What If I Can’t Afford Premiums On Medicare Supplemental Insurance?

What is Medicare Supplemental Insurance (Medigap) and how can it help me?

Medigap is a policy held by private insurance companies. It is designed to cover co-payments and deductibles from original Medicare Parts A & B plans. It is considered supplemental insurance, however, it can help you and, at times, reduce your payments to zero for certain procedures or situations.

“Extra Help”

The “low income subsidy” (LIS) is financial assistance available for individuals or families who require help in paying their Medical Supplemental Insurance (Medigap) premiums. If an individual has an income of $16,245 and assets of $12,510 or less they can qualify. If a family has assets of $25,010 and income of $21,855 or less they can qualify for help. If your situation qualifies, you can complete an SSA-1020 form and submit it to the Social Security Administration who will evaluate and determine eligibility.

Medicaid and Medicare Supplemental Insurance

For low income Seniors who are 65 and older as well as younger people with a qualifying disability, medicaid can help in paying the premiums for Medicare Supplemental Insurance. Although Medicaid is run in concert between state and federal governments, each state decides whether someone qualifies for medicaid. Visit your state’s website to find out if you might qualify for this form of assistance.

Medicare Savings Plan

This is another State-run program for low income people with few or no assets. Again, your state government can provide assistance about qualifying for this program.

Consider Switching Plans

Premiums can vary greatly between plans and, if possible, get quotes for a number of different providers. If you are able to switch to a lower-priced plan with the same or similar benefits, it might make the premiums more affordable.

14 Responses to “What If I Can’t Afford Premiums On Medicare Supplemental Insurance?”

  1. Medicare says:

    I will turn 65 May 2012 and my social security is only 780 a month. I make about 3000 a yr working part time. When you say assets, I own a car and live/own in a home which I own with 3 other people. Total value, at the highest would be 70,000 my shar one 4th if I would sell. Are car and home considered assets? If they take another 100 out of ss I would starve. Would I qualify for help in this area? Thanks,

  2. Patricia says:

    This is a query for my sister’s situation.
    She only gets $500.00 a month Social Security, so obviously far below the $16,245 and doesn’t have assets (unless a 1997 Toyota counts)If close to $100.00 is taken for premiums she will be in a very bad place obviously.
    Would she qualify for assistance?
    Also, I have heard that at age 65 she can apply for a cost of living raise so she will get a bit over $700.00 a month? One man who reached 65 about 3 years ago got this type of “raise”. Any information is appreciated, as obviously she is panicked over the whole situation.
    Thank you.

    • marilyn pope says:

      this is a problem people on medicaid get everything for FREE and people that have worked all their life have bills they cannot afford, shame on the goverment…..

  3. Tim H. Royal says:

    I applied for a Supplementat Dental plan in January of 2010. Secure Horizons/ United Health Care. I realized I couldn’t afford the premiums after paying two months. I stopped the payments thinking the coverage would be dropped, alas, not. I am now facing a payback of $608.00 which I do not have. I could not afford the $32.00 premium last year, and can not this year, I don’t know how I will pay this off. Can you help or direct me to an agency that can help? Thank You. Tim Royal

  4. Alix Christie says:

    Hello, this information appears to be wrong. Medicare Savings Plans, according the government website, only help pay for Medicare A, B, & D (Presciption Drug Benefit) premiums and co-pays, not Medigap premiums. Please double check and tell me I’m wrong!

  5. Mary says:

    Extra help is only for prescription drugs. Also, if you have an income of more than 3200 dollars a year in Florida, it is next to impossible to qualify for medicaid in Florida, even as a dual eligible. It stinks to live in Florida and not be able to afford Medigap. As a 50 something with an inherited disabling condition, it would honestly have been better for me if I had died on the operating table during my first open heart.

  6. test says:

    I agree completely with what you wrote. Great read… Keep it up

  7. Spot on with this write-up, I really feel this site needs far more attention. I’ll probably be back again to read more, thanks for the advice!

  8. Jason says:

    In some situations if you can’t afford a Medigap Suuplement policy you “may” want to look into a Medicare Advanatge Plan that comes with drug coverage (partD). I would first shop around for Medigap Supplement policies first. There are many companies that offer supplemental Medigaps. So shop around for Medigap Supplement policies first. Also there are many different types of Medigap policies. For example the least expensive Medigap policies are Medigap policy A and B (not to get confused with Medicare part A and B) Those are the basic Medigap policies. Medigap Policy F is a popular Medigap supplement policy. Policues can range from A through N. F being most popular. Shop around please.
    *Important: Best time to buy a Medigap policy is within your first 6 months on Medicare part B and you are 65 or older. This is called your “Guaranteed Issued Rights”- An insurance company cannot deny you a policy and cannot use preexisting conditions. If you do not get a Medigap within your first 6 mothns of having part B and 65 or older…you can still get a Medigap policy after your first 6 months…but a company may charge you more and can use medical underwrtitting(pre existing conditions). If you cannot afford Suppllemental, maybe look into Medicar Advantage. Make sure you fully understand the Medicare Advantage plan before you join. Sometimes you must be in the Advanatge plan’s network of doctors. Read the fine print before joining, but some Medicare Advantage Plans have $0.00 premiums including $0 for thier part D drug coverage. Plans with $0.00 premiums are usually HMO-Medicare Advantage. If you have a doctor you want to continue to see, I would strongly suggest asking your doctor’s office if they accept Medicare Advanatage Plans, and if so, which ones. Medicare Advantage is another way for you to get your Medicare coverage. The Advantage plan provides your Medicare coverage instead of Medicare A and B (must you must keep A and B to have and Advanatge plan). Medicare Advantage Plans are NOT supplemental policies. They can benefit someone if you cannot afford a supplement. Do research before joining Medicare Advantage plans, Some Advanatge plans may offer Dental Vision and Hearing. Make sure you research the coverage. Some Medicare Advantage plans “claim” they offer Dental coverage. But when you read the fine print it may say “$20 co-pay on Medicare covered dental services” –this is misleading because Medicare does not cover dental. (except in extreme/rare situations). And yes, apply and see if you qualify for Extra Help on Medicare Drug costs or Medicare Saving Programs (that may help pay for part B monthly premium). The worst they can say is “No, you don’t qualify”. Might as well try.

    Ask questions, do research. Get your ducks in a row. Goodluck. Hope this helped.

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  12. tommy says:

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