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I Can’t Afford My Medicare Premiums: What Can I Do?

Navigating healthcare costs can be a daunting task, especially when you are living on a fixed income. As of 2026, the standard monthly premium for Medicare Part B has risen to $202.90. For many, this expense—combined with Part D premiums, deductibles, and co-pays—can create significant financial strain.

 

If you find yourself struggling to keep up with these costs, you are not alone, and you are certainly not without options. The federal government and individual states offer several “safety net” programs designed specifically to help low-income beneficiaries maintain their coverage.

 

1. Medicare Savings Programs (MSPs)

The most direct way to get help with your premiums is through a Medicare Savings Program. These are state-administered programs that use Medicaid funds to pay for Medicare costs. There are four main types:

  • Qualified Medicare Beneficiary (QMB): This is the most comprehensive. It pays for Part A and Part B premiums, as well as deductibles, coinsurance, and copayments.

     

  • Specified Low-Income Medicare Beneficiary (SLMB): This program specifically pays for your Part B monthly premium.

     

  • Qualifying Individual (QI): Similar to SLMB, this pays Part B premiums but is funded by a limited federal grant and given on a first-come, first-served basis.

     

  • Qualified Disabled and Working Individual (QDWI): This helps pay the Part A premium for people with disabilities who have returned to work and lost their premium-free Part A.

     

2026 Eligibility (Approximate):

For most states, the monthly income limits (including a standard $20 disregard) for an individual are roughly:

  • QMB: $1,350

     

  • SLMB: $1,616

     

  • QI: $1,816

     

Note: Asset limits generally apply (around $9,950 for individuals), though many states like New York and California have eliminated asset tests entirely.

 

2. Extra Help (Part D Low-Income Subsidy)

If your struggle is primarily with the cost of medications, Extra Help is a federal program that helps pay for Medicare Part D prescription drug plan costs.

 

In 2026, the Social Security Administration estimates the value of this assistance at about $5,700 per year. If you qualify, you will pay $0 for your Part D premium (if you choose a “benchmark” plan) and your prescription co-pays will be capped—typically no more than **$5.10 for generics** and $12.65 for brand-name drugs.

 

How to get it: If you qualify for an MSP or Medicaid, you are automatically enrolled in Extra Help. Otherwise, you can apply directly through the Social Security Administration.

 

3. Programs of All-Inclusive Care for the Elderly (PACE)

For those who are 55 or older and require a “nursing home level of care” but wish to remain in their community, PACE is an incredible resource. It combines Medicare and Medicaid benefits into one program.

If you have Medicaid, you typically pay nothing for the long-term care portion of PACE. If you only have Medicare, you will pay a monthly premium, but the program covers all healthcare services, including medications and transportation, with no deductibles or co-pays.

 

4. State Pharmaceutical Assistance Programs (SPAPs)

Many states offer their own programs to help residents pay for drug premiums or the cost of the drugs themselves. These are separate from federal Extra Help and can often be used in tandem with Part D. States like New Jersey (PAAD) and Pennsylvania (PACE/PACENET) have robust versions of these.

 

Helpful Resources & Links

If you need help applying or determining which program fits your situation, use these resources: