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How to Qualify for Extra Help with Medicare Costs If You're on SSI or SSDI

Writer: PurplePurple

Lower Your Healthcare Costs with These Assistance Programs


Introduction: Medicare Costs Can Be Expensive—Here’s How to Get Help


If you receive Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), you may qualify for financial assistance with Medicare costs.


Many disability recipients worry about:

💰 Can I get Medicare if I'm on SSDI or SSI?

💰 What if I can’t afford Medicare premiums, deductibles, or copays?

💰 Are there programs that help pay for prescriptions and medical expenses?


The good news is YES! Several programs can reduce or eliminate Medicare costs for people with disabilities and low incomes.


In this guide, we’ll cover:

✅ Who qualifies for Medicare while on disability

✅ The Medicare Extra Help program for prescription drug savings

✅ Medicare Savings Programs that cover premiums & copays

✅ How to apply for financial help with Medicare

✅ How Purple helps track your benefits & healthcare costs


Let’s break it all down!


Can You Get Medicare While on SSDI or SSI?


Yes! But eligibility depends on whether you receive SSDI or SSI.


Medicare for SSDI Recipients

✔ If you receive SSDI, you automatically qualify for Medicare after 24 months of benefits.

✔ Medicare starts on the 25th month of SSDI payments.

✔ You can get Medicare Part A (hospital insurance) for free, but Part B (doctor visits) has a monthly premium.


💡 Tip: If you need health coverage before Medicare kicks in, check if you qualify for Medicaid.


Medicare for SSI Recipients

❌ SSI alone does NOT qualify you for Medicare.

✔ Instead, most SSI recipients qualify for Medicaid, which covers healthcare at little or no cost.

✔ Once you turn 65, you may qualify for Medicare in addition to Medicaid.


💡 If you receive both Medicare & Medicaid, you are "dual eligible" and get even more benefits!


What Is the Medicare Extra Help Program?


The Extra Help Program (also called Low-Income Subsidy, LIS) helps people on Medicare pay for prescription drugs.


What Does Extra Help Cover?

✔ Lower monthly premiums for Medicare Part D (prescription drug plans)

✔ Reduced copays for medications

✔ **No coverage gap ("donut hole") in drug costs


Who Qualifies for Extra Help?

You automatically qualify if you:

✅ Receive Medicaid

✅ Receive SSI

✅ Are in a Medicare Savings Program


💡 If you don’t automatically qualify, you can still apply based on income and assets!


How to Apply for Medicare Extra Help

📲 Apply online at SSA.gov

📞 Call Social Security at 1-800-772-1213

🏢 Apply in person at your local Social Security office


💡 Once approved, Extra Help can save you over $5,000 per year on prescription costs!


What Are Medicare Savings Programs?


If you can’t afford Medicare premiums, deductibles, or copays, a Medicare Savings Program (MSP) can help.


4 Types of Medicare Savings Programs:

Program
What It Covers
Who Qualifies?

QMB (Qualified Medicare Beneficiary)

Pays Medicare Part A & B premiums, deductibles, and copays

Lowest-income individuals

SLMB (Specified Low-Income Medicare Beneficiary)

Pays Part B premium only

Slightly higher income than QMB

QI (Qualified Individual)

Pays Part B premium only

Higher income than SLMB, must apply yearly

QDWI (Qualified Disabled & Working Individual)

Pays Part A premium

For disabled individuals who return to work

💡 **If you qualify for QMB, you pay $0 for doctor visits, hospital stays, and most medical services!


Who Qualifies for a Medicare Savings Program?


Income & Asset Limits for Medicare Savings Programs (2025)


To qualify, you must meet income and asset limits set by your state.

Program
Monthly Income Limit (Individuals)
Asset Limit (Individuals)

QMB

$1,235

$9,090

SLMB

$1,478

$9,090

QI

$1,660

$9,090

QDWI

$4,945

$4,000

💡 Assets include bank accounts, stocks, and bonds—but your home, car, and personal belongings DO NOT count.


How to Apply for a Medicare Savings Program

📲 Apply online at Medicare.gov

📞 Call your state’s Medicaid office

🏢 Visit your local Social Security office


💡 If you already get Medicaid or SSI, you may automatically qualify!


What If I Have Both Medicare & Medicaid? (Dual Eligibility)


If you qualify for both Medicare & Medicaid, you’re considered dual eligible and get even more benefits:

✔ Medicare pays first, and Medicaid covers what’s left.

✔ You may pay $0 for doctor visits, hospital stays, and prescriptions.

✔ You automatically get Extra Help for prescription drug costs.


💡 If you’re dual eligible, look into a "Dual Eligible Special Needs Plan (D-SNP)," which gives even better coverage!


How Purple Helps Track Your Medicare & Disability Benefits


Keeping up with SSI, SSDI, Medicare, and Medicaid can be overwhelming—Purple makes it easy!

💜 Track Your Disability Payments – Get alerts when SSI & SSDI deposits arrive.

💜 Monitor Your Medicare Premiums & Deductibles – Never miss a payment.

💜 Find Assistance Programs – Get matched with Medicare Savings Programs & Extra Help.

💜 Track EBT & Medicaid Benefits – Manage all your disability & healthcare benefits in one place.


💡 Purple helps you stay on top of your benefits while reducing your out-of-pocket costs!


FAQs About Medicare Help for SSI & SSDI Recipients


Does SSDI Automatically Qualify Me for Medicare?

Yes, but only after 24 months of SSDI benefits.


Can SSI Recipients Get Medicare?

No, but most SSI recipients qualify for Medicaid instead.


How Do I Know If I Qualify for Extra Help?

If you receive SSI, Medicaid, or a Medicare Savings Program, you automatically qualify.


What Happens If I Can’t Afford My Medicare Premiums?

Apply for a Medicare Savings Program—it may cover your Part A & B costs.


Conclusion: Get Help Paying for Medicare While on Disability


✅ SSDI recipients qualify for Medicare after 24 months.

✅ SSI recipients usually get Medicaid instead of Medicare.

✅ The Extra Help Program reduces prescription drug costs.

✅ Medicare Savings Programs help pay for premiums & copays.

✅ Dual-eligible individuals get the most benefits (Medicare + Medicaid).


💜 Sign Up for Purple to Track Your Disability & Medicare Benefits Easily!

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