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Do I Qualify for Extra Medicare Benefits? The Programs That Can Really Lower Your Costs

Extra Help, Medicare Savings Programs, Medicaid, special plans and the extras some Medicare Advantage plans include: who each is for, who decides, and where to ask. Start with the ones that do not depend on a commercial.

Medicare7 min readReviewed 2026-10-16
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Short answer

There are real programs that lower what people with Medicare pay, but they go to people who meet specific rules, and none of them arrive because you called a number on a commercial. Extra Help lowers drug costs, Medicare Savings Programs help with premiums and sometimes copayments, Medicaid covers more, special plans exist for people with Medicaid or certain long-term conditions, and some Medicare Advantage plans include extras like allowances for over-the-counter items. Whether you qualify is decided by Social Security, your state or the plan, never by an ad.

Use this before you call.

Want to know which of these are worth asking about for your situation? Call GetFastRates.com and a licensed agent will walk through it with you.

Write down what you want help with: drug costs, the Part B premium, doctor and hospital bills, or care at home.

Ask your state Medicaid office about Medicaid and the Medicare Savings Programs, even if you think your income is too high.

Ask Social Security about Extra Help with drug costs. If you have Medicaid or a Medicare Savings Program you generally get it automatically.

If you have both Medicare and Medicaid, or a long-term health condition, ask which special plans are offered in your county.

Before you join any plan for an extra benefit, ask for its Summary of Benefits and read what the benefit really covers.

Use our quick checker, or call us and a licensed agent will go over which of these are worth asking about.

Help from the government that does not depend on a plan

These programs are run by Social Security and your state. You apply to them directly, you never pay a fee to apply, and a commercial cannot get you into them.

  • Extra Help lowers what you pay for your Medicare drug plan. If you have Medicaid, or you are in a Medicare Savings Program, you generally get it automatically; otherwise you apply through Social Security.
  • Medicare Savings Programs (QMB, SLMB, QI and QDWI) are run by your state. They can pay your Part B premium and, for QMB, also deductibles, coinsurance and copayments.
  • Medicaid is a joint federal and state program that helps people with limited income and resources. It covers some things Medicare does not, such as nursing home care and personal care services, and its rules are different in each state.
  • Some states also have their own programs that help with prescription costs. Ask your State Health Insurance Assistance Program.

Plans built for certain people

If you choose Medicare Advantage, some plans are made for specific groups. They are still Medicare Advantage plans, with networks and rules.

  • Dual-eligible Special Needs Plans (D-SNPs) are for people who have both Medicare and Medicaid.
  • Chronic Condition Special Needs Plans are for people with certain long-term conditions, and you have to have the condition to join.
  • The Program of All-Inclusive Care for the Elderly (PACE) can help certain people get care outside of a nursing home, depending on age, health and where they live.

Extras inside some Medicare Advantage plans

Some Medicare Advantage plans add benefits on top of Medicare, such as dental, vision, hearing, a transportation allowance or an allowance for over-the-counter items or healthy food. These are benefits of that plan, in the places that plan is offered, for the people the plan chooses to offer them to. They are not government payments and they are not available with Original Medicare alone.

  • Ask which plans in your county have the extra you want, and who is eligible for it.
  • Ask what it is limited to: an amount, certain stores or items, a time period.
  • Check that your doctors are in the plan's network before you join for an extra.

Who decides

Whether you qualify is decided by Social Security (Extra Help), your state (Medicaid and Medicare Savings Programs) or the plan (its own extras and special plans). A website, a commercial or a caller cannot tell you for certain, and nobody should ask for your Medicare number to find out.

Common questions about this topic

Is there a list of benefits I am missing?

No one has a secret list. Ads that say you may be missing benefits are written to get your call. The real programs are the ones above, and you ask about them through Social Security, your state or a plan.

Do I pay to apply for Extra Help or a Medicare Savings Program?

No. Never pay a fee to apply for these. Anyone who charges you to apply, or says they can get you in for a price, is not offering a government program.

Can I get these with Original Medicare?

Yes for Extra Help, Medicare Savings Programs and Medicaid, which do not depend on the kind of Medicare coverage you have. Plan extras like over-the-counter allowances are only in some Medicare Advantage plans.

What if I think I do not qualify?

Ask anyway. States count income and resources differently, and the limits change every year, so the only reliable answer comes from the agency that decides.

Related coverage articles

Extra Help With Medicare Drug Costs: Who Gets It and How to ApplyExtra Help lowers what people with limited income and resources pay for their Medicare drug plan. Here is who gets it automatically, who has to apply, and what it does not do.Medicare Savings Programs Explained: QMB, SLMB, QI and QDWIMedicare Savings Programs are run by your state and can pay your Medicare premiums and sometimes your deductibles and copayments. Here is what each program does and how to apply.How Medicare and Medicaid Work Together: Who Pays What, and in What OrderMedicare and Medicaid are two different programs, and many people have both. Here is how they really fit together: who pays first, what each one covers, and what you still have to do.Medicare Advantage Extra Benefits: Dental, Vision, Hearing, Food and Over-the-Counter AllowancesSome Medicare Advantage plans include extras, but what you get depends on the plan, the county and sometimes your health. Here is what they usually look like in practice and what to ask before you join.

Tools that can help

Medicare Enrollment Period CalculatorFind your Medicare enrollment window and what it means for your timing.Medicare Part B Late Enrollment Penalty CalculatorEstimate whether a Part B late enrollment penalty could apply to you.Medicare Plan Ending FinderCheck your carrier and ZIP code against current, verified plan-ending records.

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