20 Financial Assistance Programs for Health Insurance

The ACA’s premium tax credits reduce your monthly health insurance premium based on your household income and the cost of the benchmark Silver plan in your area. For the current coverage year, subsidies are available to households earning between 100% and 400% of the Federal Poverty Level — roughly $15,060 to $62,600 for a single person. The subsidy is applied directly to your premium, so you only pay the difference. Enroll at HealthCare.gov during Open Enrollment (November 1 – January 15 in most states) or within 60 days of a Qualifying Life Event such as job loss, marriage, divorce, or the birth of a child. Applying takes 15–30 minutes online.

CSRs are a second layer of ACA savings that reduce your deductible, copayments, and out-of-pocket maximum — not just your monthly premium. They are only available on Silver-level marketplace plans and only for households earning between 100% and 250% of the FPL. If your income falls in this range and you pick a Gold or Bronze plan instead of Silver, you permanently forfeit the CSR benefit for that year. This is one of the most commonly misunderstood ACA provisions. Someone earning 150% FPL who enrolls in a Silver plan may face a deductible of just $200–$300 rather than the standard $1,500+. Apply through HealthCare.gov — CSR eligibility is assessed automatically when you complete your application.

In the 41 states and Washington D.C. that have expanded Medicaid under the ACA, adults with household income below 138% of the FPL — approximately $20,783 for a single person — qualify for free comprehensive health coverage. Medicaid covers doctor visits, hospital stays, prescriptions, mental health, and preventive care with little to no cost-sharing. You can apply at any time of year — there is no open enrollment period for Medicaid. Apply through HealthCare.gov, your state Medicaid agency, or by calling 1-800-318-2596. Eligibility is usually determined within a few days. In the 10 states without expansion, adults without dependent children face a coverage gap and must explore alternative options covered later in this guide.

CHIP provides free or very low-cost health coverage to children under 19 in families whose income is too high for Medicaid but too low for private insurance to be realistic. Every state runs its own CHIP program, and income limits vary — most states cover children up to at least 200% FPL, many up to 255%, and some like New York extend to 400% FPL. Coverage includes doctor visits, dental care, vaccinations, prescriptions, and emergency care. Total annual out-of-pocket costs for a family cannot exceed 5% of their income under federal law. Apply through HealthCare.gov or your state Medicaid/CHIP agency — the application is the same form, and the system determines which program applies to each child automatically.

COBRA lets you keep your exact employer health plan for up to 18 months (36 months in some circumstances) after leaving a job, as long as your employer had 20 or more employees. The catch is cost: you pay 100% of the premium — both the employee and employer share — plus a 2% administrative fee. For many people, this is $500–$1,800 per month. Before electing COBRA, compare it against an ACA marketplace plan with a subsidy based on your projected lower income after job loss — the marketplace plan is almost always cheaper for low-to-moderate income households. You have 60 days to decide. Call the Department of Labor’s EBSA helpline for COBRA questions specific to employer plans.

Small employers with fewer than 25 full-time equivalent employees, average wages below $56,000, and who pay at least 50% of employee premiums may claim a federal tax credit worth up to 50% of premiums paid (35% for tax-exempt nonprofits). To claim the maximum credit, employers must purchase coverage through the Small Business Health Options Program (SHOP) Marketplace — coverage purchased elsewhere doesn’t qualify. The credit phases out as wages and employee count increase. For small business owners who have been avoiding offering coverage because of cost, this credit can make the math work. Explore SHOP at HealthCare.gov/small-businesses or call the SHOP help line.

Navigators are federally funded, certified counselors who help people understand their coverage options, complete applications, and resolve problems with enrollment — at no cost to you. They are prohibited from selling insurance and receive no commissions, which makes their guidance genuinely unbiased. Navigators are especially valuable for people with complex situations: multiple income streams, recent immigration, recent incarceration, individuals leaving foster care, or anyone whose income fluctuates unpredictably. Find a navigator near you at LocalHelp.HealthCare.gov. Appointments are available in person, by phone, or by video in many communities.

QMB is the most comprehensive Medicare Savings Program, covering Part A premiums (if you owe them), Part B premiums ($202.90/month), deductibles, and copayments for Medicare-covered services. Providers who accept Medicare are federally prohibited from billing QMB enrollees for cost-sharing — if a provider bills you and you have QMB, that’s a violation you can report. To qualify in 2026, individual monthly income must be at or below $1,350 ($1,824 for couples) and assets must be under $9,950 for individuals ($14,910 for couples). Some states have higher limits or no asset test at all. Apply through your state Medicaid office — contact information is at Medicaid.gov or call your SHIP at 1-877-839-2675.

SLMB pays your Medicare Part B premium — $202.90 per month, or $2,434.80 per year — for people with slightly higher incomes than QMB allows. It does not cover deductibles or copays, but eliminating the premium alone is meaningful savings on a fixed income. Individual monthly income must be between $1,350 and $1,616 in 2026 ($1,824–$2,184 for couples), with the same asset limits as QMB. Enrollment in SLMB also automatically qualifies you for Medicare Extra Help for prescription drugs, adding further savings. Apply through your state Medicaid office or call 1-800-MEDICARE (1-800-633-4227) to be directed to the right agency.

QI covers the Medicare Part B premium for people with slightly higher incomes than SLMB, reaching households at 120–135% FPL. The critical distinction: QI is funded by a fixed annual federal allocation, meaning slots are limited and awarded first-come, first-served each year. Applications must be renewed annually and cannot be awarded retroactively — once the allocation runs out, new applicants wait until the next federal funding year. You also cannot receive QI if you qualify for Medicaid. Individual income limit is under $1,816/month ($2,455 for couples) with assets under $9,950 ($14,910 for couples). Apply through your state Medicaid office as early as possible in January each year to avoid losing your slot.

