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Help with Medicare Costs

If you have limited income and resources, you may qualify for one or more of the programs below. They can help reduce your out-of-pocket expenses by paying certain costs, such as these:

  • Plan premiums
  • Rx Deductibles
  • Coverage gap
  • Copays
  • Coinsurance

Use the income table below to see if you qualify for one or more of these programs. As a first step in checking to see if you qualify, make sure your income is below the preset income limits. Some programs include additional limitations beyond just income.

Additional assistance programs 2021 yearly income limit
PACENET Single: $27,500
Married:: $35,500
PACE Single: $14,500
Married:: $17,700
Partial Extra Help Single: $19,560
Married:: $26,376
Full Extra Help Single: $17,628
Married:: $23,760
Full Medical Assistance
(Full Dual)–Eligible for SNP plans
Single: $13,116
Married: $17,664

PACE and PACENET

Pennsylvania has two prescription assistance programs for older adults. PACE and PACENET offer low-cost prescription medication to qualified residents, age 65 and older.

To see if you qualify for PACE or PACENET:

Call the Pennsylvania Department of Aging at 1-800-225-7223 (TTY: 1-800-222-9004) Monday through Friday from 8:30 a.m. to 8 p.m. and Saturday from 9 a.m. to 3 p.m. or enroll online at pacecares.magellanhealth.com.

Extra Help program for Prescriptions

The federal Medicare program offers Extra Help for prescription drug costs for Medicare beneficiaries who qualify. To receive Extra Help, a person must be on Medicare, have limited resources and income, and reside in one of the 50 states or the District of Columbia.

To see if you qualify for Extra Help:

Call 1-800-MEDICARE
1-800-633-4227 (TTY: 1-877-486-2048)
24 hours a day, 7 days a week, or visit www.medicare.gov.

Call Social Security
1-800-772-1213 (TTY: 1-800-325-0778)
weekdays from 7 a.m. to 7 p.m.

Medicaid

Medicaid provides health coverage to millions of low-income individuals. It is administered by states according to federal requirements and is funded by states and the federal government together to make sure everyone can get the care they need. Medicaid is designed to cover almost all costs for those who need it most.

To see if you qualify for Medical Assistance (Medicaid):

Call Medical Assistance at 1-800-692-7462 (TTY: 1-800-451-5886) Monday through Friday from 8:30 a.m. to 4:45 p.m.

Veterans Affairs benefits

If you have served in the armed forces, you may have additional benefits provided to you by the Department of Veterans Affairs (VA).

To see if you qualify for VA benefits:

Go to your local VA facility or apply online at VA.gov.

This information is not a complete description of benefits. Call 1-866-400-5077 (TTY: 711) for more information. Out-of-network/noncontracted providers are under no obligation to treat UPMC for Life members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services. Other physicians/providers are available in the UPMC for Life network.

This information is available for free in other languages. Please call our customer service number at 1-877-539-3080 (TTY: 711).

UPMC for Life has a contract with Medicare to provide HMO, HMO SNP, and PPO plans. The HMO SNP plans have a contract with the PA State Medical Assistance program. Enrollment in UPMC for Life depends on contract renewal.

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UPMC for Life Members
Call us toll-free: 1-877-539-3080
TTY: 711

Oct. 1 through March 31:
seven days a week from 8 a.m. to 8 p.m.

April 1 through Sept. 30:
Monday through Friday: 8 a.m. to 8 p.m.
Saturday: 8 a.m. to 3 p.m.

UPMC for Life Prospective Members
Call us toll-free: 1-866-400-5077
TTY: 711

Oct. 1 through Dec. 31:
seven days a week from 8 a.m. to 8 p.m.

Jan. 1 through Sept. 30:
Monday through Friday: 8 a.m. to 8 p.m.
Saturday: 9 a.m. to 3 p.m.

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Last Updated: 10/01/2020
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