Help With Medicare Costs: Medicaid, Savings Programs, and Extra Help

If Medicare premiums or prescription costs are difficult to afford, ask about three different kinds of help: Medicaid, a Medicare Savings Program, and Part D Extra Help. Qualifying for one does not mean every other medical expense is covered. Identify which program your approval notice actually names.

Start with our Medicare coverage guide if the differences between Part A, Part B, and Part D are unfamiliar. This page focuses on paying for coverage you have or may qualify to receive.

Medicaid and Medicare Can Overlap

Medicaid is a joint federal-state program. States administer it and determine eligibility under their rules. Some people have both Medicare and full Medicaid. Others get help with specified Medicare costs through a Medicare Savings Program.

For someone with both programs, Medicare pays first for Medicare-covered services; Medicaid pays after Medicare and any other health insurance. Full Medicaid may cover services Medicare does not, subject to state coverage rules. Do not assume that a Medicare premium-assistance approval also grants every Medicaid service.

SSI is linked to Medicaid in most states, but some states require a separate Medicaid application. SSI alone is not automatic Medicare eligibility.

Identify the Medicare Savings Program

• Qualified Medicare Beneficiary (QMB): helps with Part A premiums when applicable, Part B premiums, and Medicare-covered deductibles, coinsurance, and copayments. Providers cannot bill QMB beneficiaries for Medicare-covered cost sharing, although a small Medicaid copayment may apply.
• Specified Low-Income Medicare Beneficiary (SLMB): helps pay Part B premiums.
• Qualifying Individual (QI): helps pay Part B premiums. You must apply each year; applications are handled first come, first served, with priority for people who received QI the previous year.
• Qualified Disabled and Working Individuals (QDWI): can help with Part A premiums for certain working people with disabilities who lost premium-free Part A after returning to work.

Apply through your state. Income and resource rules differ, and some states use more generous rules than the federal figures shown on Medicare’s comparison page. Do not rule yourself out using an old chart or another state’s limits.

Extra Help Addresses Part D Drug Costs

Extra Help assists with Medicare prescription drug plan costs. People with Medicare automatically qualify in certain situations, including full Medicaid coverage, a Medicare Savings Program that pays the Part B premium, or SSI. This automatic help with drug costs should not be confused with automatic eligibility for Medicare itself.

If you do not qualify automatically, you can apply for Extra Help through Social Security. The application can also start the Medicare Savings Program process by sharing information with your state, unless you opt out. The state still determines the Savings Program application.

Approval for help does not make all drugs covered in every plan. Check the plan’s drug list, pharmacy arrangements, and any applicable coverage requirements.

Prepare for a Counseling Session or Application

Make a private working folder with your current Medicare and other insurance notices, income information, and the financial records the application requests. Note whether the notice concerns full Medicaid, QMB, SLMB, QI, QDWI, or Extra Help. Use the agency’s instructions to determine what evidence is required; this checklist is preparation, not a new eligibility test.

Ask these questions:

• Which costs would this particular program pay?
• When would assistance begin?
• Is a separate drug-plan enrollment or state application still needed?
• Does this program require renewal, and how will I receive the notice?
• If I receive a bill for Medicare-covered care while on QMB, who should review it?

Keep copies of applications and decisions. If a bill appears inconsistent with QMB protection, tell the provider you have QMB and ask Medicare or your state for help resolving it.

Where to Get Help

SHIP offers free, objective counseling about Medicare and help understanding cost-assistance applications. The state Medicaid agency makes state-program decisions; Social Security handles Extra Help applications. A counselor’s explanation is not an eligibility award.

Read SSDI and SSI basics for the cash-benefit distinction and Medicare enrollment after SSDI for start-date questions.

Official Next Step

Use the official Medicare cost-help pages below to reach the appropriate application route. Contact your state Medicaid agency about Medicaid or a Savings Program, and Social Security about Extra Help. Our website’s Medicare information request is not an application for any of these programs.

Official Sources

• Medicaid
• Medicare Savings Programs
• Help with drug costs
• Supplemental Security Income (SSI) | SSI and Eligibility for Other Government and State Programs | SSA^[1]
• About SHIPs | Free Medicare Counseling from Your Local SHIP
• Parts of Medicare

Source-checked October 20, 2026. Independent educational information, not individualized legal, medical, or insurance advice. Disability Benefit Guide USA is not affiliated with the Social Security Administration, Medicare, or the Department of Veterans Affairs. See how our AI-assisted guides are prepared.

Official Sources and References

These SSA.gov links support the explanations above. Official applications, account services, and agency forms are completed through SSA.

1. Supplemental Security Income (SSI) | SSI and Eligibility for Other Government and State Programs | SSA — SSA.gov