A lot of Arizona seniors are paying more for Medicare than they need to. Not because they picked the wrong plan, but because they qualify for help they did not know existed. The federal government runs two main programs that can dramatically lower Medicare costs for people on limited incomes, and Arizona’s Medicaid program adds a layer of help on top of that. Together, they can save a qualifying person several thousand dollars a year. Yet roughly half of the seniors who qualify never apply.
I am a licensed Medicare broker in Mesa, and one of the first things I check with new clients is whether they qualify for Extra Help or one of the Medicare Savings Programs. The income and asset limits are higher than most people think, and the application process is straightforward. Here is how it works.
What Extra Help Actually Is
Extra Help, also called the Low Income Subsidy or LIS, is a federal program that helps pay for Medicare prescription drug coverage. If you qualify, the program pays your Part D premium up to a benchmark amount, eliminates or reduces your deductible, and caps your prescription copays at very low amounts. In 2026, qualifying for Extra Help can mean paying as little as $1.55 for generic drugs and $4.90 for brand name drugs, with no donut hole. For someone taking several medications, that can be the difference between filling prescriptions and skipping doses.
In 2024, Extra Help expanded so that there are now no partial benefits. Anyone who qualifies gets the full subsidy. This made the program much simpler and more valuable for people just over the old partial-benefit thresholds.
To qualify for Extra Help in 2026, your income generally needs to be at or below 150 percent of the federal poverty level, and your resources need to be below the program limits. The income limit for 2026 is approximately $1,907 per month for a single person and $2,574 per month for a married couple. The resource limit is around $17,220 for a single person and $34,360 for a married couple. Resources include checking and savings accounts, stocks, and bonds. They do not include your home, your car, household belongings, or burial plots.
If you are receiving full Medicaid benefits, get help from your state with Medicare premiums, or get Supplemental Security Income, you automatically qualify for Extra Help and do not need to apply separately.
Medicare Savings Programs in Arizona
Medicare Savings Programs, or MSPs, are state-administered programs that help pay Medicare premiums and sometimes deductibles and coinsurance. In Arizona, MSPs are run by AHCCCS, the state Medicaid agency. There are three main levels.
The Qualified Medicare Beneficiary program, or QMB, is the most generous. If you qualify, the state pays your Part B premium, your Part A premium if you have one, and your Medicare deductibles and coinsurance. Effectively, your out-of-pocket Medicare costs go to zero. The 2026 income limit for QMB in Arizona is approximately $1,304 per month for a single person and $1,762 per month for a married couple.
The Specified Low-Income Medicare Beneficiary program, or SLMB, pays your Part B premium only. The 2026 income limit is approximately $1,564 per month for a single person and $2,114 per month for a married couple.
The Qualifying Individual program, or QI, also pays your Part B premium. The 2026 income limit is approximately $1,754 per month for a single person and $2,371 per month for a married couple. QI funding is limited each year, and applications are processed in the order they are received.
All three MSPs have a resource limit of approximately $9,660 for a single person and $14,470 for a married couple. As with Extra Help, your home, your car, and personal belongings do not count.
People who qualify for any MSP automatically qualify for Extra Help. So if you sign up for QMB, SLMB, or QI, your prescription costs drop dramatically as a bonus.
Why So Many Eligible Seniors Never Apply
There are a few reasons people who could qualify never get the benefit.
The first is a misconception about income limits. People hear “low income” and assume the limits are very low. They are not. A senior in Arizona living on $1,800 a month from Social Security and a small pension is right at the SLMB or QI threshold. Plenty of my clients are surprised to find out they qualify.
The second is the asset question. People assume their savings disqualify them. The resource limits are reasonable, especially when you remember that the home and car do not count. A widow with $30,000 in savings, no car payment, and a paid-off house can absolutely qualify.
The third is paperwork avoidance. The application is not that bad, but it is not zero work. People put it off, and putting it off costs them real money every month.
The fourth is pride. Some seniors do not want to feel like they are taking welfare. I get it. I gently push back on this when it comes up. These programs exist because Medicare premiums and drug costs have outpaced what most retirees actually have to spend. There is no shame in using a program designed for exactly your situation.
How to Apply in Arizona
You can apply for Extra Help directly through the Social Security Administration. The application is free, takes about 30 minutes, and can be done online at ssa.gov, by phone at 800-772-1213, or in person at any Social Security office. You will need basic information about your income, your bank accounts, and your retirement assets.
For Medicare Savings Programs in Arizona, you apply through AHCCCS. You can apply online at healthearizonaplus.gov, by phone, or by mail. AHCCCS will ask for proof of income, proof of resources, and Medicare eligibility documentation. The decision usually comes within 45 days.
If you qualify for an MSP, that automatically triggers the Extra Help application, so you only need to apply once. The state and Social Security coordinate behind the scenes.
If you are denied and you believe the decision was wrong, you can appeal. Income and asset rules have specific exclusions and definitions, and a denial sometimes comes from a misunderstanding of what counts. A licensed Medicare broker or a SHIP counselor can help you review the denial and decide whether to appeal.
What Happens to Your Plan When You Qualify
Once you qualify for Extra Help, you can change your Medicare drug plan or Medicare Advantage plan at any time, not just during the Annual Enrollment Period. This is one of the few Special Enrollment Periods that lasts as long as you qualify. If your current plan is not the best one for your situation given the new lower costs, you can move to a different plan immediately.
People with full Extra Help also have access to a feature called Limited Income Newly Eligible Transition coverage, or LI NET. If you have a brief gap between qualifying and getting enrolled in a new plan, LI NET provides interim drug coverage so you do not go without medications. This is administered by Medicare directly and most pharmacies handle it automatically.
If you qualify for QMB, your providers cannot bill you for Medicare deductibles or coinsurance. The state pays them. If you ever get a bill from a doctor or hospital after qualifying, you should call the provider, point out your QMB status, and they need to cancel the bill. This is required by federal law.
Special Cases I See in Arizona
A few specific scenarios come up regularly with my Mesa clients.
A senior who recently lost a spouse. Their household income drops from two Social Security checks to one, and they may now qualify for an MSP they did not qualify for before. I always recommend rechecking eligibility after any major income change.
A senior who started taking Required Minimum Distributions from a retirement account and now has higher income on paper. The income that counts for MSP is mostly Social Security and ongoing income, but RMDs can affect things. Worth applying anyway and letting the agency calculate it.
A senior whose adult children are paying their bills. The children’s resources do not count toward the parent’s eligibility. The parent’s own income and assets are what matters.
A senior who got rejected years ago when limits were lower. The 2024 expansion of Extra Help and the gradual increase in MSP thresholds mean that someone who was denied in 2018 might qualify today. Reapply.
Need Help Figuring Out If You Qualify?
If you think you might qualify for Extra Help or a Medicare Savings Program, or you are not sure, I can help you check. I work with seniors in Mesa, Gilbert, Chandler, Tempe, Scottsdale, and across the East Valley. We will go through your income and assets, see which programs you qualify for, and help you start the application.
Call me at 480-296-5804 or request a free consultation. No pressure, no obligation, and no cost to you. If you qualify for Extra Help, we may also be able to switch you to a better Medicare plan that takes advantage of the lower costs you are now eligible for.