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Your spouse needs nursing home care. The bills run $7,000 or more a month. Medicaid will pay, but to qualify, you have to spend down nearly everything you both spent a lifetime saving. Then what do you live on?

That’s the scenario Congress was trying to fix when it passed spousal impoverishment protections in 1988. Before those rules existed, the healthy spouse at home routinely ended up with almost nothing. Today, federal law sets a floor on how much income and assets the community spouse, which is what Medicaid calls the at-home partner, gets to keep. It isn’t perfect, and the amounts vary by state, but the protections are real and a lot of families don’t know they exist.

If your spouse is applying for Medicaid long-term care, or you’re planning ahead, here is what the rules actually do for you.

What counts as a community spouse

The term sounds bureaucratic but the definition is simple: you are the community spouse if your husband or wife is applying for Medicaid-funded long-term care, and you are still living at home. That includes nursing home care, but it also covers home-based care through what Medicaid calls a Home and Community-Based Services waiver. The ACA expanded these protections to HCBS recipients in 2014, so one spouse does not have to be in a facility for the rules to apply.

One thing that surprises people: separation does not disqualify you. An estranged spouse is still legally a community spouse for Medicaid purposes until a divorce is finalized. Prenuptial agreements do not change the calculation either. The protections follow the legal marriage, not the financial arrangements you made within it.

The rules also cover same-sex marriages. Any legally married couple, in any state, qualifies.

The community spouse resource allowance

This is the asset protection piece. When one spouse applies for Medicaid long-term care, Medicaid looks at everything both of you own together, regardless of whose name it’s in. The applicant spouse generally must be down to $2,000 or less in countable assets to qualify. But the community spouse is allowed to keep a much larger share, called the Community Spouse Resource Allowance, or CSRA.

The federal government sets the floor and ceiling. For 2026, the minimum CSRA is $32,532 and the maximum is $162,660. States can set their own standard within that range, and many use the maximum. A few states are more restrictive: South Carolina caps it at $66,480, for example. Your state’s number matters a lot here.

In most states, the CSRA is calculated as half the couple’s total countable assets on the “snapshot date,” which is generally the first day your spouse was institutionalized for a continuous period of at least 30 days. Half of your combined assets goes to the community spouse, subject to the minimum and maximum figures above. In some states, the community spouse can keep the full amount up to the maximum, not just half.

Not all assets are countable. The primary home is exempt as long as the community spouse is living in it. One car is exempt. Household furnishings and personal belongings don’t count. Prepaid irrevocable funeral trusts are typically exempt up to a state-specific limit. Whether retirement accounts like IRAs and 401(k)s count depends on your state and whether the account is in payout status, which is why talking to a Medicaid planner before the application is filed matters.

The minimum monthly maintenance needs allowance

The CSRA protects assets. The Minimum Monthly Maintenance Needs Allowance, MMMNA, protects monthly income. These are two separate things.

Here’s the problem the MMMNA solves: the applicant spouse often has more income than the community spouse. Social Security, a pension, maybe a retirement account distribution. Under Medicaid rules, the applicant spouse’s income generally goes toward paying the cost of care. If the community spouse has little income of their own, that can leave them with almost nothing to live on each month.

The MMMNA sets a floor. If the community spouse’s own income falls below $2,643.75 a month (the federal minimum effective July 2025 through June 2026), the applicant spouse can redirect enough of their income to bring the community spouse up to that amount. The federal maximum, which applies when higher shelter costs justify it, is $4,066.50 a month for 2026. States set their own allowances within those brackets.

There is also a housing component called the excess shelter allowance. If the community spouse’s actual housing costs, including rent or mortgage, property taxes, and homeowner’s insurance, exceed a federally set shelter standard, the MMMNA can be bumped up accordingly. This is how someone with high housing costs can end up with a larger income allowance than someone with lower costs. Ask your state Medicaid office specifically about this calculation if your housing expenses are significant.

How the snapshot date affects your CSRA

The asset assessment happens at a specific moment in time, and when that snapshot is taken has real financial consequences. Generally, it’s the date your spouse first enters a hospital or care facility for a continuous stay of at least 30 days. Medicaid adds up all countable assets both spouses hold on that date, and uses that total to set the CSRA.

Either spouse can request a formal resource assessment from the state Medicaid office, even before an application is filed. The state will document the couple’s total countable resources and establish what the community spouse is entitled to keep. Getting that assessment on paper early, before assets are spent down on care costs, can protect the community spouse from ending up with less than they are legally owed.

One practical note: transfers between spouses are not penalized. Moving assets from the applicant spouse into the community spouse’s name, up to the CSRA limit, does not trigger the five-year look-back rules. That window closes once eligibility is established, so the time to act on this is early in the process.

