy)
- State Pharmaceutical Assistance Programs (SPAPs)
- PACE (Program of All-Inclusive Care for the Elderly)
- Medicaid for Medicare Beneficiaries (Full or Partial Dual Eligibility)
- Medicare Advantage Special Needs Plans (D-SNPs)
- Nonprofit & community-based cost assistance programs
This guide will walk through each one in detail.
1. Medicare Savings Programs (MSPs)
The most important Medicare assistance program for reducing premiums and medical costs.
Medicare Savings Programs are federal programs managed by each state, designed to help people with limited income pay for Medicare expenses.
There are four types:
QMB — Qualified Medicare Beneficiary
QMB is the most comprehensive Medicare assistance program. It can pay for:
- Medicare Part A premium (if you owe one)
- Medicare Part B premium
- All deductibles
- All copayments and coinsurance
People on QMB cannot be billed for Medicare-covered services. Providers must accept Medicare’s payment in full.
Who QMB Helps Most:
- Low-income seniors
- Individuals with disabilities
- Those who struggle with medical bills
- Anyone who wants their Part B premium eliminated
SLMB — Specified Low-Income Medicare Beneficiary
SLMB helps pay for Part B premiums only.
This is ideal for people just above the QMB income limit but still struggling financially.
QI — Qualifying Individual Program
QI also pays for Part B premiums only, but funding is limited and granted on a first-come, first-served basis each year.
Applicants must reapply annually.
QDWI — Qualified Disabled Working Individual
QDWI helps pay for Part A premiums for individuals who:
- Are under 65
- Returned to work
- Lost free Part A because of returning to work
- Meet income and asset limits
Financial Impact of Medicare Savings Programs
Most people don’t realize the magnitude of savings:
- Part B premium in 2025: $174.70/month (or more for higher-income individuals)
- QMB beneficiaries save: $2,000–$5,000+ per year
- SLMB/QI beneficiaries save: $2,000+ per year
Millions qualify—but over 50% do not apply because they don’t know these programs exist.
2. Extra Help (Low-Income Subsidy for Part D)
Extra Help is a federal program that lowers the cost of prescription drugs for Medicare beneficiaries with limited income.
Extra Help provides:
- Low or $0 Part D premiums
- Low or $0 deductibles
- Greatly reduced copays
- Protection from Part D late-enrollment penalties
- Savings of up to $5,300 per year in drug costs
Who Qualifies for Extra Help?
Eligibility is based on:
- Income
- Financial resources (checking, savings, etc.)
- Whether you receive Medicaid or SSI
- Whether you are enrolled in a Medicare Savings Program (automatic qualification)
People receiving QMB, SLMB, or QI automatically qualify for Extra Help—no separate application needed.
3. Medicaid for Medicare Beneficiaries
Full or partial dual eligibility.
Medicaid is a state-run program for individuals with limited income. Many people qualify for both Medicare and Medicaid.
There are two types:
Full Dual Eligible
Medicaid pays for:
- Medicare premiums
- Deductibles
- Copays
- Nursing home costs
- Home and community-based services
- Long-term care
- Certain transportation costs
- Dental, hearing, and vision services (varies by state)
Partial Dual Eligible
Medicaid pays for some Medicare costs—usually premiums or specific medical services.
Why Dual Eligibility Matters
Dual-eligible beneficiaries often receive:
- Lower out-of-pocket healthcare costs
- Additional care coordination
- Access to specialized Medicare Advantage plans (D-SNPs)
4. D-SNP (Dual-Eligible Special Needs Plans)
D-SNPs are Medicare Advantage plans specifically designed for people who qualify for both Medicare and Medicaid.
They typically offer:
- $0 premiums
- $0 medical copays
- Added dental, vision, hearing
- OTC benefits
- Transportation benefits
- Grocery cards (in many plans)
- Case management and coordinated care
These plans can be powerful tools for improving long-term health outcomes for lower-income seniors.
