If You Live on Social Security Alone, These 5 Programs Could Help Pay Your Medicare Costs

If Social Security makes up most or all of your monthly income, Medicare premiums and out-of-pocket costs can take a real bite out of your budget. The standard Medicare Part B premium is $202.90 a month in 2026, according to the Social Security Administration, and that's before you factor in deductibles, coinsurance, and prescription drug costs.

Here's the thing many retirees don't realize: simply collecting Social Security doesn't automatically qualify you for extra help with those costs. But several federal and state programs exist specifically to ease the burden for people with limited income and resources. Knowing which ones exist, and how they differ, could make a meaningful difference in what you pay each month.

Qualified Medicare Beneficiary (QMB) Program

The QMB Program is generally the most comprehensive of the Medicare Savings Programs. It can help cover Part A premiums (if you don't qualify for premium-free Part A), plus Part B premiums, deductibles, coinsurance, and copayments for Medicare-covered services, according to Medicare.gov.

For 2026, the monthly income limit is $1,350 for an individual and $1,824 for a married couple, with a resource limit of $9,950 for an individual and $14,910 for a couple, per Medicare.gov. Income limits run slightly higher in Alaska and Hawaii. If you qualify for QMB, Medicare providers generally can't bill you for covered services, and you'll also automatically get Extra Help, paying no more than $12.65 per covered drug in 2026.

You apply for QMB and the other Medicare Savings Programs through your state, not through Medicare or Social Security directly. Even if your income looks slightly too high, it's worth applying. States can use more generous rules than the federal limits listed here, so you may still qualify.

Specified Low-Income Medicare Beneficiary (SLMB) Program

SLMB has a narrower focus than QMB: it helps pay Part B premiums only, according to Medicare.gov. You'll need both Part A and Part B to qualify.

The 2026 monthly income limit is $1,616 for an individual and $2,184 for a married couple, with the same resource limits as QMB — $9,950 for an individual and $14,910 for a couple. If you qualify for SLMB, you'll also get Extra Help with drug costs automatically, paying no more than $12.65 for each covered drug in 2026.

Because SLMB only covers the Part B premium, it can still add up meaningfully over a year, especially for someone living on a fixed Social Security check.

Qualifying Individual (QI) Program

The QI Program also helps pay Part B premiums, but it comes with a catch: funding is limited, and approvals go out on a first-come, first-served basis, with priority given to people who received QI benefits the previous year, according to Medicare.gov. You also have to reapply every year.

For 2026, the monthly income limit is $1,816 for an individual and $2,455 for a married couple, with resource limits matching QMB and SLMB at $9,950 and $14,910. QI is only available if you don't already qualify for Medicaid, though you may still qualify for a different Medicare Savings Program. Like the others, QI comes with automatic Extra Help for prescription drug costs.

Part D Extra Help

Extra Help is a separate Medicare program that specifically targets prescription drug costs under Part D. It can help with Part D premiums, deductibles, coinsurance, and other drug costs, and it also waives the late enrollment penalty for Part D while you're enrolled, according to Medicare.gov.

The income limit to qualify is $23,940 for an individual and $32,460 for a married couple, with resource limits of $18,090 for an individual and $36,100 for a couple, per Medicare.gov. Under full Extra Help, Medicare.gov notes enrollees pay no plan premium and no plan deductible. At participating pharmacies, you'll pay up to $5.10 for each generic drug and up to $12.65 for each brand-name drug, and once your total drug costs reach $2,400 in a year, you'll pay $0 for each covered drug for the rest of that year.

Some people qualify automatically. If you have full Medicaid coverage, get help from a Medicare Savings Program, or receive Supplemental Security Income (SSI) payments from Social Security, Medicare.gov notes you'll be enrolled in Extra Help without applying. Everyone else needs to apply directly, either online through the Social Security Administration or by calling the SSA at 1-800-772-1213 (TTY 1-800-325-0778).

Medicaid

Medicaid is different from the Medicare Savings Programs in an important way: it's a joint federal and state program that covers a much broader range of medical costs, not just Medicare premiums and cost-sharing, according to SSA's Extra Help publication. If you qualify for both Medicare and Medicaid, known as being "dual eligible," Medicaid may cover services Medicare doesn't, and your out-of-pocket costs could be sharply reduced or eliminated.

Each state sets its own Medicaid eligibility rules and income limits, which can differ significantly from the Medicare Savings Program limits above. Because rules vary so much by state, the best step is contacting your state's Medicaid office directly to find out what applies where you live.

Bottom line

Living on Social Security alone doesn't mean you're stuck absorbing every Medicare cost by yourself. Between the Medicare Savings Programs, Part D Extra Help, and Medicaid, there are multiple paths to lowering what you pay for premiums, deductibles, copayments, and prescription drugs, and applying for one often opens the door to automatic enrollment in another.

Because income and resource limits update annually and states can apply more generous rules than the federal minimums, it's worth checking eligibility even for those who were turned down in the past. Free, unbiased help is available through local State Health Insurance Assistance Programs (SHIP), which can walk applicants through any of these programs at no cost.

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