Spending down without giving everything away

If a couple’s combined assets exceed what Medicaid allows even after the CSRA is set aside, the excess has to be spent down before the applicant spouse qualifies. This sounds blunt, but there are legitimate ways to do it that don’t amount to throwing money out the window.

Paying off debt is allowed, whether that’s a mortgage balance, car loan, or other obligation. Home improvements and accessibility modifications are an accepted spend-down strategy, since the primary home is an exempt asset and improving it doesn’t increase countable assets. A new car is allowable. Prepaying funeral and burial expenses through an irrevocable funeral trust removes those funds from countable assets immediately and is generally exempt from the look-back period.

Medicaid-compliant annuities are another option. They convert a lump sum of countable assets into a monthly income stream for the community spouse, which reduces the countable asset total while providing the at-home partner with more reliable monthly income. The rules around these are strict and vary by state, and getting one wrong can result in a penalty period that delays care, so this is not a do-it-yourself strategy. An elder law attorney or Medicaid planner who works in your state is worth the consultation fee.

What is not allowed: giving assets away, transferring property for less than fair market value, or moving money to adult children to reduce the countable total. Medicaid reviews transactions going back five years. Transfers that look like divestment to qualify can trigger a penalty period during which Medicaid won’t pay for care.

Requesting a fair hearing if the numbers are wrong

Medicaid caseworkers make mistakes. The CSRA or the income allowance can be calculated incorrectly, or your circumstances may genuinely justify a higher allowance than the initial determination reflects. Either spouse has the right to appeal.

To have the MMMNA increased, you need to show that the initial allowance is inadequate due to exceptional circumstances causing financial hardship. Examples include medical expenses the community spouse carries, debts incurred before long-term care began, or financial responsibility for another family member. High housing costs that weren’t properly reflected in the excess shelter allowance calculation also qualify.

The right to request a fair hearing exists from the moment a Medicaid application is filed, but timing matters. Once assets are spent down and eligibility is established, it can be difficult to recapture what should have been protected. Families are not always told about their right to request a fair hearing, and by the time they find out, the window may have passed. If the determination feels wrong, request a review immediately rather than assuming the state’s calculation is final.

What these protections don’t cover

Spousal impoverishment rules apply to Medicaid long-term care, which includes nursing home Medicaid and HCBS waiver programs. They do not apply when both spouses are applying for regular Medicaid, sometimes called Aged, Blind and Disabled Medicaid. In that case, the couple is generally limited to around $3,000 in combined countable assets with no CSRA.

The protections also don’t shield the home permanently. While the community spouse is alive and living in it, the home is exempt and Medicaid cannot force a sale. After the community spouse dies, however, Medicaid estate recovery rules come into play. Most states will seek to recover what they spent on the institutionalized spouse’s care from the estate, which can include the home. This is a known issue in Medicaid planning and there are legal strategies to address it, but that is a separate conversation that requires a qualified elder law attorney in your state.

These rules are a baseline. They keep the community spouse from destitution, but they are not a guarantee of financial comfort. The numbers, especially the income allowance, are tied to federal poverty-level calculations that don’t always reflect real cost-of-living realities in expensive areas.

Knowing the protections exist, and understanding what they actually give you, puts you in a much better position to push back when the numbers aren’t being applied correctly.

Learn how to stretch your retirement savings and maximize your Social Security benefits for a comfortable retirement:

18 ways to stretch your retirement savings without feeling poor: The goal isn’t to pinch every penny — it’s to protect the big stuff and trim quiet leaks. Here are simple moves that keep freedom high and stress low.

18 budgeting rules that actually work for people over 50: Money habits change as we age. In this post, discover budgeting rules that fit your income and shift of priorities when you’re over 50.

15 clever strategies to maximize your Social Security benefits: Use the facts in this post to make choices that raise your monthly check for years.

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You’ve already donated three bags of them. The ones you kept are in a stack somewhere, underneath a printer that stopped working in 2019. Before the whole pile goes to the thrift store, flip a few of them over. Some DVD box sets and out-of-print discs have become genuinely valuable over the past few years, and the collector market for physical media is growing, not shrinking, as streaming libraries keep disappearing and rotating.

Most DVDs are worth nothing. The average used disc from 2004 will get you fifty cents at a garage sale if you’re lucky. But certain titles, particularly ones that went out of print and were never reissued, and box sets with packaging that can never be replicated, have developed real secondary markets. The difference between a worthless disc and a $400 one often comes down to which logo is on the spine, whether the packaging is intact, and whether every disc is present and plays cleanly.

Criterion Collection “Hard Boiled,” spine #9 (1998)

John Woo’s 1992 Hong Kong action masterpiece was one of the very first DVDs the Criterion Collection ever released, then it went out of print almost immediately due to licensing complications. It has never come back. No Blu-ray, no reissue, nothing. For collectors who track down every Criterion spine number in order, Spine #9 is considered one of the great white whales.

