Medicare is not free. Premiums, deductibles, copays, and drug costs add up quickly, and for many beneficiaries on fixed incomes, those costs create real financial strain. What a surprising number of Medicare enrollees do not know is that several programs exist specifically to reduce or eliminate those costs for people who qualify.

These programs are not difficult to access. They are simply not well advertised. If you or a family member is on Medicare and managing a limited income, spending thirty minutes learning about these programs could save thousands of dollars a year.

Extra Help: The Part D Low-Income Subsidy

The Extra Help program, formally known as the Part D Low-Income Subsidy, helps Medicare beneficiaries with limited income and resources pay for prescription drug costs. This includes Part D premiums, deductibles, and copays. For people who qualify for full Extra Help, the savings are substantial. Premiums for qualifying plans may be covered entirely, deductibles are eliminated, and copays for covered drugs are reduced to a few dollars or less.

Eligibility is based on income and resource limits that the Social Security Administration updates each year. Resources include savings accounts, stocks, and bonds, but generally not your home, vehicle, household belongings, or life insurance policies. The income limits are more generous than many people expect, and it is worth checking even if you believe you do not qualify.

Applying for Extra Help is done through the Social Security Administration, either online at SSA.gov or by calling Social Security directly. The application is separate from Medicare enrollment and requires information about income and assets. If you qualify, the benefit is applied to your Part D plan and reduces what you pay at the pharmacy automatically.

People who receive Medicaid, participate in a Medicare Savings Program, or receive Supplemental Security Income are automatically enrolled in Extra Help. If you fall into any of those categories and have been paying standard Part D costs, contact Social Security to confirm your status.

The expansion of Medicaid and related programs is creating new pathways for families to access coverage support. Our guide on Medicaid expansion in 2026 and what families gain covers how those changes affect eligibility for connected programs including Medicare cost assistance.

Medicare Savings Programs: Help With Part A and Part B Costs

Medicare Savings Programs are state-administered programs that help pay Medicare premiums and, in some cases, deductibles and cost-sharing. There are four levels, each with different eligibility thresholds and different benefits.

The Qualified Medicare Beneficiary program, the most comprehensive level, pays Part A and Part B premiums, deductibles, and copays. The Specified Low-Income Medicare Beneficiary program pays Part B premiums only, as does the Qualifying Individual program, though at a slightly higher income threshold. The Qualified Disabled and Working Individuals program covers Part A premiums for people who are working despite a disability and have lost premium-free Part A eligibility.

Eligibility limits for Medicare Savings Programs vary by state. Some states have expanded their income limits above the federal minimums, meaning you might qualify in one state and not another. To find out whether you qualify in your state, contact your State Health Insurance Assistance Program, commonly known as SHIP, which provides free local counseling on Medicare options.

Applying for a Medicare Savings Program is done through your state Medicaid agency. The enrollment process requires income and asset documentation similar to other assistance programs. One important benefit of enrolling in a Medicare Savings Program is that it automatically qualifies you for Extra Help with Part D costs, so addressing both together in a single application process makes sense.

PACE and Other Programs Worth Knowing

The Program of All-inclusive Care for the Elderly, or PACE, is a Medicare and Medicaid option for people age 55 and older who meet a nursing home level of care but prefer to live in the community. PACE provides comprehensive medical and social services through a team-based care model, and for eligible individuals it can replace both Medicare and Medicaid coverage entirely with a fully integrated program.

State Pharmaceutical Assistance Programs exist in many states and provide additional drug cost help beyond the federal programs, particularly for beneficiaries who fall just above the Extra Help income limits. These programs vary considerably by state in terms of eligibility and benefit design, but they are worth checking with your state insurance commissioner's office.

The common thread across all these programs is that they go underused simply because people do not know they exist. Social Security estimates that hundreds of thousands of Medicare beneficiaries qualify for Extra Help each year but have not applied. If you are on Medicare and managing a fixed income, checking your eligibility for these programs is one of the highest-return uses of your time in terms of potential annual savings.