What If You Can’t Afford Medicare Premiums?
Hi Matt,
Like most people today, I’m working with a limited income and need to save money where I can. However, I also don’t want to compromise on my Medicare needs. Can you give me a breakdown of how much premiums cost as well as what financial assistance is available?
Ernest
Hi Ernest,
Thanks for your question. Medicare is intended to help people 65 and older, and those with disabilities, get the medical care they need to live a full and healthy life. But no matter how much it can improve your life, if you can’t afford to pay the monthly premiums for it, it’s all for nothing.
That’s why there are multiple programs to help people on a limited income afford this extremely important benefit.
How Much Do Medicare Premiums Cost?
There are several parts to Medicare. Your monthly premium will depend on which of these parts you choose to enroll in. You’ll find more details at Medicare.gov, but here’s a summary:
Medicare Part A: Hospitalization Insurance
If you or a spouse worked and paid Medicare taxes for at least ten years, your premiums will be $0. If you haven’t paid enough into the system, you might be able to purchase Part A for either $278 or $506 a month, based on the amount you’ve already paid into the program.
Medicare Part B: Medical Insurance
If you get free Medicare Part A, it is not required to buy Part B. However, if you have to pay for Part A, you must also purchase Part B. The premium for Part B is based on your income and costs a minimum of $164.90 per month, as of 2023. There’s also a permanent penalty added to your monthly premiums if you don’t sign up for Medicare when you first become eligible for it (usually at 65).
Medicare Part C: Medicare Advantage
This type of plan often combines a Part A and Part B plan with additional coverage for dental, hearing, vision, and prescription drugs. It is required to have Medicare Part B in order to enroll. The premiums for Medicare Advantage depend on the provider and coverage level of the plan you choose. On average though, these premiums can cost less than $17.60.
Medicare Part D: Prescription Drugs
Part D plans are meant to supplement a Part A or Part B plan with prescription drug coverage. The monthly premiums vary depending on the provider and level of coverage you choose. There are penalties for not signing up for this plan when you first enroll in Medicare or going more than 63 days without drug coverage. The national average for these types of plans is about $32.74.
Financial Assistance for Medicare Premiums
As you see, there’s a wide range of costs for Medicare premiums, depending on your individual situation. You might pay nothing, or $700 a month or more. Whatever your level of need is, there are resources available to help. Below are four Medicare Savings programs that you can apply for through your state:
Qualified Medicare Beneficiary (QMB) Program
This program assists people with the cost of Part A and Part B premiums, deductibles, coinsurance, and copayments for medical costs covered by Medicare. To qualify, an individual can make no more than $1,235 a month and have assets of no more than $9,090. For couples, those limits are $1,663 and $13,630, respectively. These figures are all up-to-date as of 2023.
Specified Low Income Medicare Beneficiary (SLMB) Program
Under this program, you’ll get assistance with paying Part B premiums. In order to receive this, you must be enrolled in both Part A and Part B. In 2023, the income limit for individuals to qualify for this program is $1,478 and the resource (asset) limit is $9,090. The financial limits for couples are $1,992 in income and $13,630 in resources.
The Qualifying Individual (QI) Program
This is a program to help pay for Medicare Part B premiums. You have to reapply for it every year, and priority is given to people who received the benefit the previous year. If you also qualify for Medicaid, the QI program is not available to you. The individual income limit in 2023 for the QI program is $1,660 and the resource limit is $9,090. For couples, it is $2,239 and $13,630, respectively.
Qualified Disabled & Working Individual (QDWI) Program
This is a program that pays for Part A premiums. You could qualify for this program if you have a disability and are working, and you also lost your Social Security disability benefits and premium-free Part A because of going back to work. The 2023 income limit for individuals is $4,945 a month and a limit of $4,000 in resources. For married couples, those limits are $6,659 and $6,000.
Want to Know More?
I’ve just given a brief summary here of the highlights of these programs. Here are some links where you can learn more:
Select Your State for more information or to apply for programs
State Health Insurance Assistance Programs
If you’re nearing retirement don’t delay investigating your options, as the premiums go up on some programs if you don’t apply for them when you become eligible. Help is available! Investigate your options and ask questions boldly until you get the information you need to make a well-informed decision.
I hope this helps!
Yours,
Matt
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Author Bio: Matt Feret is the author of the Prepare for Social Security -The Insider’s Guide and the Prepare for Medicare – The Insider’s Guide book series. He launched PrepareforSocialSecurity.com to help people get objective answers to questions about Social Security and Medicare. Matt is also the host of The Matt Feret Show. He has held leadership roles at numerous Fortune 500 Medicare health insurers in sales, marketing, operations, product development, and strategy for over two decades.
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