The disc brings $150 or more in clean, complete condition with its original insert, and sealed copies command significantly more. Look for the original 1998 packaging with the Criterion logo and John Woo’s name clearly on the cover. Counterfeits exist and are discussed at length on collector forums because demand has stayed consistently high. The disc itself should have the Criterion logo and spine number printed clearly. A worn or scratched disc is worth noticeably less than a clean one, and missing the insert drops the value further.

AK 100: 25 Films by Akira Kurosawa, Criterion Collection (2009)

This is a 25-disc linen-bound box set released by Criterion to mark the centenary of Kurosawa’s birth. It includes films that had never been available on DVD anywhere at the time of release, and the set came with an illustrated book. It originally retailed for around $400. Clean copies in good condition regularly bring $250 to $850 depending on completeness and condition, with sealed examples pushing higher.

The completeness question matters a lot here. The set should have all 25 discs, the illustrated hardbound book, and the outer linen box with no significant damage. Torn or heavily worn box art drops the value considerably. The book should be free of writing and water damage. Individual discs that have been viewed will show minor wear, which is expected; discs with scratches that affect playback do not. This is the kind of set that was bought as a collector’s piece and often kept in excellent shape, which is part of why clean examples are worth what they are.

Criterion Collection “Essential Art House: 50 Years of Janus Films” (2006)

Fifty discs in a single box, now out of print, covering the classic art house and foreign cinema catalog distributed by Janus Films: Bergman, Truffaut, Kurosawa, Fellini, and dozens more. This was the most ambitious and expensive thing Criterion produced for the DVD era. It originally sold for $850. Complete, clean sets in good condition bring $800 to $1,900, with mint examples reaching the higher end.

The completeness check is essential. All 50 discs must be present and functional, the outer box must be intact without major structural damage, and the booklet should be included. Even one missing disc makes this a much harder sell. Buyers in this market are serious collectors who will check everything. If you have this in the back of a closet, treat it carefully before you evaluate it.

Dragon Ball Z Dragon Box complete set, volumes 1–7 (FUNimation, 2009)

The Dragon Box sets were FUNimation’s premium US release of Dragon Ball Z, each volume coming in a large box with episode masters restored from the original 16mm film and collectible Dragon Ball figurines included. The full seven-volume set is considered the definitive collector’s version of the series by hardcore fans. Individual volumes have become hard to find for reasonable prices, and the complete set is increasingly rare.

A complete set with all volumes, boxes in good shape, and figurines included brings $800 to $1,700. Individual volumes from the earlier part of the run are especially hard to find and can bring $200 to $400 each on their own. The figurines were packaged separately in each box and are often missing from used sets, which reduces value. Boxes with dents, tears, or fading bring less than clean ones. If you have the complete panoramic spine display set up intact, that is the condition collectors are paying for.

Neon Genesis Evangelion: Platinum Complete Collection (ADV Films, 2005)

The Platinum Complete Collection was the definitive US DVD release of the landmark 1995 anime series, a six-disc set with remastered video, 5.1 surround sound, and four director’s cut extended episodes that added scenes unavailable in any other format. ADV Films lost the rights, and this edition went out of print. The series matters enough that collectors consistently hunt for this specific release.

Clean complete sets bring $80 to $300 depending on condition, with factory-sealed copies reaching well beyond that. The Holiday Limited Edition variant, which came in different packaging, fetches higher prices from completionists. All six discs must be present and play cleanly. The outer slipcase is part of the package and missing or crushed slipcase reduces value. This is a disc set genuinely likely to be found at an estate sale or in the back of a DVD collection from someone who bought it when it came out.

Futurama: The Complete Collection in Bender head box (2009)

The 19-disc complete set of Futurama’s original run comes housed inside a large plastic replica of Bender’s head, his back panel opening to reveal the discs stored inside. This is the kind of novelty packaging that can’t be replicated and that fans remember. The set includes all four original seasons plus the four feature films. Clean sets with the Bender head in good condition regularly bring $150 to $450.

The Bender head itself is the thing. Without it, or with a badly cracked or repaired head, the set’s value drops sharply. The head is made of hard plastic and chips or cracks are common on sets that have been moved around a lot. Check the back panel hinge carefully. All 19 discs should be present. A Comic-Con exclusive variant existed with a numbered letter from creators Matt Groening and David X. Cohen, and those bring considerably more from fans who specifically collect that version.

The Real Ghostbusters: Complete Collection, Time-Life firehouse box (2008)

Time-Life released the complete series across 25 discs packaged in a box designed to look like the Ghostbusters’ firehouse headquarters, complete with lenticular panel art showing Slimer and the Ecto-1. This was the only release to include every episode of both The Real Ghostbusters and Slimer!, plus a bonus disc of bonus material and a companion booklet. Later editions on other labels were missing roughly 29 episodes. This Time-Life firehouse set is the complete version.

