There are a number of government programs that may help reduce your health care and prescription drug costs if you meet the eligibility requirements.
Do you need help paying for health care costs even though you have Medicare?
- Medicare Savings Program: If you have a low income, you may qualify for a Medicare Savings Program (MSP) that helps pay some of Medicare’s out-of-pocket costs.
- Veterans Benefits: If you qualify for health benefits from the Department of Veterans Affairs (VA), the VA system may provide you health care and prescription drugs at a lowered cost.
- Low-cost health centers and clinics: You will pay less for Medicare-covered services if you receive them through low-cost health centers and clinics in your state. For more information, contact your State Health Insurance Assistance Program (SHIP). You can find the number for your SHIP by visiting www.shiptacenter.org.
- Medigaps: It might also be a good idea to sign up for supplemental insurance if you have Original Medicare and your out-of-pocket costs are high. You can get supplemental insurance from an employer or a Medigap policy that works with Original Medicare.
Do you need help paying for prescription drugs?
- Extra Help is a federal program that helps pay for some to most of the costs of Medicare prescription drug coverage (Part D). You may be eligible for Extra Help if your monthly income is up to $1,528 ($2,050 for couples) in 2018 and your assets are below $14,100 ($28,150 for couples). If you are enrolled in Medicaid, a Medicare Savings Program, or you receive Supplemental Security Income (SSI) you will get Extra Help automatically, and you do not need to apply. You can apply for the Extra Help program through the Social Security Administration or your local Medicaid office.
Note: The above income limits include a $20 income disregard that the Social Security Administration automatically subtracts from your monthly unearned income.
- State Pharmaceutical Assistance Programs (SPAPs) are offered in some states to help pay for prescriptions. Most SPAPs have income guidelines. Many also require you to enroll in a Medicare Part D plan and to apply for Extra Help. SPAPs generally pay or help pay for the Part D premium and any cost-sharing, as well as offering lower costs while you are in the donut hole. Some may also pay for drugs that are excluded from Medicare Part D or are not included in your plan’s formulary.
Note: There may be other programs that can help you pay for your prescriptions.