Extra Help — also called the Low Income Subsidy (LIS) — is a federal program that dramatically reduces what Medicare beneficiaries pay for prescription drugs under Part D. In the current period, qualifying individuals pay no more than $5.10 for each generic drug and $12.65 for each brand-name drug their plan covers, with no deductible. Once total drug costs reach the catastrophic threshold ($2,100), copays drop to zero. The estimated annual value is $5,700 per person. Income must be under $2,015 per month for individuals ($2,725 for couples) with assets under $18,090 ($36,100 for couples). Apply through Social Security at SSA.gov/extrahelp, by calling 1-800-772-1213, or at your local Social Security office.

SHIP counselors are federally funded, trained volunteers who provide free, unbiased, one-on-one counseling to Medicare beneficiaries and their families. They help people understand their Medicare options, apply for savings programs (QMB, SLMB, Extra Help), compare Part D plans, review Medicare Advantage options, and resolve billing problems. Unlike insurance agents, SHIP counselors receive no commissions and are prohibited from selling anything. Every state has a SHIP. Find yours at shiphelp.org or call the national referral line. Services are available by phone, in person at senior centers, and at home for homebound individuals in many states.

Several states operate their own programs that pay prescription drug costs beyond what Medicare Part D and Extra Help cover. New York’s EPIC program, Pennsylvania’s PACE and PACENET, and similar programs in New Jersey, Connecticut, and about a dozen other states provide additional cost reductions for seniors and people with disabilities. SPAPs typically stack on top of Extra Help rather than replacing it — meaning an eligible person in New York, for example, may pay nothing at all for covered drugs by combining the two programs. Contact your State Health Insurance Assistance Program (SHIP) or your state Department of Aging to find out whether your state runs a SPAP and what it covers.

Federally Qualified Health Centers are community-based clinics funded by the federal government through the Health Resources and Services Administration (HRSA). They are required by law to serve all patients regardless of their ability to pay and to charge on a sliding scale based on household income — meaning a visit might cost $20, $5, or nothing at all depending on your circumstances. FQHCs provide primary care, dental, mental health, substance use treatment, and pharmacy services. More than 1,400 health center sites exist nationwide, serving about 31 million people annually. Find the nearest one instantly at findahealthcenter.hrsa.gov using your ZIP code. No appointment required at many locations.

The Ryan White HIV/AIDS Program is a federal program that funds comprehensive health services for Americans with HIV who are uninsured or underinsured and cannot afford care. It pays for insurance premiums, copays, deductibles, and direct medical services, including antiretroviral medications that can cost $3,000–$5,000 per month without assistance. Income eligibility varies by state, but the program prioritizes people who would otherwise face a complete care gap. To find your local Ryan White-funded provider, contact your state health department’s HIV program, the HIV/AIDS Bureau at 1-301-443-6745, or search the HRSA Ryan White Data Dashboard at hab.hrsa.gov.

The Indian Health Service provides comprehensive federal healthcare to eligible members of federally recognized American Indian and Alaska Native tribes. Services include primary care, hospital care, dental, behavioral health, vision, and preventive care — at no cost for eligible individuals receiving care at IHS, Tribal, or Urban Indian Organization facilities. IHS coverage works alongside Medicare, Medicaid, and private insurance when a patient has other coverage, which can effectively eliminate all remaining cost-sharing. Find your nearest IHS facility at ihs.gov/locations or call IHS headquarters at 1-301-443-3593. Urban Indian organizations serve Native people living in urban areas — IHS’s Urban Indian Health Program locator is at ihs.gov/urban.

Veterans who served on active duty and were discharged under conditions other than dishonorable may be eligible for VA health care, which covers primary care, specialist services, mental health treatment, prescriptions, and more. Copays are based on service-connected disability rating and financial need — veterans with service-connected disabilities rated 50% or higher receive free VA care for all conditions. Post-9/11 veterans, combat veterans, and veterans with low incomes often qualify with little or no out-of-pocket cost. Enroll at VA.gov or call 1-877-222-8387 (1-877-222-VETS). Enrollment is the first step — eligibility and priority group assignment determine your copay level.

Patient Advocate Foundation (which merged with the PAN Foundation in March 2026) maintains disease-specific financial assistance funds that pay health insurance premiums and cost-sharing for patients with serious or chronic illnesses. Programs cover dozens of diagnoses including cancer, autoimmune conditions, kidney disease, heart disease, and neurological conditions. Assistance is not purely income-based — patients who are insured but face overwhelming out-of-pocket costs from a specific diagnosis may qualify regardless of total household income. Funds open and close as donations allow, so checking current availability is essential before applying. Contact at patientadvocate.org or by phone.

HealthWell Foundation provides financial assistance to underinsured Americans who need help paying health insurance premiums, deductibles, copayments, and coinsurance for specific covered conditions. Unlike some disease funds that only pay for treatment, HealthWell specifically helps people maintain their insurance coverage — keeping them in the system rather than losing coverage during a financial hardship that coincides with a health crisis. More than 80 disease funds are active, covering everything from rheumatoid arthritis and multiple sclerosis to rare diseases. Apply at healthwellfoundation.org — the eligibility check takes under five minutes. Funds open and close based on available grants.

Dialing 2-1-1 from any phone in the U.S. connects you to a live operator with real-time access to local health coverage assistance programs, free clinic listings, prescription assistance, and community health funds that don’t appear in any national database. Operators have program information updated weekly by social service agencies. BenefitsCheckUp at ncoa.org/benefitscheckup is the National Council on Aging’s free online screening tool — enter your ZIP code, age, and income to see every federal, state, and local benefit program you may qualify for, including health coverage, drug assistance, and utility help. Both tools are especially powerful for older adults and people in rural areas where local resources vary widely.