Clean examples with the firehouse box in good structural shape bring $250 to $450. The firehouse box uses lenticular panels that can crack or peel, and a damaged box brings less. Originally the five inner volumes were housed in Steelbook metal cases; the Steelbook edition commands more than the later plastic Amaray version. All 25 discs, the companion booklet, and the intact firehouse outer box are what the higher end of the price range requires.

Walt Disney Treasures: The Chronological Donald, volumes 3 and 4 (2005, 2008)

The Walt Disney Treasures DVD series ran from 2001 to 2009 as a collector-oriented line of limited edition tin-packaged sets covering classic Disney animation, shorts, and television material. All 30 titles are now out of print and have never been reissued on Blu-ray, and Disney has shown no interest in reviving the series. Volume 4 of the Chronological Donald is among the hardest to find, bringing $150 to $425 in clean condition. Volume 3 runs close behind.

Each Treasures set was released in a collectible tin with a limited edition number stamped on the disc. The tin should be intact without dents or significant rust. The discs inside should play cleanly. Sets that are still factory sealed command the highest prices, though opened examples in good condition are still worth real money. The earlier volumes in the Chronological Donald series are easier to find and worth less. If you have any of the rarer later Treasures volumes, particularly the final wave sets from 2008 and 2009, check completed sales carefully before pricing them.

Mighty Morphin Power Rangers: The Complete Series, Shout Factory 25th anniversary Steelbook (2018)

Shout Factory’s 25th anniversary set contains all three seasons of the original series, the Mighty Morphin Alien Rangers miniseries, and the 1995 theatrical film on Blu-ray making its home video debut, all in a 20-disc Steelbook case. The set originally sold for $160 to $200 and is now out of print. Completed sales for clean sets run $300 to $800, with factory-sealed sets pushing above $1,000.

The Steelbook case itself must be in good condition for the higher values to apply. Steelbooks scratch and dent easily, and any significant damage to the case’s surface or spine lowers value noticeably. All 19 DVDs and the one Blu-ray must be present. The bonus content discs are part of what collectors want. A 2024 Walmart reprint without the Steelbook packaging exists and is worth considerably less than the original 2018 Steelbook edition.

Disney Pixar Ultimate Movie Collection, 8-film DVD set (2008)

This eight-disc set collected the first eight Pixar features: Toy Story, A Bug’s Life, Toy Story 2, Monsters Inc., Finding Nemo, The Incredibles, Cars, and Ratatouille. It was a retail exclusive that sold briefly and then disappeared. Individual films have been reissued many times, but this specific bundled collection is out of print and sought after by Disney collectors who want original editions.

Clean complete sets bring $200 to $600, with sealed copies at the higher end. All eight discs must be present and playing cleanly. The outer box should be intact without major crushing or water damage. This is a set people bought for their kids and left in a shelf, which means condition varies significantly. Discs with deep scratches from being grabbed by small hands are common, and a scratched disc on a title that won’t play will keep a buyer away.

War and Remembrance: The Complete Epic Mini-Series (MPI, 2008)

This 1988 ABC miniseries cost $110 million to produce, filmed at actual historical locations across three continents over years of production. It was one of the last great old-school network event miniseries, and because it has never been available to stream and isn’t on any major platform, the DVD set is the only way to watch it. Complete 12-disc or 13-disc sets in good condition bring $150 to $300.

The set surfaces regularly at estate sales because the generation that watched it on TV is now in their 70s and 80s, and it gets cleaned out of living rooms. That makes it one of the more genuinely thrift-store findable titles on this list. All discs must be present and functional. The companion soundtrack CD included in some versions adds value. Condition of the outer box matters less than disc completeness here. If you find this at a garage sale for a dollar, it’s worth picking up.

Criterion Collection “The Third Man,” 2-disc set, spine #64 (out of print)

Carol Reed’s 1949 British noir was one of Criterion’s most beloved releases before StudioCanal reclaimed the rights and pulled it from the collection. It’s the kind of film where the Criterion supplements, including the original Orson Welles radio broadcast and an extensive making-of documentary, were genuinely irreplaceable. The set was later reissued by a different label, but without those extras.

The original Criterion 2-disc set with booklet brings $60 to $150 in clean condition, with the specific desirability coming from collectors completing their Criterion spine number runs. The booklet should be present, as this was one of the sets with a substantive essay collection. The insert is commonly missing from used copies found in the wild, and a complete set with booklet commands more than a disc-only copy.

