Get clear, plain-English guidance on Medicaid eligibility, income & asset limits (2025), expansion status, and what’s covered vs. not covered. We break down home health, HCBS waivers (1915(c)), 1915(i) state plan services, Community First Choice (1915(k)), spend-down rules, and non-emergency medical transportation (NEMT)—with step-by-step how to apply checklists. Compare states, see FPL thresholds, and learn proven ways to keep coverage while working or moving. Designed for seniors, disabled adults, and low-income families who need benefits that actually pay—without guesswork.
Here’s the simple version: QMB pays your Part B premium and almost all Medicare copays/deductibles; SLMB and QI pay Part B premium only. QI has slightly higher income limits and is first-come, first-served. Below, you’ll see exactly how each program changes a real bill—with links to apply. Medicare+1 What Medicare Savings Programs do (1-minute primer) … Read more
Need help paying Medicare Part A/B premiums and cost-sharing? In many states you can get QMB/SLMB/QI help without any asset test—meaning savings and checking balances won’t block you. Below: a map of no-asset states and fast-apply steps so you can qualify sooner. Sources are official state sites where possible. Medicare What Medicare Savings Programs cover—and … Read more
If you take pricey Part D drugs, 2025 brought two big changes: your total annual drug spending now caps at $2,000, and you can opt into a Prescription Payment Plan (PPP) that spreads those costs into monthly bills. One limits how much you pay; the other changes when you pay. Here’s how to pick. What … Read more
Medicare Prescription Payment Plan (PPP) 2025—Quick Answer Starting January 1, 2025, Medicare’s Prescription Payment Plan (PPP) lets Part D and MA-PD enrollees pay $0 at the pharmacy and get a monthly bill from their plan for their out-of-pocket drug costs, spread across the calendar year. It doesn’t lower what you owe overall; it smooths payments … Read more
Quick answer: What changed in 2025—and who should switch? In 2025, Medicare Advantage (MA) still covers over half of eligible beneficiaries. The Inflation Reduction Act added a $2,000 annual out-of-pocket cap for Part D drugs and a new Prescription Payment Plan that lets you spread drug costs over the year—changes that affect both MA-PD and … Read more
Medicaid drug coverage is not one size fits all—and 2025–2026 brings some of the biggest shifts in years. Below, we break down the federal rules now in force, how states are handling GLP-1 weight-loss drugs and sickle cell gene therapies, and where to click to confirm your state’s latest PDL. What changed federally for 2025–2026? … Read more
In 2025, the Affordable Care Act (ACA) still shapes Medicaid in two big ways that seniors feel indirectly: (1) which states expanded Medicaid (affecting local delivery systems and budgets), and (2) how states process applications/renewals (streamlined rules and timelines that also touch seniors). But core senior eligibility (SSI-based) remains largely outside ACA’s MAGI rules. KFF+2Medicaid+2 … Read more
In 2025, California remains the only state that has fully suspended (eliminated) the Medicaid asset test—for Medi-Cal non-MAGI programs—while other states are raising limits or considering a phase-out. Below is the plain-English rundown of what’s in effect now and what’s proposed next, with official sources. Quick answer: Which states suspended Medicaid asset tests in 2025? … Read more
Medicaid covers over 70 million Americans, but what it covers for adults depends heavily on the state you live in. In 2025, the biggest differences show up in adult dental/vision, postpartum coverage, behavioral health, long-term care at home, and expansion to low-income adults. Below is a plain-English, state-by-state guide with trusted sources. Quick answer: What … Read more
Medicare got pricier in 2025—and early 2026 projections point to another bump. The good news: Medicaid programs (QMB/SLMB/QI) and Extra Help can cover your Part B premium and most drug costs, and a new $2,000 Part D cap plus a monthly payment option can tame pharmacy shocks. Here’s exactly what changed and how to cushion … Read more