✔ Backed by: Medicare · Social Security Administration · State Health Insurance Assistance Programs (SHIP). Each fact links to its source, and the full list is at the bottom of this post.
Medicare premiums, deductibles, and drug copays can add up fast. For many people on a fixed income, these costs mean hard choices at the pharmacy counter or at the end of the month. Yet many people who could get help paying these costs do not know the help exists. Some who qualify never apply. Programs like Extra Help can make a real difference.
This post explains two programs that may lower what you pay: Extra Help for prescription drugs, and Medicare Savings Programs for premiums and other costs. It also shows you where to get free, one-on-one help with the paperwork.
Why now is a good time to check
Medicare Open Enrollment runs from October 15 to December 7. During this time, people can join, switch, or drop Medicare Advantage Plans and Medicare drug plans. Changes made during Open Enrollment take effect on January 1 of next year [5].
Since you may already be looking at your plan and your costs, it is a natural time to ask one more question: “Could I get help paying for this?” You do not have to wait for Open Enrollment to apply for Extra Help, though. Social Security says you can apply any time, before or after you join a Part D drug plan [2].
Program 1: Extra Help for prescription drugs
Extra Help is a Medicare program for people with limited income and resources. It helps pay Part D drug plan premiums, deductibles, coinsurance, and other drug costs [1]. It also has a hidden benefit. If you joined a drug plan late, you may owe a penalty that adds to your premium. Medicare.gov says you will not pay a Part D late enrollment penalty while you get this help [1].
What could that look like at the pharmacy? Medicare.gov says that in 2027, people in the program will pay up to $5.80 for each generic drug and up to $14.40 for each brand-name drug [1]. Your exact costs depend on your plan and your medicines.
For 2026, Medicare.gov lists these limits: $23,940 in yearly income and $18,090 in resources for one person, and $32,460 in income and $36,100 in resources for a married couple [1]. These numbers can change each year, so check the current Medicare.gov page before you decide.
Some people get Extra Help automatically. Medicare.gov says this happens if you have full Medicaid coverage, get Supplemental Security Income (SSI), or get help from your state paying your Part B premium through a Medicare Savings Program [1].
Everyone else can apply through Social Security. You can apply online, or call 1-800-772-1213, Monday through Friday, 8 a.m. to 7 p.m. If you are deaf or hard of hearing, the TTY number is 1-800-325-0778. Help is available in English, Spanish, and other languages [2]. You can say: “I would like to set up an appointment to apply for Part D Extra Help.”
Program 2: Medicare Savings Programs
Medicare Savings Programs are run by each state. They help pay Medicare costs, mainly premiums. There are four types, and each has its own rules [3].
The program with the most help is called QMB, or Qualified Medicare Beneficiary. It can pay Part A premiums (if you have to pay them), plus Part B premiums, deductibles, coinsurance, and copays. Two others, called SLMB and QI, help pay the Part B premium only. The fourth, called QDWI, helps pay the Part A premium for certain people with a disability who are working [3].
QMB also comes with an important protection. Medicare.gov says Medicare providers cannot bill people in QMB for services and items Medicare covers, including deductibles, coinsurance, and copays. You may still get a bill for a small Medicaid copay, if one applies [3]. For example, imagine you have QMB and get a bill for a Medicare copay after a doctor visit. You can call the office and say: “I am in the QMB program. I understand I should not be billed for this Medicare copay. Can you check my account?”
For 2026, the monthly income limit for one person ranges from $1,350 for QMB to $1,816 for QI, with a resource limit of $9,950 for one person in those programs. Limits are higher for married couples and slightly higher in Alaska and Hawaii [3].
Here is the part many people miss. You apply through your state, not through Medicare. And some states do not count certain income or resources, so you may qualify even if you are over the federal limits. Medicare.gov says, “Even if you don’t think you qualify, you should still apply” [3].
How the two programs work together
You can apply for Extra Help and a Medicare Savings Program at the same time. When you apply for Extra Help, Social Security will send your information to your state to start a Medicare Savings Program application, unless you tell them not to [1]. That means one application can open the door to both.
It also works the other way. People in QMB, SLMB, or QI also get Extra Help with drug costs [3]. So if you are helping a parent or friend, it is worth asking about both programs, not just one.
Gather these before you apply
Having your papers ready can make the application go faster and with less stress. Social Security suggests gathering bank statements, tax returns, retirement account balances like IRA or 401(k), and statements for pensions, veterans’ benefits, annuities, or Railroad Retirement benefits. If you are married, gather these for your spouse too [2].
It also helps to keep your Medicare card nearby, along with the name of your drug plan and a list of the medicines you take. A simple folder or large envelope works well. Label it “Medicare help” so everything stays in one place.
Tru-Tips: Make a copy or take a phone photo of every form you send. Write the date you mailed or submitted it on the copy. If anything gets lost, you will not have to start from scratch.
Get free, one-on-one help
Forms and rules can feel overwhelming. You do not have to figure this out alone. Your State Health Insurance Assistance Program, called SHIP, offers Medicare counseling at no cost. SHIP describes itself as a trusted, unbiased source, and its counseling is confidential and personal [4]. Medicare.gov also says a SHIP can give you free help applying for Extra Help [1].
A SHIP counselor can help you compare costs, review your coverage, and understand your choices [4]. Here are a few questions you can bring to a SHIP counselor or your state office:
- “Which programs might I qualify for in my state?”
- “What income and savings do you count, and what do you leave out?”
- “How long will a decision take, and how will I be told?”
- “Will this change my drug plan or my costs next year?”
If you are a caregiver, you can ask these on behalf of someone else, with their permission. Rules can change, so it is always a good idea to confirm what you hear with the program itself.
Let’s talk about it
Have you or someone you care for applied for Extra Help or a Medicare Savings Program? What was the hardest part, and what helped? Your tip could make the process easier for someone reading this.
One Tru Step: Look up your local SHIP at shiphelp.org and write its phone number on your Medicare folder today.
Sources and further reading
- Help with drug costs (Extra Help) – Medicare.gov
- Medicare Part D Extra Help – Social Security Administration
- Medicare Savings Programs – Medicare.gov
- State Health Insurance Assistance Program (SHIP)
- Open Enrollment – Medicare.gov
Sources checked October 15, 2026. General education; individual care and coverage questions require an appropriate professional.
Related Health Hubs
Join the conversation 💬
This is your space. Share a tip that helped you, ask the question you have been wondering about, or cheer on someone going through the same thing. Your comment shows up right away, and no account is needed.
Our house rules (they keep this a feel-good spot): Be kind. Stay on topic. Keep it free of religion, politics, and anything hurtful. Comments that break these rules are removed.
Protect your privacy: Use a first name or nickname, and skip full names, phone numbers, and personal health details.
If you or someone you know is in crisis, call or text 988. In an emergency, call 911.