Criterion Collection “Dead Ringers” (David Cronenberg, 1998)

Cronenberg’s identical twin psychological horror film with Jeremy Irons in a double performance has had multiple DVD releases, but the Criterion edition was distinguished by its presentation in Cronenberg’s preferred 1.66:1 aspect ratio and its director-approved supplements. The rights lapsed and it went out of print. Scream Factory later released a Blu-ray, but the Criterion DVD remains sought after by spine-number completionists.

Clean copies with insert bring $80 to $150. This is one of the out-of-print Criterions most likely to surface at an estate sale, since it was widely purchased by film fans when it was available and the horror audience is large. Counterfeit Criterion discs exist across several titles, and Dead Ringers is among them, so verify the disc printing matches the Criterion logo standard before paying top dollar.

Real Ghostbusters Complete Collection, Time-Life Steelbook inner volumes, sold separately (2008)

The firehouse box set originally shipped with the five inner volumes in individual Steelbook metal cases. Later, when the volumes were sold separately without the firehouse box, they came in standard plastic Amaray cases instead. That means the original Steelbook inner cases are only found inside the original firehouse box set, and individual Steelbook volumes separated from the main set have become collectible on their own. A single clean Steelbook volume from the original set brings $40 to $80 individually, and a full set of all five original Steelbooks in clean condition, even without the firehouse outer box, brings $150 to $300.

The metal Steelbook cases can develop surface scuffs and corner dents, which affect value. Look for the Time-Life branding on the spine and the original disc tray inside. The later plastic Amaray versions have a noticeably cheaper look and are worth less. If you find the original firehouse box set but only the Steelbook inner volumes are present without the outer firehouse box, you still have something worth selling, just not the premium version.

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The moment you turn 62, Social Security becomes available. After decades of watching that line item leave every paycheck, you can finally start getting something back. For people who are done working, burned out, or dealing with health problems, that feels less like a choice and more like a relief.

The pull is real. But so is the cost. Claiming at 62 locks in a permanently reduced benefit, and “permanently” means exactly that. The reduction doesn’t go away at 65 or 67 or any other age. It follows you for the rest of your life, and it follows your spouse too if they’re depending on your benefit after you’re gone.

For most people born in 1960 or later, full retirement age is 67. Claiming five years early means taking roughly 30% less every month, forever. Whether that trade makes sense depends on how long you live, what else you have coming in, and how clearly you’re thinking about this as a long-term financial decision rather than a short-term cash flow fix.

What the reduction actually looks like in dollars

The math is straightforward, and it’s worth sitting with for a minute. Say your projected benefit at full retirement age is $2,000 a month. Claim at 62 and you’d receive around 70% of that, or about $1,400. The gap is $600 a month, every month, for life.

At the other end of the window, waiting until 70 instead of filing at your full retirement age adds roughly 8% per year in delayed retirement credits. That same $2,000 benefit becomes approximately $2,480 a month if you hold out until 70. So the real range isn’t just 62 versus 67. It’s $1,400 versus $2,480, a difference of more than $1,000 a month, every month, for the rest of your life.

Over 20 years of retirement, that gap compounds significantly. The person who waited until 70 ends up with a lot more total income if they live long enough, which brings us to the central question of the whole exercise: how long do you expect to live?

The break-even problem

Social Security’s structure is designed so that, on average, you collect roughly the same total lifetime amount regardless of when you claim. If you file early, you get more checks but smaller ones. If you wait, you get fewer checks but bigger ones. The system assumes you’ll die somewhere near the average life expectancy, at which point the totals roughly balance out.

The break-even age is the point where the delayed benefit catches up and then overtakes what you’d have collected starting early. Comparing 62 versus 67, the break-even lands around age 78 to 79. Compare 62 to 70, and you’d need to live until roughly 80 to 82 before the later-claiming strategy pays off in total dollars.

Here’s the uncomfortable part: a 65-year-old man has an average life expectancy of around 84, and a 65-year-old woman around 87. Most people who make it to their mid-60s will live well past their break-even age. That doesn’t mean everyone should wait, but it does mean early filing is a bigger gamble than it looks at the moment you’re making the call.

The permanent nature of the reduction

People often understand intellectually that claiming early means a smaller check. What they sometimes miss is how that reduction compounds over decades. The lower base amount isn’t just your starting point. It’s what every annual cost-of-living adjustment gets applied to.

If inflation runs at 2.5% a year and you’re collecting $1,400 a month instead of $2,000, you’re getting 2.5% of a smaller number every year. Twenty years out, the person who waited has both a higher base and a larger cumulative COLA stack. The gap widens over time rather than closing.

This matters especially for people who don’t have substantial savings or a pension. For them, Social Security isn’t supplemental income. It’s the floor. Locking in a lower floor at 62 can leave you financially exposed in your 80s, which is statistically when the most expensive health and care costs tend to hit.

When claiming at 62 actually makes sense

There are real situations where filing early is the right call, and it’s worth naming them plainly rather than pretending the decision is always obvious.

