Medicare plays a crucial role in providing health coverage for aging adults, especially those who are low-income, but whether it is doing enough is a complex question that depends on various factors including eligibility, coverage scope, out-of-pocket costs, and recent policy changes.
Medicare primarily serves people aged 65 and older, as well as some younger individuals with disabilities or specific diseases. For low-income seniors, Medicare often works in tandem with Medicaid, a state and federally funded program that helps cover costs Medicare does not fully pay for, such as premiums, deductibles, and long-term care. However, qualifying for Medicaid alongside Medicare (dual eligibility) requires meeting strict income and asset limits, which vary by state but are generally very low. For example, in 2025, the federal income limit for Supplemental Security Income (SSI), a common pathway to Medicaid eligibility, is under $1,000 per month for individuals, though some states have higher thresholds. Many low-income seniors fall into this category, but those just above the limits may struggle to afford care[2][6].
Medicare itself covers hospital care (Part A), medical services (Part B), and prescription drugs (Part D), but it does not cover everything. Many low-income seniors rely on additional coverage through Medicare Advantage plans or Medigap policies to fill gaps. However, recent legislative changes, such as those introduced in the “One Big Beautiful Bill” of 2025, have led to funding cuts and new work requirements for Medicaid, which could indirectly affect low-income seniors’ ability to maintain supplemental coverage. For instance, while seniors 65 and older are exempt from Medicaid work requirements, those under 65 who are dual-eligible may face barriers, potentially disrupting their coverage continuity[1].
Another challenge is the rising out-of-pocket costs. Medicare premiums, deductibles, and copayments can be burdensome for low-income seniors, especially if they do not qualify for Medicaid assistance. Although there is a new $6,000 senior tax deduction introduced in 2025 to help offset some costs, it does not affect income calculations used to determine Medicare surcharges, meaning it may not reduce premiums for higher-income seniors who still face significant expenses[1]. Additionally, programs designed to help with premiums and drug costs, like the Medicare Savings Programs (MSPs) and Extra Help, have seen delays in expansion, leaving some low-income seniors to pay more out-of-pocket[1].
Access to supplemental benefits such as denta
