Medicare Savings Programs and Extra Help: the benefits that pay your Medicare bills

Here is a conversation we have about once a week. A daughter is walking us through her mother’s finances so we can confirm what Navigate Care will cost, and somewhere in the list is a Social Security deposit of $1,400 a month, a Part B premium coming out of it, a Medigap policy she can barely afford, and a stack of pharmacy receipts. We stop her and ask whether her mother has ever applied for a Medicare Savings Program. The answer, almost always, is: what is that?

It is a set of programs, run by every state’s Medicaid office and paid for largely with federal money, that exist to cover Medicare’s own costs for people who cannot afford them. They have been law since the late 1980s. Roughly half of the people eligible have never enrolled. This guide is the explanation that should have come in the Medicare & You handbook, with the 2026 numbers.

There are three Medicare Savings Programs for people 65 and over, and they stack by income. The lower your income, the more the program pays.

Even the two smaller programs are worth real money. Having the Part B premium paid puts $202.90 a month back into a Social Security check, which is $2,434.80 a year. For someone living on $1,700 a month, that is a 12% raise.

These are the federal baseline monthly limits for 2026 in the 48 contiguous states and DC. Alaska and Hawaii are higher. The figures already include the standard $20 a month that every state ignores when counting income, so they are the effective cutoffs.

Income means gross income before anything is taken out: Social Security before the Part B premium is deducted, pensions, wages, interest, most everything. Two things make the real limits more generous than the table suggests. First, many states disregard additional kinds of income, which raises the effective cutoff. Second, if your parent’s income is a little over, ask anyway; the counting rules have exceptions, and a SHIP counselor knows them.

At the federal baseline, countable resources must be under $9,950 for a single person or $14,910 for a couple in 2026. Countable means bank accounts, stocks, bonds and retirement accounts. It does not mean the house they live in, one car, household goods, personal belongings, a burial plot, or life insurance with a small face value. A parent with a paid-off home, a car and $6,000 in the bank is under the limit.

Several states have eliminated the resource test for Medicare Savings Programs altogether, and others set it far above the federal figure. If your parent has more in savings than the table allows, do not assume they are out; check the rule in their state. This is exactly what SHIP counselors are for.

Extra Help, formally the Part D Low-Income Subsidy, is the prescription-drug side of the same idea. Anyone enrolled in a Medicare Savings Program gets it automatically. People who do not qualify for an MSP can still qualify for Extra Help on its own, because its limits are higher.

• 2026 income limit: $23,940 a year for a single person, $32,460 for a married couple (higher in Alaska and Hawaii).
• 2026 resource limit as Medicare states it: $18,090 for a single person, $36,100 for a couple. (The strict figure is $16,590 and $33,100; the higher number applies when you tell Social Security some of the money is set aside for burial expenses, which is how Medicare.gov presents it.)
• What it pays in 2026: a $0 plan premium for a benchmark drug plan, a $0 deductible, and copays of no more than $5.10 for each generic and $12.65 for each brand-name drug. Once total drug costs reach $2,100 for the year, covered drugs are $0.
• No Part D late-enrollment penalty while you have it.

For a parent taking five or six medications, Extra Help is frequently worth more per month than the Part B premium. Apply through Social Security, online at ssa.gov/extrahelp or by phone at 1-800-772-1213, and Social Security will also send the application to the state so the Medicare Savings Program is considered at the same time.

1. 1.Gather the paperwork: Medicare card, Social Security award letter or the most recent 1099, pension statements, the latest bank statements for every account, and any life insurance policies.
2. 2.Call your state’s SHIP, the free Medicare counseling program (national line 1-877-839-2675, or find yours at shiphelp.org). Ask for help applying for a Medicare Savings Program. They will know your state’s actual limits and will often fill in the form with you.
3. 3.Or apply directly to the state Medicaid office. Every state has an MSP application; in many states it is a short form, separate from the full Medicaid application.
4. 4.Apply for Extra Help through Social Security at the same time if you have not already; the two applications feed each other.
5. 5.Expect a decision within about 45 days. QMB coverage starts the month after approval; SLMB and QI can be retroactive up to three months, so a late application still recovers premiums already paid.
6. 6.Keep the approval letter. It is the document you show a billing office that wrongly charges a QMB patient, and it is what Navigate Care uses to confirm a $0 cost.

• QI is funded by a fixed federal allotment each year, granted first come, first served, and it has to be renewed annually. Apply early in the year if you can, and put the renewal on the calendar.
• Enrolling in QMB or SLMB does not put a lien on anyone’s house. Medicaid estate recovery rules apply to long-term care Medicaid, not to Medicare Savings Program premium payments.
• You can have a Medicare Advantage plan or Medigap and still be in an MSP. Many QMB patients drop their Medigap policy afterwards, because QMB already covers what Medigap was paying for, and the premium savings is real.
• Income counted is your parent’s (and a spouse’s), not the children’s. Helping your mother with rent does not count against her.
• If your parent is turned down, you can appeal the state’s decision, and you can reapply any time circumstances change.

The programs live in the Medicaid office, and many older adults will not apply for anything with Medicaid in the name; they think of it as welfare, or assume the house is at risk, or simply never hear about it because Medicare and Medicaid are run by different agencies that do not always talk to each other. The forms ask about assets, which feels intrusive. And there is no advertising budget for a benefit that saves the government nothing.

None of those are good reasons for a mother living on $1,500 a month to hand $202.90 of it back every month. If your parent’s income is anywhere near the figures above, spend an hour on this with a SHIP counselor. It is one of the highest-return hours in all of elder care.

“The government already decided your mother should not have to pay this. She just has to ask.”