Health is the biggest one. If you have a serious illness or a family history that suggests a shorter-than-average lifespan, the break-even math tilts in favor of claiming early. Filing at 62 means more total checks, and that matters if you genuinely don’t expect to make it to 79 or 80. This is especially true for single people who don’t need to weigh the impact on a surviving spouse.

Immediate income need is another valid reason. If you’re out of work at 62, have limited savings, and can’t realistically return to employment, Social Security isn’t optional. Taking a reduced benefit is better than accumulating high-interest debt or depleting a retirement account at the wrong time. The earnings limit is also worth knowing: if you claim before full retirement age and continue working, Social Security temporarily withholds $1 for every $2 you earn above $24,480 in 2026. Once you reach full retirement age, that penalty disappears and your benefit gets recalculated upward.

Certain spousal situations can also make early filing a smart move. In some couples, it makes sense for one spouse to claim early while the higher-earning spouse delays to maximize what will eventually become the survivor benefit. This is a planning decision that’s worth running through with a financial advisor, because the right answer varies significantly depending on the age gap between spouses, each person’s health, and who has the higher lifetime earnings.

The fear-based case for claiming early

One factor worth addressing directly: a lot of people file at 62 not because of financial need or health concerns but because they’re worried Social Security won’t be there if they wait. Surveys consistently show this anxiety driving early claims, and it’s understandable given how much noise surrounds the program’s funding future.

The reality is that even in a worst-case scenario where Congress fails to act on the program’s funding gap, the system wouldn’t just stop paying. Current projections suggest benefits could face a cut of roughly 24% around 2032 if no legislative fix passes, but that’s a cut, not an elimination, and most analysts expect Congress to address it before it reaches that point. Claiming five years early and locking in a 30% permanent reduction in order to avoid a possible future 24% cut is, mathematically, a losing hedge.

The spousal and survivor angle

If you’re married, the decision to claim at 62 isn’t just about you. A surviving spouse typically receives the higher of their own benefit or their deceased spouse’s benefit. That means the claiming age of the higher-earning spouse has long-term consequences for the survivor.

A spouse who claims at 62 and locks in a 30% reduction is also locking in a reduced survivor benefit. If the higher earner dies first and the surviving spouse lives into their 80s or 90s on that lower amount, the cumulative impact can be substantial. For married couples where one person earned significantly more than the other, this is often the most important consideration in the whole timing decision.

How to actually think about this decision

The claiming decision is fundamentally a bet on your own longevity, and you’re making it with incomplete information. No one knows exactly how long they’ll live. But you’re not entirely in the dark either. Your current health, your parents’ longevity, your access to healthcare, and your lifestyle all provide real signal.

Start by pulling your Social Security statement through My Social Security at ssa.gov, which will show you projected monthly amounts at 62, 67, and 70 based on your actual earnings history. Run the break-even math for your specific numbers rather than using averages. Consider whether your other retirement income is sufficient to cover the gap if you delay. And if you’re married, model both scenarios side by side.

Sixty-two is a legitimate claiming age. It’s not always the wrong choice. But it should be a decision, not a default.

Learn how to stretch your retirement savings and maximize your Social Security benefits for a comfortable retirement:

18 ways to stretch your retirement savings without feeling poor: The goal isn’t to pinch every penny — it’s to protect the big stuff and trim quiet leaks. Here are simple moves that keep freedom high and stress low.

18 budgeting rules that actually work for people over 50: Money habits change as we age. In this post, discover budgeting rules that fit your income and shift of priorities when you’re over 50.

15 clever strategies to maximize your Social Security benefits: Use the facts in this post to make choices that raise your monthly check for years.

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You’ve been renting for years, you have a steady income, and you could absolutely afford a mortgage payment. The thing standing between you and owning a home isn’t your ability to pay month to month. It’s the $20,000 or $30,000 you’d need upfront for a down payment and closing costs. That’s the situation millions of buyers are in, and it’s exactly what down payment assistance programs exist to fix.

These programs are far more available than most people realize. There are currently more than 2,600 down payment assistance programs operating across the country, a number that has grown 6% in the past year alone. The average benefit is around $18,000. And income limits are not as low as people assume: more than 60% of programs have income limits above $100,000.

The problem is that most buyers have no idea these programs exist, or they’ve heard vague things about them and assumed they wouldn’t qualify. Here’s how they actually work.

What down payment assistance actually is

Down payment assistance, usually abbreviated as DPA, is money provided by a government agency or nonprofit to cover part or all of the cash you’d otherwise need upfront to buy a home. It can cover your down payment, your closing costs, or both. The money comes from state housing finance agencies, county and city programs, federal sources, and sometimes banks or employers.

