Medicare has costs like premiums, deductibles, and coinsurance. That said, resources are available for those who need financial support.
Medicare is a federal health insurance program for people 65 years and over. Some younger people with disabilities are also qualified to enroll.
Medicare has several parts. A person must enroll in each part separately. Medicare Part A and Medicare Part B are called Original Medicare. Part A covers hospital insurance, while Part B covers general hospital insurance.
Private medical insurance companies approved by Medicare also offer Medicare Part C and Part D, as well as Medicare supplementary insurance (Medigap).
This article discusses how to get help with costs for Medicare.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
If someone has difficulty paying for Medicare, they have several options that can help them reduce costs.
Medicare savings programs
can receive help paying for Medicare Part A and B premiums through one of four Medicare Savings Programs (MSP).
If a person qualifies, MSPs may also pay for Part A and Part B deductibles, coinsurance, and copayments. A person applies for an MSP through their state. The state will determine which program or programs a person qualifies for.
To qualify for an MSP, a person must meet certain income and resource limits. Resources include stocks, bonds, and money in checking, savings, or retirement accounts. For information on MSPs, a person can contact their state here.
The 2025 eligibility criteria for the four MSPs are detailed below.
| MSP | Eligibility |
|---|---|
| Qualified Disabled and Working Individuals (QDWI) | Individual Income: $5,302 Assets:$4,000 Married Income: $7,135 Assets:$6,000 |
| Qualifying Individual (QI) | Individual Income: $1,781 Assets: $9,660 Married Income: $2,400 Assets: $14,470 |
| Qualified Medicare Beneficiary (QMB) | Individual Income: $1,325 or less Assets: $9,660; Married Income: $1,783 or less, Assets: $14,470 |
| Specified Low-Income Medicare Beneficiary (SLMB) | Individual Income: $1,585 Assets: $9,660 Married Income: $2,135 Assets: $14,470 |
Medigap supplementary insurance plans
Medicare plans that help pay for some out-of-pocket expenses are known as supplementary insurance or Medigap plans. These plans can cover out-of-pocket costs from Medicare Parts A and B. A person cannot use them to cover costs related to Part C.
Types of out-of-pocket expenses covered may include:
- copayments
- deductibles
- coinsurance
Some Medigap plans also cover medical treatment required when traveling outside the United States.
Some exclusions apply to Medigap policies. The following are generally not covered:
- eyeglasses
- long-term care
- hearing aids
- vision care
- dental treatment
- private nursing
Other assistance
Older adults may also qualify for other programs to help pay healthcare expenses. These include:
- SSI: A person may be eligible for Supplemental Security Income (SSI), a needs-based program run by the federal government. Certain income and asset requirements apply.
- Extra help: Medicare has a program called Extra Help for those with limited income and resources. The program helps pay for prescription drug costs, such as premiums, deductibles, and coinsurance.
- Pace: The Program of All-Inclusive Care for the Elderly (PACE) is available through both Medicare and Medicaid. To qualify, a person must have Medicare, Medicaid, or both and live where PACE is available. A helpful tool is available to find PACE plans in specific locations.
Both Medicare and Medicaid involve certain costs. With Medicare, in 2025, after a person meets the $257 deductible, Medicare Part B will cover 80% of services. In addition, a person has to pay a monthly premium starting at $185, depending on their income.
Glossary of Medicare terms
- Out-of-pocket cost: This is the amount a person must pay for care when Medicare does not pay the total amount or offer coverage. Costs can include deductibles, coinsurance, copayments, and premiums.
- Premium: This is the amount of money someone pays each month for Medicare coverage.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before Medicare starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, coinsurance is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
On the other hand, most people pay no premium for Part A but need to meet a $1,676 deductible. After that, Part A covers the full cost of 60 days of hospitalization.
Medicare Advantage (Part C) and Part D costs vary depending on the plan as private insurers manage these.
Healthy aging resources
To discover more evidence-based information and resources for healthy aging, visit our dedicated hub.
A person who wishes to speak to a Medicare representative can join a live chat on Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) or TTY 1-877-486-2048.
In addition, a person can consider speaking with a State Health Insurance Assistance Program (SHIP), a free service that helps people understand and manage Medicare coverage. The contact information will depend on the state.
A person can also consider consulting with a Medicare broker if they want help comparing Part C, Part D, or Medicare costs. A broker will not charge a person for their services, though they may make recommendations based on the insurance companies with which they contract. Examples of Medicare brokers include:
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Medicaid and Medicare help older adults pay for medical and healthcare costs.
Medicare has several options to help pay for hospital stays, doctor visits, and prescription medication.
Medicaid is a state-run, income-based program that can help older adults pay for medical costs. A person must qualify under their state program rules.
A person can also apply for MSPs through their state.
Older adults may qualify for SSI, Extra Help, or PACE to help pay for medical costs.