Medicare programs for financial help

Medicare Prescription Payment Plan (M3P) 

Beginning January 1, 2025, there will be a new payment option to help Medicare members manage their out-of-pocket drug costs. 

Learn more about this plan: English (PDF, XX KB) / Espanol (PDF, XX KB)

You can also learn more about this plan https://www.medicare.gov/prescription-payment-plan or by calling (833)-696-2087 (TTY: 711) between 8 a.m. and 8 p.m., seven days a week (during AEP), or 5 a.m. and 5 p.m., Monday through Friday (non-AEP).

Medicare Savings Programs

If you have limited income and assets, you may qualify for a Medicare Savings Program to help you pay your Medicare costs. There are four types of Medicare savings programs.

Qualified Medicare Beneficiary (QMB) Program

The QMB program helps pay for:

  • Medicare Part A premiums
  • Medicare Part B premiums
  • Deductibles, coinsurance, copayments (for services and items Medicare covers)

Specified Low-Income Medicare Beneficiary (SLMB) Program

The SLMB program can help pay for:

  • Medicare Part B premiums (You must have both Part A and Part B to qualify.)

Qualifying Individual (QI) Program

The QI program can help pay for:

  • Medicare Part B premiums (You must have both Part A and Part B to qualify.)

Qualified Disabled and Working Individuals (QDWI) Program

The QDWI program can help pay for:

  • Medicare Part A premiums only
     

Save on your Medicare Part D drug costs with Extra Help

People with limited income and resources may qualify for the Extra Help program to help pay for their Part D premiums, deductibles, and copayments. If eligible, Medicare could help pay for your drug costs. Also, those who qualify will not be subject to the coverage gap or a late-enrollment penalty.

If you get Extra Help from Medicare to help pay for your Medicare prescription drug plan costs, the amount of extra help you get will determine your total monthly plan premium as a member of our plan.

Download the chart to see what your monthly plan premium will be if you get extra help.

Medicare Advantage Prescription Drug Plan (MA-PD) LIS Premium summary chart: English (PDF, 161 KB) / Español (PDF, X KB)

Prescription Drug Plan (PDP) LIS Premium summary chart: English (PDF, 180 KB) / Español (PDF, X KB)

Dual Special Needs Plan (HMO D-SNP) LIS Premium summary chart: English (PDF, 78 KB) / Español (PDF, X KB)

 

How do I know if I qualify for extra help?

If you believe you qualify for Low-Income Subsidy (LIS) and are paying 100% of your premium, you can contact the resources below for more information:

  • The Medicare office 1-800 MEDICARE (1-800 633-4227), 24 hours a day/seven days a week (except some federal holidays). TTY users can call  1-877 486-2048, 24 hours a day/seven days a week.
  • The Social Security Office at 1-800 772-1213 between 8 a.m. and 7 p.m., Monday through Friday. TTY users can call 1-800 325-0778, or visit https://www.ssa.gov/benefits/medicare/prescriptionhelp.
  • Your state Medicaid office 

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This is not a complete description of benefits. Current members can contact Customer Service at (800) 776-4466 (TTY: 711) for more information. Hours of operation 8 a.m. to 8 p.m., seven days a week. Members with Blue Shield of California Dual Special Needs Plans can contact (800) 452-4413 (TTY:711), 8 a.m. to 8 p.m., seven days a week.

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Page last updated: 10/1/2024

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