Most programs are structured as either a grant or a second mortgage. A grant is free money with no repayment required. A second mortgage sits alongside your primary home loan and has its own terms, which vary widely by program. Some require monthly repayment. Others don’t require any payment until you sell or refinance. And some are forgiven entirely after you stay in the home for a set number of years.

The program that’s right for you depends on what’s available in your area, your income, and how long you plan to stay in the home. No single program is best for everyone, and the rules differ considerably from state to state and even county to county.

Grants: Free money, no strings

A homebuyer grant is a one-time cash payment toward your down payment or closing costs that you never have to pay back. Grants are the simplest form of assistance, and they’re the most straightforward win for buyers who qualify. You get the money at closing, it goes toward your costs, and that’s the end of it.

Grants tend to be smaller than other forms of assistance, typically ranging from around $2,500 to $10,000, though some programs go higher. The Kansas statewide DPA program, for example, offers grants covering up to 5% of the home’s purchase price. Some banks have also launched grant programs of their own for buyers in qualifying income brackets and geographic areas.

The trade-off is that grant funds are often limited and distributed on a first-come, first-served basis. If a program runs out of funding mid-year, it closes until the next allocation. That makes it worth applying early in your homebuying process rather than waiting until you’ve found a specific house.

Forgivable loans: The disappearing second mortgage

A forgivable loan is technically a second mortgage, but it comes with conditions under which repayment is waived entirely. The most common structure is a percentage-based forgiveness schedule: a set portion of the loan is forgiven each year for a predefined period, often five to ten years. If the full period passes and you’re still in the home, the loan disappears. No balance due, no interest owed.

If you sell, refinance, or move before the forgiveness period ends, you typically have to repay whatever portion hasn’t been forgiven yet, sometimes with interest. The key is that these programs reward buyers who intend to stay put. If you’re buying a home you plan to live in for the foreseeable future, a forgivable loan can effectively function as a grant. If you think you might move in three years, you need to factor in the repayment risk.

One practical note: when a forgivable loan is fully wiped out, that forgiven amount may count as taxable income in the year it’s discharged. It doesn’t happen in all cases, and it depends on the program structure, but it’s worth discussing with a tax professional before you close.

Deferred or “silent second” loans

A deferred loan, sometimes called a silent second, is a second mortgage that requires no monthly payment while you’re living in the home. The balance doesn’t come due until you sell the property, refinance, or stop using it as your primary residence. At that point, you pay back the original loan amount, and depending on the program, possibly interest that has been accruing the whole time.

This structure works well for buyers who need help getting in the door but expect to build equity over time. When you eventually sell, you repay the deferred loan from the proceeds, and whatever appreciation you’ve accumulated above that is yours. The City of Napa, for example, offers a silent second program providing up to $58,000 or 30% of the purchase price, with a 1% simple interest loan that stays deferred as long as you remain in the home as owner-occupant.

The risk with deferred loans is that you can forget the obligation exists. When it comes time to sell, the payoff may be larger than you remembered, especially if interest has been accruing. Always keep a copy of the loan documents and factor the balance into any future sale planning.

Repayable DPA loans

Some down payment assistance programs give you money upfront but structure it as a genuine second mortgage with regular monthly payments. These tend to come with 0% or low interest rates, and terms ranging from 5 to 30 years. You make a separate payment on this loan alongside your regular mortgage payment every month.

This form of assistance adds to your monthly obligations, so lenders factor it into your debt-to-income ratio when determining what you can borrow for your primary mortgage. That can affect how much house you qualify for. On the positive side, repayable DPA loans often carry below-market interest rates that you won’t find through a standard lender. And because the assistance is structured as a proper loan rather than a forgivable or deferred one, there’s no forgiveness clawback risk if you move earlier than planned.

If you’re weighing options, a repayable loan at 0% is still a meaningful deal even if it adds a payment. Run the math on what your total monthly obligation would be and compare it to renting. For many buyers, it still wins.

Who qualifies: income limits and the AMI formula

Most programs set their income limits based on a percentage of the Area Median Income, or AMI, for the county where you’re buying. The AMI is calculated annually by the federal Department of Housing and Urban Development and varies significantly by location. What counts as “low income” in a rural county in Mississippi is a different number than in San Jose.

Many programs accept buyers earning up to 80% of AMI. Others stretch to 120% or even higher. Some programs have income limits as high as 80 to 100 percent of AMI, and a meaningful share have no income limit at all. If you’ve assumed you earn too much to qualify, it’s worth running your actual numbers through a program finder before writing it off.

Eligibility typically requires a credit score of at least 620, sometimes 640. You’ll generally need to be purchasing a primary residence, not an investment property. And the home itself usually needs to fall under a purchase price cap. These caps are set by the program and also vary by area. Most programs require you to pair the assistance with a 30-year fixed-rate mortgage from an approved lender, which means you can’t use assistance with just any loan from any bank.

