Medicare is a federal insurance program for older adults and people with disabilities; enroll through Social Security. Help with Medicare-related costs is available through the following programs:
1. Extra Help / Low Income Subsidy
Help with Part D prescription drug plan premiums, deductibles, and copays; if eligible for Medicaid, Extra Help will be automatic. Otherwise, apply through Social Security at www.ssa.gov or contact your local State Health Insurance Assistance Program (SHIP) at (888) 696-7213.
Full Extra Help
| Filing Status | Income | Assets |
|---|---|---|
| Individual | $1,903 | $17,220 |
| Couple | $2,575 | $34,360 |
Starting in 2024 the Partial Subsidy will be eliminated and eligibility for the Full Subsidy will be expanded to people with income up to 150% of the FPL. In 2024, most people who qualify for Extra Help will pay:
- No premiums for their drug plan
- No deductibles
- No more than $11.20 in 2024 for each brand-name drug the plan covers ($4.50 for generic)
2. Manufacturer’s Assistance with Medication Costs
Information on manufacturer’s cost breaks on some prescriptions, depending on income and insurance. Medicare’s website offers program information organized by drug name.
3. Medicaid
State-administered program for certain lower income individuals; enroll through county human services. May provide Medicare premium assistance and/or help with Medicare copays and deductibles. Note: Assets don’t include home or car.
Medicare Savings Programs (MSP)
QI-1-Pays Part B Premium
| Filing Status | Income / Month | Assets |
|---|---|---|
| Individual | $1,715 | $10,930* ($9,430) |
| Couple | $2,320 | $17,130* ($14,130) |
SLMB-Pays Part B Premium
| Filing Status | Income / Month | Assets |
|---|---|---|
| Individual | $1,526 | $10,930* ($9,430) |
| Couple | $2,064 | $17,130* ($14,130) |
QMB-Pay B Premium, co-pays and deductibles
| Filing Status | Income / Month | Assets |
|---|---|---|
| Individual | $1,275 | $10,930* ($9,430) |
| Couple | $1,724 | $17,130* ($14,130) |
Income limits include $20 disregard.
*Includes $1,500 for burial per person, must prove. Without burial in parenthesis
Full Medicaid (SSI / OAP)
May pay for some items that Medicare won’t cover; income may be higher if employment-based. Contact the county Department of Human Services for application and information or apply online at coloradopeak.secure.force.com/.Note: Assets do not include home or car.
SSI (Supplemental Security Income)
| Filing Status | Income / Month | Assets |
|---|---|---|
| Individual | $942 | $2,000 (SSI) |
| Couple | $1,415 | $3,000 (SSI) |
Long-Term Care Medicaid – HCBS / ALF / NF
Pays for home-based care (HCBS) or nursing facility care; must need assistance with Activities of Daily Living; income limit much higher than Full Medicaid; special income/ asset protections for spouses. Contact county Department of Human Services for application information.
Long-Term Care Medicaid Programs (Colorado)
| Filing Status | Income / Month | Assets |
|---|---|---|
| Individual | $2,829 | $2,000 |
| Couple | Only counts assets per couple | $3,000 |
Additional Assistance
BenefitsCheckUp is an online screening tool that can check eligibility for assistance with food, utility bills, and other needs. Go to https://benefitscheckup.org or call your local State Health Insurance Assistance Program (SHIP) at (888) 696-7213.
Call toll-free 1-888-696-7213
to talk to a local SHIP counselor who can direct you to your source for guidance with Medicaid and other benefits.
https://doi.colorado.gov/insurance-products/health-insurance/senior-health-care-medicare
This project was supported, in part by grant number 2201COMISH, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects with government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official ACL policy.