Extra Help and Medicare Savings Programs in Tennessee

There are two programs that quietly pay a large share of Medicare costs for people with modest income, and most of the folks who qualify for them in Knox County have never applied. One covers your prescription costs. The other covers your Part B premium, and in some cases your deductibles and coinsurance too.

The income limits are higher than people assume, and your house and your car generally do not count against you. It is worth ten minutes to check before Annual Enrollment starts on October 15.

The Two Programs, and What Each One Does

They are separate, they are run by different agencies, and you can have both. People mix them up constantly.

• Extra Help, also called the Low Income Subsidy, handles the drug side. It is run by Social Security and it applies to your Part D coverage.
• Medicare Savings Programs handle the Part A and Part B side. In Tennessee they are run by the Division of TennCare, and they pay your Part B premium, which is the amount taken out of your Social Security check every month.

What Extra Help Pays For

If you qualify, Extra Help covers your Part D premium up to the benchmark amount for our region, wipes out the drug deductible entirely, and caps what you pay at the pharmacy counter. For 2026 those caps are $5.10 for a generic and $12.65 for a brand name drug, and they run lower if you also have TennCare. Once your out of pocket drug spending reaches the annual cap, you pay nothing for covered drugs the rest of the year.

Put that next to what a full price plan looks like. In 2026 a Part D deductible can run up to $615 and the out of pocket cap is $2,100. For 2027 those numbers rise to $700 and $2,400. Extra Help removes the deductible and most of what sits above it.

The Extra Help Income and Resource Limits for 2026

Two tests, income and resources. For 2026 the figures are roughly:

• One person. About $23,940 a year in income, and $16,590 in countable resources.
• A married couple living together. About $32,460 a year, and $33,100 in resources.
• The burial exclusion. Tell Social Security you expect to set aside money for burial expenses and the resource limits go up to $18,090 for one person and $36,100 for a couple.

Countable resources means bank accounts, stocks, bonds and similar. It does not mean your home, your vehicle, your personal belongings or your burial plot. That single point is the reason most of the people I sit down with assumed they were over the limit when they were not.

Medicare Savings Programs in Tennessee

TennCare runs three of them. Which one you land in depends on your monthly income, and the resource limit for 2026 is the same for all three at $9,950 for one person and $14,910 for a couple.

• QMB. Monthly income up to about $1,350 for one person or $1,824 for a couple. This is the big one. It pays your Part B premium, your Part A premium if you owe one, and your deductibles, coinsurance and copays. Providers are not allowed to bill you for the cost sharing it covers.
• SLMB. Up to about $1,616 or $2,184. Pays the Part B premium only.
• QI. Up to about $1,816 or $2,455. Also pays the Part B premium only. It is funded on a first come first served basis and you have to reapply every year, so do not sit on it.

The Part B premium is $202.90 a month in 2026 and is projected to be about $209.50 in 2027. A program that pays it is worth roughly $2,400 a year to you, before you count anything else.

Qualifying for One Gets You the Other

This is the part worth knowing. Anyone approved for QMB, SLMB or QI is automatically enrolled in full Extra Help. You do not fill out a second application. So if you are anywhere near the TennCare limits, apply there first and the drug help follows on its own.

Where to Apply

• Extra Help. Social Security, not your drug plan and not Medicare. Apply online at ssa.gov, or call (800) 772-1213, or walk into the Social Security office.
• Medicare Savings Programs. TennCare Connect at tenncareconnect.tn.gov, or by phone at (855) 259-0701.

Both applications ask for income and asset information. Neither costs anything to file, and being turned down once does not stop you from applying again if your situation changes.

Why the Timing Matters Right Now

Annual Enrollment runs October 15 through December 7 for coverage that starts January 1. If Extra Help comes through, it changes which drug plan makes sense for you, because the premium help only goes so far and some plans sit above that benchmark. People with Extra Help also get chances to switch drug plans outside the normal window, which almost nobody uses.

If you are already gathering your paperwork, our open enrollment prep checklist walks through the rest, and the Annual Notice of Change post covers the letter your current plan already mailed you.

Not Sure Whether You Qualify

These limits move every year and the rules around what counts as income are fussier than any short article can cover. Check with Social Security and TennCare before you assume anything either way.

If you would rather have somebody local look at it with you, that is what we do, and it does not cost anything. We will go through your numbers, tell you honestly whether it is worth applying, and help you fill it out if it is. Call (865) 591-9884 or reach out through the site and we will set up a time.