The Tool Desk
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What should you do first if you can’t pay your bills?
Make a one-page picture of the shortfall
Write down your monthly income, essential expenses, due dates, overdue amounts, and any notices or deadlines. Include rent or mortgage, utilities, food, medicines, insurance, and transportation needed for daily life. Mark any eviction, foreclosure, shutoff, repossession, or court notice with its response date. Do not ignore court papers or assume a creditor or provider has paused action.
Contact billers before deadlines when possible
Call each landlord, lender, utility, medical provider, or other creditor and ask what hardship plan, payment arrangement, due-date change, fee waiver, or assistance application it offers. These are options to ask about, not guaranteed rights. Record when you called, whom you spoke with, what was agreed, and any confirmation number or written terms. If a deadline is already close, say so clearly and ask what immediate steps are available.
Get local referrals
Call 211 or visit 211.org to ask about local rent, utility, food, and other assistance. The Social Security Administration describes 211 as a free, confidential social-service referral service, and the Consumer Financial Protection Bureau recommends it for finding local rent or utility assistance. A referral does not guarantee that a program has funds or that you qualify. USA.gov also directs people to information about federal, state, and local benefits.
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Which programs might increase income or reduce regular costs?
Different routes address different parts of a budget gap. Social Security’s Supplemental Security Income (SSI) may add income for some people; Medicare Savings Programs and Extra Help can reduce certain Medicare costs; and local programs may help with a specific urgent bill. Applications, timing, eligibility rules, and administering agencies differ.
| Option | What it may change | Who to contact | Important qualification |
|---|---|---|---|
| SSI | May provide additional income | Social Security Administration (SSA) | Means-tested; age 65 or older alone does not ensure eligibility. |
| Medicare Savings Programs (MSPs) | May pay Part A and/or Part B premiums and, depending on the program, Medicare deductibles, coinsurance, and copayments | Your state’s Medicaid agency | Income and resource rules apply; states may allow eligibility above federal limits. |
| Extra Help | Helps with Medicare Part D prescription-drug costs | SSA or your state assistance contacts; a State Health Insurance Assistance Program (SHIP) counselor can help | Income, resources, and counting rules apply; some people qualify automatically. |
| Local rent, utility, food, or emergency aid | May provide a referral or help with a particular need | 211 and local or state agencies | Availability, eligibility, and funding vary by community. |
Check SSI if you have limited income and resources
SSI may be available to people age 65 or older, as well as people who are blind or have qualifying disabilities, if they meet SSA’s income and resource rules. It is not automatic: SSA decides based on the applicant’s circumstances and program requirements. SSI recipients may also want to check eligibility for SNAP food assistance and Medicaid.
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Ask the state about Medicare Savings Programs
If you have Medicare, ask your state Medicaid agency about MSPs. Depending on the specific program, assistance may cover Part A and/or Part B premiums and may also cover deductibles, coinsurance, and copayments. Federal income and resource limits are not the only consideration: states may have more generous eligibility rules, and Alaska and Hawaii have adjustments to federal figures.
Medicare.gov lists these 2026 monthly income and resource limits. They are published program thresholds, not a decision about any individual’s eligibility; state rules and household circumstances matter.
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| MSP category | 2026 monthly income limit: individual / married couple | 2026 resource limit: individual / married couple |
|---|---|---|
| Qualified Medicare Beneficiary (QMB) | $1,350 / $1,824 | $9,950 / $14,910 |
| Specified Low-Income Medicare Beneficiary (SLMB) | $1,616 / $2,184 | $9,950 / $14,910 |
| Qualifying Individual (QI) | $1,816 / $2,455 | $9,950 / $14,910 |
| Qualified Disabled and Working Individual (QDWI) | $5,405 / $7,299 | $4,000 / $6,000 |
QDWI is a specialized category, rather than the usual starting point for most retirees. Confirm current figures, state rules, and how income and resources are counted with the state agency or Medicare before relying on a threshold.
Check Extra Help for prescription costs
Extra Help assists with Medicare Part D costs. Medicare.gov lists 2026 income and resource thresholds of $23,940 and $18,090 for an individual, and $32,460 and $36,100 for a married couple. Some people qualify automatically. The full counting rules and the person’s circumstances affect eligibility, so check the current Medicare and SSA information rather than treating those figures as universal cutoffs. SHIP provides free, individualized Medicare counseling and can help with questions and applications.
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What can you do about medical bills and prescription costs?
Review a medical bill before borrowing to pay it
Ask the hospital or provider for an itemized bill and its financial assistance policy. Compare the charges with your insurance explanation of benefits, if you have coverage, and ask the provider to explain any discrepancy. Ask whether you can apply for charity care or arrange payments. USA.gov identifies charity care, Medicare Savings Programs, Extra Help, and help from a credit counselor as potential routes to investigate; availability and eligibility vary.
Address an immediate medicine gap directly
If you may have to stop or delay a medicine because of cost, contact the prescribing clinician or pharmacy promptly and explain the problem. Ask whether there is a safe, lower-cost option or a relevant assistance route, and check Extra Help if you have Part D. Do not change or stop prescribed treatment without discussing it with a qualified health professional.
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How should you respond to debt collectors or legal notices?
Do not assume a collection notice is correct, but do not ignore it. Verify the collector and the debt, keep copies of notices and records of calls or payments, and follow the instructions and deadlines on a validation notice if you dispute the debt. The CFPB explains consumer rights and options for disputed debts; federal law prohibits unfair practices by covered debt collectors. The rules and available remedies depend on the debt and circumstances.
If you are sued, get legal help promptly and respond according to the court’s instructions and deadlines. Contact local legal aid or the court for information about help in your area. Do not assume Social Security funds are protected from every garnishment or offset: the rules depend on the type of debt and legal process.
When might a representative payee help?
If keeping track of benefit payments has become difficult, ask SSA whether a representative payee is appropriate. This is a formal role for managing Social Security or SSI payments, not permission for someone to informally take control of another adult’s finances. SSA says a payee must use benefits for current needs such as housing, utilities, food, and medical expenses, keep records, and may use remaining money for past-due bills.
How to choose the next call
- Risk of eviction, foreclosure, shutoff, repossession, or a lawsuit: Contact the landlord, lender, utility, court, or legal aid promptly about the specific notice and deadline; use 211 to look for local referrals.
- Not enough for food or essential medicine: Call 211 for local referrals and contact the relevant health professional or pharmacy about a medicine-cost problem.
- Medicare premiums or prescription costs are squeezing the budget: Ask the state Medicaid agency about MSPs, check Extra Help, and contact SHIP for free Medicare counseling.
- Income remains too low despite reviewing expenses: Check SSI eligibility with SSA if you are age 65 or older, blind, or have a qualifying disability.
- A medical balance is growing: Ask the provider about itemized charges, its financial assistance policy, charity care, and payment options before turning to credit.
- Several debts are difficult to manage: Consider asking a credit counselor about debt-management help. Public referrals and nonprofit counseling are not interchangeable with commercial debt-settlement or borrowing products; understand fees and risks before agreeing to anything.
This guide is for people in the United States and is general information, not individualized financial, benefits, tax, or legal advice. For an immediate threat to housing, utilities, legal rights, food, or access to medicine, contact the relevant local authority, provider, legal aid service, or emergency referral service without delay.
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