Medicare Savings Program Check

Help with Medicare costs exists, and far too few people claim it. This tool is a first look at whether you should apply.

What the questions are screening for

Two separate kinds of help sit behind them. Medicare Savings Programs are run by the state and can pay your Part B premium. Extra Help lowers what you pay for prescriptions under Part D. Qualifying for one often opens the door to the other.

Why so many eligible people never apply

• The limits are updated and they move. An old no can become a yes.
• Not all of your income is counted. Some is set aside before the test is applied.
• Your home and your car are generally not counted as resources.
• Applying costs you nothing and does not change your Medicare coverage.

In California, Medicare Savings Program applications go through your county Medi-Cal office. Extra Help is handled by Social Security at ssa.gov. You can pursue both. If a savings program approves you, Extra Help often follows without a second application.

What approval actually changes

• Your Part B premium can be paid for you, which raises your Social Security deposit.
• Doctor and hospital cost sharing can be limited or removed, depending on the level.
• Drug copays drop to a set small amount under Extra Help.
• You gain a Special Enrollment Period, so you can change drug plans outside the fall window.

The programs come in levels, with names like QMB, SLMB, and QI. Each level covers a different slice of your Medicare costs. You do not need to decide which one you want. The county sorts that out when it reviews your file, and places you at the level your paperwork supports.

One timing note. These programs are not tied to the fall enrollment window. You can apply in any month, and approval sometimes reaches back a short way. There is no reason to wait for October.

What to have in hand

A licensed agent can run a screening at no cost to you and help you file. Read about dual eligible coverage and Part D, or try the dual eligible check. Benefits and rules vary and can change. Verify everything at medicare.gov, ssa.gov, or 1-800-MEDICARE.