Help with Medicare costs: Medicare Savings Programs, Extra Help, and EPIC

Why this matters

The standard Medicare Part B premium in 2026 is $202.90 a month, taken out of the Social Security check before it arrives. For a parent on a fixed income, getting that premium paid is like a raise. The programs below are underused because nobody tells families about them. HIICAP counselors at the county Office for the Aging will check all three in one visit, for free: 1-800-701-0501.

Medicare Savings Programs (New York)

Run through the county Department of Social Services. The 2026 income limits on the state's page, after a $20 disregard:

• QMB (Qualified Medicare Beneficiary): income at or below $1,856 a month single, $2,509 a couple. Pays the Part B premium and Medicare deductibles and coinsurance. The state's page lists no resource limit for QMB or QI.
• QI (Qualifying Individual): income below $2,494 a month single, $3,375 a couple. Pays the Part B premium only. Cannot be combined with Medicaid.
• Full Medicaid for people with both Medicare and Medicaid: income at or below $1,856 single and $2,509 couple, resources at or below $33,038 single and $44,796 couple. Pays premiums, cost sharing, and full Medicaid benefits.

How to apply for a Medicare Savings Program

Use the state application, form DOH-4328, and mail it to the county Department of Social Services, or apply online through NY State of Health. The Medicaid Helpline, (800) 541-2831, answers questions. Figures above are for 2026 and change each year.

Extra Help (Part D drug costs)

Extra Help is the federal program that lowers Medicare drug plan premiums, deductibles, and copays for people with limited income and resources, and removes the Part D late enrollment penalty. Anyone with full Medicaid, a Medicare Savings Program, or SSI gets it automatically. Others apply through Social Security, online or by phone. Medicare's page says you can apply for Extra Help and a Medicare Savings Program at the same time; Social Security passes the information to the state unless you say not to.

EPIC (New York's drug program for seniors)

EPIC helps New Yorkers 65 and older with Medicare Part D costs. The person must live in New York permanently, be enrolled or eligible for a Part D plan, and be under the program's income limits, which the state posts on its eligibility page. People on Medicaid are not eligible. There is no paperwork to prove income at enrollment, and you can apply any time of year.

Bring to the HIICAP appointment

• Medicare card and any drug plan or Medicare Advantage card.
• The most recent Social Security benefit letter and any pension statement.
• A recent bank statement.
• The list of prescriptions and the pharmacy.