Medicare is not free for most people. In 2026, the standard Part B premium is $202.90 per month, and prescription drug plans add their own premiums and copays on top. For folks in Charlotte and across North Carolina living on a fixed income, those costs add up fast. The good news: if your income and resources are limited, real help exists — and it is badly under-used, often simply because people do not know it is there. Here is how the two main types of help work and how to apply.

The two kinds of help, in plain English

There are two separate programs, and they cover different pieces of the bill:

  • Extra Help (the Low-Income Subsidy, or LIS) — a federal program that lowers your Part D prescription drug costs: the drug plan premium, the deductible, and your copays at the pharmacy.
  • Medicare Savings Programs (MSPs) — state-run programs, administered in North Carolina through NC Medicaid, that help pay your Part B premium — and, in the most generous version, your deductibles, coinsurance, and copayments too.

You can qualify for one, the other, or both. And here is a detail many people miss: enrolling in QMB, SLMB, or QI automatically qualifies you for Extra Help with your drug costs. One application can unlock both.

Extra Help: lower prescription drug costs

Extra Help is run at the federal level and applies to Medicare Part D drug coverage. When you qualify, your drug plan premium, deductible, and copays can be greatly reduced. That help stacks on top of a protection every Part D enrollee already has: in 2026, Part D out-of-pocket drug costs are capped at $2,100 for the year, after which you pay $0 for covered drugs the rest of the year.

Who gets it automatically

You are enrolled in Extra Help automatically — no separate application — if you have any of these:

  • Full Medicaid benefits
  • Supplemental Security Income (SSI)
  • A Medicare Savings Program (QMB, SLMB, or QI — covered below)

How to apply if it is not automatic

Everyone else applies through Social Security. Income and resource limits apply and are set federally, and they change from year to year — so rather than guess at a number, check the current limits at ssa.gov, Medicare.gov, or by calling 1-800-MEDICARE. If your finances are anywhere close to modest, it costs nothing to apply and find out.

Medicare Savings Programs: help with the Part B premium and more

These three programs are run through your state Medicaid agency — in North Carolina, that means NC Medicaid. Each state sets its own income and resource limits, and they change yearly, so confirm the current North Carolina figures with NC Medicaid or Medicare.gov before assuming you do or do not qualify.

QMB — Qualified Medicare Beneficiary

The most generous of the three. QMB helps pay your Part A and Part B premiums AND your deductibles, coinsurance, and copayments. Providers generally cannot bill a QMB member for those Medicare cost-shares — which can effectively wipe out most of your out-of-pocket exposure for covered care.

SLMB — Specified Low-Income Medicare Beneficiary

SLMB helps pay your Part B premium only — not deductibles or coinsurance. The income limits sit somewhat higher than QMB, so people who earn a little too much for QMB may still fit SLMB. With the 2026 standard Part B premium at $202.90 a month, that is over $2,400 a year back in your pocket.

QI — Qualifying Individual

QI also pays the Part B premium only, for people whose income is just above the SLMB level. Two things to know: QI is first-come, first-served each year, and you must reapply annually. You generally cannot get QI if you also qualify for other Medicaid benefits. Because funding runs on a first-come basis, applying early in the year matters.

A fourth, less common program — QDWI, the Qualified Disabled and Working Individual program — helps certain working people with disabilities pay the Part A premium.

What if I qualify for both Medicare and Medicaid?

People who have both Medicare and full Medicaid are called dual eligible. Medicare pays first, and Medicaid pays second — picking up costs Medicare does not cover, often leaving little or no out-of-pocket expense. Dual-eligible North Carolinians may also have access to D-SNPs (Dual Eligible Special Needs Plans) — a type of Medicare Advantage plan built specifically for people with both programs, which can coordinate Medicare and Medicaid benefits through a single plan. Whether a D-SNP fits your situation depends on your Medicaid status and the plans available in Mecklenburg County, so it is worth a careful, individual review rather than a blanket answer.

How to apply in Charlotte and North Carolina

  • Medicare Savings Programs (QMB, SLMB, QI): apply through NC Medicaid — in Charlotte, that runs through the Mecklenburg County Department of Social Services.
  • Extra Help: apply through Social Security at ssa.gov, by phone at 1-800-772-1213, or at a local Social Security office (unless you qualify automatically through Medicaid, SSI, or an MSP).
  • Free counseling: North Carolina's SHIIP (Seniors' Health Insurance Information Program), run through the NC Department of Insurance, offers free, unbiased help with these applications.
  • Current income limits: because both the federal Extra Help limits and North Carolina's MSP limits change every year, check Medicare.gov or call 1-800-MEDICARE for this year's figures before ruling yourself out.

One honest note: many people assume they earn too much and never apply. The limits are higher than most expect, resources like your home generally are not counted the same way as cash savings, and the worst outcome of applying is a "no." If money is tight, apply.

How The Jordan Insurance Agency helps

The Jordan Insurance Agency is an independent, full-time, licensed insurance agency in Charlotte, North Carolina, serving clients across the state. Because we are independent and work with multiple carriers, our job is to fit coverage to your situation — and that includes flagging when you may qualify for Extra Help, a Medicare Savings Program, or a D-SNP, and pointing you to the right application. Our agents complete annual AHIP and carrier certifications, carry errors-and-omissions coverage, and review your plan every year at renewal, so if your income situation changes, your coverage strategy changes with it. Best of all, our guidance costs you nothing: the carrier pays the agent, and your premium is the same whether you enroll on your own or with our help. If you are in Charlotte or anywhere in North Carolina and wondering whether help paying for Medicare is within reach, reach out to The Jordan Insurance Agency — we will walk through it with you in plain English.

Plan availability & disclaimer

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. The Jordan Insurance Agency is not connected with or endorsed by the United States government or the federal Medicare program.