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Medicare Savings Programs and Extra Help: When Medicare Pays Your Part B Premium and Drug Costs

A stack of U.S. quarters on a white surface, with a sticky note reading “$202.90 a month?”.
Photo by Joshua Hoehne on Unsplash

Before your Social Security deposit reaches the bank, the Part B premium is already gone. Your state may be willing to pay it for you. Plenty of people who'd qualify never ask. They figure owning a house, a few thousand in savings or forty years on a payroll puts them out of reach. Usually it doesn't, not by itself. It comes down to two numbers on your own paperwork, and one is easy to read off the wrong line.

See what counts against the limits

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By Margaret Linwood · Updated Oct 15, 2026 · Reviewed against Medicare.gov, CMS, Medicaid.gov, SSA POMS, JAMA Network Open

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In one recent study, roughly two in five people who qualified got no help with a premium their state would have paid. The reasons are ordinary. The name sounds like welfare, and the income lines are odd monthly figures that don't match anything on a tax return.

The federal chart is only the floor. A state can count income more generously, drop the savings test or set higher lines of its own, which is how two people with the same check in two different states can get two different answers. Get into any one of these programs, and Extra Help with drug costs comes along with it.

See how QMB can stop Medicare's bills too

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The worries that keep people from applying

Most of what stops people isn't the income line. It's something they've heard, or assumed, about what happens once Medicaid money is involved.

  1. "I'd lose my Medicare." You don't. You keep Medicare and your plan, and the state pays part of the cost.
  2. "The state will take the house." Under federal rules, states can't recover Medicare cost-sharing paid through these programs from your estate. Full Medicaid, the kind that pays for a nursing home, has rules of its own.
  3. "My cost-of-living raise put me over." Maybe not. New income limits come out early each year, after the federal poverty guidelines are updated, so the line moves too.
  4. "I'm a little over on paper." Medicare.gov's advice is to apply even if you don't think you qualify. The state does the counting, not a chart.
  5. "I'd need to pay someone to file." You shouldn't. A State Health Insurance Assistance Program, or SHIP, gives free one-on-one help and has nothing to sell.

With those out of the way, the article gets into what your state counts as income and savings, and where the application goes.

See how to apply, step by step

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