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Getting Help Paying for Heatlthcare Costs

In 2022, Medicare Part B premiums saw their largest one year increase ever. Even with the higher-than-average cost of living increase through Social Security this year, many older adults are finding it difficult to cover all their healthcare costs. Fortunately, there are assistance programs that can help with these costs. These programs have different eligibility criteria with both income and asset limits. And even if you have looked into these programs in the past, eligibility criteria changes slightly each year so you may qualify even if you didn’t in the past.

For those with slightly more income and assets, the Low-Income Subsidy, or Extra Help Program is available to help with prescription drug plan premiums and copays. There are multiple assistance levels within the Extra Help program ranging from a sliding scale for premiums and copays to full assistance with premiums and very low fixed copays for prescriptions.

For those with lower incomes and assets, Medicare Savings Programs offer assistance in paying for Part B premiums. Again, there are multiple assistance levels within the Medicare Savings Program. All levels offer the Extra Help assistance as well as paying the Part B premium in full. In addition, the QMB program pays any Medicare deductibles, copays and coinsurances. These programs will not cover services not covered by Medicare (vision, dental, etc.)

Finally, for those who have very low income and assets or exceptional medical need, Medicaid has programs that provide additional coverage or reduced costs. Medicaid has a wide variety of programs for individuals with varying needs. Programs include community Medicaid for the aged, blind or disabled, the Medically Needy Spenddown program, Home and Community Based Waiver programs and Nursing Home Medicaid. Eligibility for these programs can vary and may have additional requirements beyond financial eligibility.

To find out if you may qualify for any of these programs or to get assistance applying for benefits, contact the Area Agency on Aging- Five County SHIP program at (435)673-3548.

Fraud also contributes to the rising healthcare costs for Medicare. Do your part to prevent healthcare fraud by checking your Medicare Summary Notices or Explanation of Benefits for errors. The SHIP program can also help resolve these issues should they arise.

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