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If money is tight, the most important thing to know before you even start comparing Medicare Advantage plans is this: there are federal and state assistance programs that can dramatically lower your Medicare costs, and a lot of eligible people never apply simply because they don’t know these programs exist. One SHIP counselor estimated that roughly half the seniors she works with qualify for some form of assistance but never applied. Before picking a plan, it’s worth checking whether you qualify for help first — it can change which plan actually makes sense for you.
The Quick Answer
- Check for assistance first: Medicare Savings Programs (MSPs) and Extra Help can cover your Part B premium, deductibles, copays, and prescription costs — worth more than $2,400/year for many people.
- Best carriers for low-cost plans in 2026: Aetna, UnitedHealthcare, Humana, Devoted Health, and SCAN Health Plan all offer strong $0-premium options — but the right one depends on which covers your specific doctors and prescriptions.
- The cheapest plan on paper isn’t always the cheapest to actually use. A $0-premium plan with high specialist copays can cost more over a year than a plan with a small premium and low copays.
Step 1: Check If You Qualify for Assistance Programs
This is the step most people skip, and it’s the one that can save the most money.
Medicare Savings Programs (MSPs)
MSPs are state-administered programs (funded partly by Medicaid) that help pay for Medicare costs, even if you don’t qualify for full Medicaid. There are four levels, and you’re automatically enrolled in whichever one matches your income — you don’t choose:
- Qualified Medicare Beneficiary (QMB): Pays both Part A and Part B premiums, plus deductibles and coinsurance. Providers cannot charge you cost-sharing at all if you have QMB status.
- Specified Low-Income Medicare Beneficiary (SLMB): Covers your Part B premium ($202.90/month in 2026 — over $2,400/year).
- Two additional levels exist for slightly higher incomes, with narrower benefits.
Enrolling in any MSP also automatically qualifies you for Extra Help — you don’t need to apply separately.
Extra Help (Part D Low-Income Subsidy)
Extra Help reduces or eliminates your prescription drug costs under Part D. For 2026, most people who qualify pay no premium (or a reduced one) and see dramatically lower copays at the pharmacy — often just a few dollars per prescription.
How to check: Contact your state Medicaid office or call 1-800-MEDICARE. Income and asset limits change annually and vary somewhat by state, so it’s worth checking even if you weren’t eligible in a previous year.
Step 2: Compare Total Cost, Not Just the Premium
A genuinely low-cost Medicare Advantage plan is one where your total yearly spending stays low — not just the monthly premium. That total includes:
- The plan premium (often $0)
- Your Part B premium
- Any plan deductible
- Copays and coinsurance for the care you actually use
- Your worst-case exposure — the plan’s annual out-of-pocket maximum
The federal cap on in-network out-of-pocket costs for 2026 is $9,250, but the average plan actually caps spending much lower — around $5,421. A plan with a slightly higher premium but a lower out-of-pocket maximum and lower specialist copays can easily cost less over a full year than a $0-premium plan with $45 specialist copays, if you see doctors regularly.
Strong Low-Cost Carriers for 2026
Aetna, UnitedHealthcare, and Humana — All three offer widely available $0-premium plans in most states, often bundled with $0 primary care copays, dental/vision/hearing coverage, and — on many Humana and some Aetna plans — a Part B Giveback benefit that effectively reduces what’s deducted from your Social Security check.
Devoted Health — A newer, Medicare-focused insurer that has built a strong reputation for competitive low-cost plans and member service in the states where it operates.
SCAN Health Plan — A nonprofit carrier focused specifically on Medicare, known for competitive low-cost plans in the states it serves (primarily western states).
What to Look for Beyond the Premium
- A flex card or OTC allowance. Many plans include a card usable for dental, vision, hearing, or over-the-counter items — some now offer $500+ per quarter.
- Transportation benefits. Valuable if you don’t drive and need rides to medical appointments — increasingly common on low-cost plans.
- $0 copay for primary care and telehealth. Reduces the cost of routine checkups significantly.
- Disease management programs. If you manage a chronic condition like diabetes or heart disease, some plans include free monitoring devices, nutrition counseling, and care coordination at no extra cost.
- A Part B premium reduction/rebate. Even if you don’t qualify for a Medicare Savings Program, some Medicare Advantage plans offer their own rebate toward your Part B premium.
If You’re Considering Medigap Instead
If you’re weighing Medicare Advantage against Original Medicare plus a Medigap policy, cost matters differently. Medigap Plan K has the lowest average premium of any standardized Medigap plan (around $77/month), though it requires more cost-sharing than Plan G or Plan N. If you have QMB status through a Medicare Savings Program, a Medigap policy may actually become less necessary, since providers can’t charge you cost-sharing at all under QMB.
Frequently Asked Questions
How do I find out if I qualify for a Medicare Savings Program? Contact your state Medicaid office directly, or call 1-800-MEDICARE. Eligibility is based on income and assets, and limits change annually and vary somewhat by state.
If I qualify for Extra Help, do I need to apply separately for a Medicare Savings Program? No — and it works the other way too. If you’re already enrolled in an MSP, you’re automatically enrolled in Extra Help without a separate application.
Is a $0 premium plan always the cheapest option for a low-income beneficiary? Not necessarily. If you use a lot of care, a plan with a small premium but much lower copays and a lower out-of-pocket maximum can cost less over a full year. Always compare total potential annual cost, not just the monthly premium.
Can I have both Medicaid and a Medicare Advantage plan? Yes — if you qualify for both, you may be eligible for a D-SNP (Dual Eligible Special Needs Plan), a type of Medicare Advantage plan built specifically for people with both Medicare and Medicaid, often with extra benefits and very low cost-sharing.
What’s the biggest mistake low-income beneficiaries make when choosing a plan? Not checking for assistance programs first. Many eligible people never apply for Medicare Savings Programs or Extra Help simply because they don’t know these programs exist — leaving significant savings unclaimed.
Bottom Line
If cost is your top concern, start with assistance programs — not plan comparisons. Checking your eligibility for a Medicare Savings Program and Extra Help can be worth more than $2,400 a year and should happen before you pick a plan, not after. Once that’s settled, compare total annual cost (not just premium) across strong low-cost carriers like Aetna, UnitedHealthcare, Humana, Devoted Health, and SCAN, focusing on the specific plan’s copays, out-of-pocket maximum, and whether it covers your doctors and prescriptions.
Check your eligibility for assistance programs by calling 1-800-MEDICARE or contacting your state Medicaid office, and compare plans available in your ZIP code using the official Medicare Plan Finder. Your local State Health Insurance Assistance Program (SHIP) also offers free, unbiased guidance.
Disclaimer: Figures, income thresholds, and program details mentioned in this article reflect 2026 federal guidelines and are subject to change; eligibility varies by state. Always confirm current details directly with Medicare.gov, your state Medicaid office, 1-800-MEDICARE, or a licensed agent before making a decision.