If you are currently eligible for Medi-Cal and are turning 65, you may be eligible for Cal MediConnect. Learn about Cal MediConnect

If you have limited income and assets, you may qualify for a Medicare Savings Program to help you pay your Medicare costs.

Four types of Medicare Savings Programs

Qualified Medicare Beneficiary (QMB) Program:
What it helps pay for: 

  • Medicare Part A premiums
  • Medicare Part B premiums
  • Deductibles, coinsurance, copayments

Specified Low-Income Medicare Beneficiary (SLMB) Program:
What it can help pay for:

  • Medicare Part B premiums

Qualifying Individual (QI) Program:
What it can help pay for: 

  • Medicare Part B premiums

Qualified Disabled and Working Individuals (QDWI) Program:
What it can help pay for:

  • Medicare Part B premiums

Paying for your Part D prescription drug costs

People with limited income may qualify for extra help to pay for their prescription drug costs. If eligible, Medicare could pay up to 100% of drug costs – including monthly prescription drug premiums, annual deductibles, and coinsurance. Additionally, 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.

This table shows you what your monthly plan premium will be if you get extra help. 

Download the chart: 

MAPD LIS Premium summary chart: English (PDF, 193 KB) / Español (PDF, 131 KB)
PDP LIS Premium summary chart: English (PDF, 127 KB) / Español (PDF, 73 KB)

  Your level of extra help
Plan name 100% 75% 50% 25%
Blue Shield 65 Plus (HMO), Blue Shield 65 Plus Choice Plan (HMO), Blue Shield 65 Plus Plan 2 (HMO), Blue Shield Inspire (HMO) Blue Shield Vital (HMO)1* $0 $0 $0 $0
Blue Shield Inspire (PPO) (Alameda County)* $77.40 $82.50 $87.70 $92.80
Blue Shield Inspire (HMO) (Alameda County)* $45 $45 $45 $45
Blue Shield Inspire (HMO) (Fresno and Madera counties)* $0 $0 $0 $0
Blue Shield Inspire (HMO) (San Mateo County)* $35 $35 $35 $35
Blue Shield Inspire (HMO) (Sacramento County)* $39 $39 $39 $39
Blue Shield RX Plus (PDP) $27.50 $35.40 $43.30 $51.10
Blue Shield RX Enhanced plan (PDP) $98.90 $106.80 $114.70 $122.50
Blue Shield AdvantageOptimum Plan (HMO) (Los Angeles, Orange, Santa Clara, San Joaquin, Stanislaus, Merced, Fresno counties) $0 $0 $0 $0
Blue Shield AdvantageOptimum Plan (HMO) (Santa Clara County) $48 $48 $48 $48
Blue Shield AdvantageOptimum Plan 1 (HMO) (San Diego County) $0 $0 $0 $0
Blue Shield AdvantageOptimum Plan 2 (HMO) (San Diego County) $0 $0 $0 $0
Blue Shield Coordinated Choice Plan (HMO) (Los Angeles, Orange, San Bernardino, Riverside, San Diego, Fresno, Santa Clara, Merced, San Joaquin, Stanislaus Counties) $0 $7.90 $15.80 $23.60
Blue Shield Total DualPlan (HMO D-SNP) (Los Angeles, Orange, San Bernardino, San Diego Counties) $0 $7.90 $15.80 $23.60
Blue Shield Total DualPlan (HMO D-SNP) (Fresno, San Joaquin, Stanislaus Counties) $0 $7.90 $15.80 $23.60

1. Los Angeles, Orange, San Diego, Kern, Riverside, San Bernardino, Ventura, San Luis Obispo, and Santa Barbara counties
*This does not include any Medicare Part B premium you may have to pay.

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 call: