The Medicare help millions qualify for and never claim
Four programmes pay your Part B premium, your deductibles, or your drug costs. The income limits are higher than most people assume, and take-up is dismal.
If your income is modest, there are programmes that will pay your Medicare Part B premium — $202.90 a month in 2026, straight out of your Social Security payment — and in some cases your deductibles and copays too.
They are chronically under-claimed. Millions of people who qualify have never applied, generally for one of three reasons: they've never heard of them, they assume the limits are far lower than they are, or they think of this as welfare and would rather not.
So here are the actual numbers.
| QMB | About $1,350 single / $1,824 couple. The most comprehensive: pays your Part B premium and your deductibles, coinsurance and copays. |
|---|---|
| SLMB | About $1,616 single / $2,184 couple. Pays the Part B premium. |
| QI | About $1,816 single / $2,455 couple. Pays some or all of the Part B premium. First come, first served each year. |
| Resource limit | Around $9,950 for an individual. Your home and usually one car don’t count. |
| Extra Help | Separate programme for drug costs — roughly $23,475 a year single / $31,725 couple. |
| The automatic part | Qualify for any Medicare Savings Program and you are automatically eligible for Extra Help too. |
What it’s actually worth
Start with the Part B premium: $202.90 a month is about $2,435 a year, added straight back onto your Social Security payment. For someone on the average benefit of $2,071 a month, that's close to a 10% raise.
QMB goes considerably further. It covers deductibles, coinsurance and copays, and QMB enrollees are protected from being billed by providers for Medicare-covered services at all.
And Extra Help transforms drug costs. With it, generics run about $5.10 and brand-name drugs about $12.65 in 2026, with no late-enrolment penalty for Part D.
Also on The Second Half Guide The Medicare deadline that never forgives you Almost every date in this decade is negotiable. This one isn’t — miss your enrolment window without the right coverage and you pay a surcharge every month for the rest of your life. Read it →Qualifying for the smallest of these programmes is worth roughly $2,400 a year. Qualifying for the largest can be worth several times that.
Four things people get wrong
- “My income is too high.” Maybe. But states set their own limits and many are more generous than the federal floor — some have raised limits substantially, and a few have removed the asset test entirely. The only way to know is to apply in your state.
- “I own my house, so I won't qualify.” Your primary home doesn't count toward the resource limit. Neither, usually, does one car.
- “It's welfare.” These are Medicare programmes funded partly by the payroll taxes you paid for forty years. You are not taking someone else's place; QI is the only one with a cap, and it routinely goes unfilled.
- “It'll affect my estate.” Medicare Savings Programs are not long-term-care Medicaid, and estate recovery rules generally do not apply to MSP benefits in the way people fear. Worth asking about specifically rather than assuming the worst.
How to apply
- Apply for Extra Help directly with Social Security at ssa.gov, by phone on 1-800-772-1213, or on paper. It is a short form.
- Apply for Medicare Savings Programs through your state Medicaid office — not Medicare. This split confuses people and is the commonest reason an application never gets made.
- Do it even if you think you are slightly over. State limits vary and some income is disregarded in the calculation.
- Ask your SHIP counsellor to help — free, and they do these applications constantly. shiphelp.org.
- Try BenefitsCheckUp at benefitscheckup.org, which screens for these alongside food, energy and property tax help in one pass.
- If your income drops — a spouse dies, you stop working — apply again. Eligibility is not a one-time verdict.
The reason to take this seriously even if you're comfortable: circumstances change. The most common path into these programmes is a household going from two Social Security payments to one, which is the subject of a separate piece on this site and is far more financially violent than people expect.
Twenty minutes and a form is a strange price for $2,400 a year, and it's the reason this is probably the most materially useful article we've published.
This is general information, not personal advice. We report the rules, the numbers and the deadlines as clearly as we can. We don't know your income, your state, your health or your family — and all four can change the answer. Treat this as a good place to find the right questions, not a substitute for someone looking at your actual situation.
Where these facts come from
Checked against primary sources on 10 August 2026. Dollar limits and program rules change — if you're reading this well after that date, verify the numbers at the links below.
- Medicare — Medicare Savings Programs — https://www.medicare.gov/basics/costs/help/medicare-savings-programs
- SSA — Extra Help with Medicare prescription drug costs — https://www.ssa.gov/medicare/part-d-extra-help
- NCOA — BenefitsCheckUp — https://benefitscheckup.org/
- SHIP — Free local Medicare counselling — https://www.shiphelp.org/
Edward Silva
Edward spent more than forty years as a computer professional — long enough to pick up one useful occupational habit: when somebody hands you a summary, go and read the actual documentation. He started The Second Half Guide after noticing that most writing aimed at people his age was either talking down to him or quietly selling him something, and that the plain facts — the dates, the thresholds, the dollar figures — were somehow the hardest part to find.
He's married, with two grown sons, both married themselves. He is not a financial adviser, an attorney or an insurance agent, and this site doesn't tell you what to do with your money. It tells you what the rules actually say, and links to where he checked.