Key Takeaways

• You may be eligible for free or low-cost Medicare help from government-backed sources, even if you’ve never heard of them.

• Getting the right support now can prevent costly enrollment errors, coverage gaps, and benefit denials later.

Why Most People Miss Out on Available Help

Even though Medicare serves more than 65 million people, most beneficiaries never take full advantage of the help available. Some assume they’re on their own. Others think help must come at a price. But in reality, there are multiple free or low-cost resources, many backed by the federal government, that can simplify Medicare decisions.

A major reason people miss out is timing. If you wait until something goes wrong—such as being denied a service or missing a deadline—you may already be facing financial consequences. That’s why it’s essential to understand what help exists before you run into trouble.

1. State Health Insurance Assistance Programs (SHIPs)

SHIPs are federally funded programs that provide one-on-one counseling to people with Medicare. Every state has its own version. Trained counselors can help you:

• Understand Medicare Parts A, B, C, and D

• Compare plan options and costs

• Avoid late penalties

• File appeals or complaints

• Apply for financial assistance programs

These counselors are not trying to sell anything. They give unbiased information to help you make informed choices.

When to use SHIP: Ideally, before your Initial Enrollment Period (IEP), during Annual Enrollment (Oct 15–Dec 7), or if your circumstances change midyear (like retirement or a move).

2. Medicare Savings Programs (MSPs)

If your income and assets fall below certain limits, you could qualify for an MSP. These programs help pay for your Medicare Part B premium—and in some cases, deductibles and coinsurance too.

In 2025, most states follow income limits close to these:

• Individual: ~$1,750/month

• Married couple: ~$2,645/month

You can apply through your state’s Medicaid office. Once approved, MSPs automatically qualify you for Extra Help with prescription drug costs (discussed below).

3. Extra Help for Prescription Drugs

The Extra Help program (also called the Low-Income Subsidy or LIS) is designed for people with limited income and assets. In 2025, it provides:

• Lower drug plan premiums

• Reduced or eliminated deductibles

• Fixed copayments or coinsurance for drugs

You can apply anytime through the Social Security Administration. If approved, you won’t enter the Part D coverage gap, and your out-of-pocket drug costs will be significantly lower throughout the year.

4. Local Area Agencies on Aging (AAA)

Your local AAA office offers a variety of senior services, including help with Medicare. They may have:

• Medicare counselors or navigators

• Educational workshops or webinars

• Help applying for Medicaid or financial aid

• Resources for caregivers and family members

These services often coordinate closely with SHIP and other state programs, so they can serve as a one-stop shop for aging and healthcare help.

5. 1-800-MEDICARE and the Medicare.gov Website

While calling a government hotline might sound daunting, 1-800-MEDICARE is staffed 24/7 with trained representatives who can help answer your questions. You can:

• Check enrollment dates

• Confirm plan coverage or network providers

• Get help appealing a denial

• Ask for printed materials to be mailed

The Medicare.gov website is also more user-friendly than many realize. You can:

• Log in and review your current coverage

• Compare plans side by side

• Estimate out-of-pocket costs for services or drugs

• Find forms, deadlines, and program guides

6. Social Security Field Offices

If you’re enrolling in Medicare for the first time, or if you’ve delayed Part B and are ready to sign up, the Social Security Administration handles your enrollment.

Local offices can:

• Process Medicare enrollment or disenrollment

• Help apply for Extra Help

• Verify your eligibility for premium-free Part A

• Correct errors in your record

It’s recommended to schedule an appointment or apply online if possible. Field offices are open on weekdays, and wait times vary.

7. Medicare Rights Center

This nonprofit offers a free national helpline, along with legal information and advocacy services. While not government-run, it is widely trusted.

The Medicare Rights Center can:

• Help you understand your rights

• Guide you through appeals

• Educate you about coverage denials

• Provide online tools and fact sheets

It’s especially helpful if you’re facing a complex situation such as denied coverage for a necessary procedure or confusing coordination of benefits.

8. Assistance for Caregivers and Family Members

If you’re helping a parent or spouse manage their Medicare, you don’t have to do it alone. Many SHIPs, AAAs, and nonprofits have dedicated resources for caregivers, including:

• Permission forms to speak on a loved one’s behalf

• Step-by-step enrollment support

• Tips for long-term planning

• Referrals to elder law or financial advisors

Being a caregiver is already hard work. Getting trusted Medicare support can reduce stress and avoid mistakes that could affect your loved one’s care.

9. Help for People with Disabilities

Medicare isn’t just for people over 65. If you’ve received Social Security Disability Insurance (SSDI) for 24 months, you become eligible for Medicare automatically.

But navigating Medicare with a disability can be uniquely challenging. Disability-focused organizations can assist with:

• Accessible plan comparisons

• Applying for Special Needs Plans (SNPs)

• Coordinating with Medicaid or VA benefits

• Advocating for needed treatments or devices

If you’re under 65 with a disability, it’s especially important to work with an expert to ensure your coverage works for your health situation.

10. When to Ask for Help—and Why Timing Matters

Knowing help exists is one thing. Using it early is another. These are the most important times to reach out:

• Three months before turning 65: Start your Initial Enrollment Period planning.

• October–December each year: Review and compare plans during the Annual Enrollment Period.

• When you lose other coverage: COBRA, employer insurance, or retiree benefits ending? Ask about Special Enrollment.

• After a move: Changing ZIP codes may affect plan networks and availability.

• When a health condition changes: You may qualify for a Special Needs Plan or different benefits.

Delaying could mean paying penalties, losing access to certain plans, or facing coverage gaps.

Real Help Is Available—But You Have to Ask

Medicare isn’t designed to be intuitive. But it’s not designed for you to go through it alone either. Support systems exist—and in many cases, they’re completely free. You just have to know where to look and when to ask.

Whether you’re just getting started or already enrolled, don’t hesitate to reach out for help. A licensed agent listed on this website can walk you through your options and help you avoid common pitfalls that may cost you money or benefits down the line.