5. State Pharmaceutical Assistance Programs (SPAPs)
Some states run additional drug assistance programs separate from Medicare.
These can help pay for:
- Part D premiums
- Drug deductibles
- Drug copays
- Gap coverage during the donut hole
Not every state offers SPAPs, and program details vary widely.
(Your state-specific pages will help readers understand their local options.)
6. PACE (Program of All-Inclusive Care for the Elderly)
PACE is designed for individuals who:
- Are 55 or older
- Need nursing home–level care
- Want to remain living at home
PACE provides:
- Medical care
- Prescription drugs
- Home care
- Adult day care
- Rehabilitation
- Meals
- Transportation
PACE is one of the most comprehensive support programs in the country.
7. Nonprofit and Community Medicare Assistance Programs
Several national organizations also help beneficiaries reduce medical or prescription costs:
- Patient Access Network Foundation
- NeedyMeds
- GoodRx discount programs
- RxAssist
- RX Outreach
- Partnership for Prescription Assistance
- State Aging Agencies and SHIP programs
These can be helpful, especially for individuals who don’t meet income limits for government programs.
How to Know Which Medicare Assistance Program You Qualify For
Eligibility varies based on:
- Income (monthly or yearly)
- Resources (savings, checking, etc.)
- Disability status
- Age
- State-specific requirements
- Whether you currently pay for Part A or Part B
Most people qualify for at least one program.
Many qualify for multiple programs simultaneously, resulting in thousands of dollars in savings every year.
How to Apply for Medicare Assistance Programs
1. Medicare Savings Programs (QMB, SLMB, QI, QDWI)
Apply through your state’s Medicaid office or your state’s Department of Human Services.
2. Extra Help (LIS)
Apply through Social Security:
- Online
- By phone
- By mail
Or automatic enrollment if you already qualify for an MSP.
3. Medicaid (Full or Partial Dual)
Apply through your state Medicaid office.
4. D-SNP Plans
Enroll through a licensed Medicare agent (like Menke Insurance), by phone, or through Medicare.gov.
5. PACE
Apply through local PACE organizations (available in select regions).
Why Millions of Americans Don’t Apply for Medicare Assistance
The #1 reason is:
They don’t know the programs exist.
Other reasons include:
- Misunderstanding eligibility rules
- Fear of losing Social Security or Medicare (they won’t)
- Confusion about the application process
- Difficulty navigating government websites
- Believing they “make too much” when they don’t
- Confusing resources with income
- Lack of updated information
This is why clear, simple guides like this matter.
Common Myths About Medicare Assistance Programs (Debunked)
Myth 1: “I make too much money to qualify.”
Many programs have higher income limits than people expect, especially Extra Help.
Myth 2: “If I get help, I’ll lose my Social Security check.”
False. Assistance programs never reduce Social Security benefits.
Myth 3: “Medicare assistance is only for Medicaid recipients.”
Millions qualify without being on Medicaid.
Myth 4: “These programs are scams or too good to be true.”
All programs listed here are federal or state-run, with full legal protection.
How a Licensed Medicare Agent Can Help
Navigating Medicare assistance programs can be overwhelming.
A licensed Medicare agent can:
- Check your eligibility
- Help you apply for savings programs
- Compare Medicare Advantage, Supplement, and Part D plans
- Ensure you receive every benefit available
- Provide local guidance based on your state’s rules
Insurance agents do not approve or deny applications—but they help ensure applications are correct and guide beneficiaries through the process.
Conclusion: You May Qualify for More Medicare Assistance Than You Realize
Medicare assistance programs exist to help with:
- Premiums
- Deductibles
- Copays
- Prescription costs
- Long-term care
- Transportation
- Dental, vision, hearing
And much more.
Most beneficiaries qualify for at least one program—often without knowing it.
Whether you are looking for help with Part B premiums, prescription savings, or full dual-eligible support, there is likely a program that fits your situation.
For state-specific eligibility details, income limits, and application instructions, be sure to read your state’s Medicare assistance guide.