Understanding Medicare and Low-Income Subsidy programs can seem overwhelming at first. But the best thing to do is to apply for the subsidy. Those programs will sometimes approve you when your income is slightly higher than the maximum, in some cases.

There are times when you must submit several applications for Extra Help before any approval takes place. If your income or resources change, you may no longer qualify for the program.

Keep reading to learn more about Medicare low-income subsidy benefits.

Can I be eligible for Medicare and Low-Income Subsidy?

It’s possible to be eligible for Medicare and Low-Income Subsidies or Extra Help. Some people with low incomes or limited resources will qualify for Medicaid and Medicare.

If you’re on Medicare and have a low income, you may qualify for a subsidy. This subsidy will help you cover the cost of your medical needs and medications. Those that don’t qualify for Medicaid may still be eligible for one of the Low-Income Subsidy programs.

If you’re eligible for Medicaid, you’ll automatically qualify for Extra Help.

How Do I Qualify for Medicare Low-Income Subsidy?

To be eligible for a Medicare Low-Income Subsidy, you’ll need to meet certain income and resource requirements. Those over the limit might not qualify. But you can always re-apply if you’re denied the first time.

If you feel your income is low, it’s worth submitting your application. If there are changes to your income, your benefits could reflect those changes.

What are the Income Limits for a Medicare Low-Income Subsidy?

Income limits are a little over $19,000 for individuals and a little over $25,000 for married couples. Depending on your need, there are different levels of assistance.

Your assets must be below a certain amount to be eligible. You could discover you’re eligible for a low-income subsidy and not eligible for Medicaid.

What are the Various Low-Income Subsidy Programs?

Qualifying Individuals (QI) can get help paying the Part B premium. However, you have to apply for assistance every year since your income is almost too high to qualify for help. If you got benefits last year, you’re on priority to receive them this year.

Specified Low-Income Medicare Beneficiary (SLMB) program covers the Part B premium if your income and resources are low but not too low, you could qualify for this program.

Qualified Medicare Beneficiaries (QMB) have the benefit of Part A and Part B premium being paid. QMB also covers the Part A and Part B deductible and coinsurance. Income and resource limits are the lowest for this subsidy program.

Can a Medicare Low-Income Subsidy Help with Medicare Premiums?

Depending on your income, Low-Income subsidies can help pay Medicare Part B and D premiums. Some beneficiaries are eligible for Medigap premium reimbursement through an active or former employer.

Medicare Advantage plans have a give-back option that allows you to get a portion of your Part B premium. There may even be a Part C plan specifically for people with a lower income.

Extra Help will cover the cost of your Part D premium, deductible, coinsurance, and copays. You must sign up for a Part D plan to have coverage.

Can a Subsidy Help with Part D Costs?

Beneficiaries that qualify for a low-income subsidy are exempt from paying costs associated with prescription drugs during the coverage gap.

Depending on your Part D plan, and Low-Income Subsidy eligibility, your premium could be little to nothing. The subsidy can help cover costs like premiums, deductibles, copays, and more.

Is Extra Help Available for Supplemental Security Income Recipients?

Those eligible for Supplemental Security Income (SSI) are likely eligible for Medicaid. You’ll need to apply to the state program to find out about your eligibility.

If you’re eligible for Medicaid, the state will help pay your Medicare monthly premiums. Medicaid automatically includes qualification for Extra Help.

How Do I Get Medicare Insurance with a Low-Income Subsidy?

A Medicare Low-Income Subsidy can help you save on medical costs. If you qualify for Extra Help or any other subsidy, you still need to have Part D insurance.

Give us a call at the number above to find the right Medicare plan for you. You can also compare rates online to determine which plans make the most sense for you.

Written By:
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Lindsay Malzone, Lindsay Malzone is the Medicare editor for Medigap.com. She's been contributing to many well-known publications since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.
Reviewed By:
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Rodolfo Marrero, Rodolfo Marrero is one of the co-founders at Medigap.com. He has been helping consumers find the right coverage since the site was founded in 2013. Rodolfo is a licensed insurance agent that works hand-in-hand with the team to ensure the accuracy of the content.