First-time buyer requirements, and the exception that matters

A large portion of DPA programs are designed for first-time homebuyers. But the definition of “first-time buyer” is more generous than most people expect. For the purposes of these programs, you count as a first-time buyer if you haven’t owned a home in the past three years, even if you’ve owned before. If you sold a house four years ago and have been renting since, you likely qualify as a first-time buyer again under most program rules.

Not all programs have a first-time buyer requirement either. About 40% of DPA programs nationally don’t require first-time buyer status at all, meaning repeat buyers can access them too. There are also dedicated programs for specific occupations: teachers, first responders, healthcare workers, veterans, and other public servants often have access to additional assistance that general buyers don’t. Florida’s Hometown Heroes program, for example, provides up to 5% of the first mortgage amount with a $35,000 cap for qualifying community workers.

First-generation homebuyers, meaning buyers whose parents never owned a home, are also increasingly being targeted by newer programs. That category has grown 32% year-over-year as more agencies focus on breaking cycles of wealth inequality tied to homeownership gaps.

The homebuyer education requirement

Nearly every DPA program requires you to complete a homebuyer education course before closing. This is non-negotiable. You will not receive the funds without the certificate. It is also genuinely useful, not just a box to check.

The standard is an 8-hour course from a HUD-approved provider, available online and in person. Online versions typically cost around $99 and let you complete the material at your own pace. HUD maintains a search tool at hud.gov/counseling where you can find approved providers and local counseling agencies near you. Some agencies offer the counseling component for free, or on a sliding scale for those who can’t afford it.

The certificate you receive has an expiration date for purposes of most programs, typically one year from the date of completion. If you take the course and then take 18 months to close on a home, you may need to redo it. Time the course so you’re within about six months of actively house hunting.

The mortgage credit certificate: an ongoing tax break

Separate from down payment assistance but often offered alongside it, a Mortgage Credit Certificate is a federal tax program that reduces what you owe in income taxes every year for as long as you live in the home. It’s not a deduction. It’s a direct, dollar-for-dollar credit against your federal tax bill.

The way it works: your state housing finance agency sets an MCC percentage, typically between 10% and 50% of the mortgage interest you pay each year. That percentage of your annual interest becomes a tax credit, capped at $2,000 per year by the IRS. So if you pay $10,000 in mortgage interest in a year and your MCC percentage is 20%, you get a $2,000 credit on your federal taxes that year. You can still deduct the remaining $8,000 in interest as a standard deduction if you itemize.

That credit applies every year for the life of the mortgage, as long as the home remains your primary residence. Over a 30-year loan, that’s a substantial amount of money. Some lenders will also count the expected annual credit as additional qualifying income, which can help buyers who are right at the edge of what they qualify for. Not every state offers an MCC program, and availability varies, so check with your state housing finance agency or ask your lender when you’re shopping.

How to actually find programs in your area

The fastest way to find what’s available is through Down Payment Resource at downpaymentresource.com, which aggregates more than 2,600 programs and lets you search by location and situation. Your state’s housing finance agency is also a direct source. Every state has one, and they maintain lists of current programs, participating lenders, and eligibility details. HUD’s website at hud.gov/findacounselor connects you with local housing counselors who can help you identify programs you qualify for at no cost.

One thing that trips people up: not every lender participates in every program. If you find a DPA program you want to use, confirm that your lender is approved to offer it before you get too far into the process. Switching lenders mid-search because yours doesn’t participate wastes time. Ask upfront.

The gap between renting indefinitely and owning a home is often smaller than it looks. The programs exist. The money is real. Most people just need to know where to look.

Expert advice on buying a home, including buying tips, home repair strategies, and loans for single moms.

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9 low-income home loans: Affordable mortgage options and support programs available for people with modest incomes looking to buy a house.

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You planned to retire, not re-parent. Then your grandchildren needed somewhere stable to land, and you said yes. Now you’re buying school supplies on a fixed income, navigating pediatrician visits, and figuring out how to get a child added to your health insurance. The financial reality hits fast, and it hits hard.

About 2.5 million children in the U.S. are being raised by grandparents or other kin with no parent in the home. Most of these grandparents took on that responsibility with little warning, no time to adjust their budget, and no roadmap for the benefits they’re now entitled to claim.

The good news is that the support system is more substantial than most people realize. Federal and state programs exist specifically for households like yours. Many grandparents qualify for multiple overlapping benefits, and some don’t require legal custody or adoption to access. The problem is that these programs are scattered across agencies and require some legwork to find. Here’s what to look for.

Child-only TANF grants: your income doesn’t count

Temporary Assistance for Needy Families, better known as TANF, is one of the most useful programs available to grandparents raising grandchildren, and one of the least understood. Most people assume they earn too much to qualify. That’s often wrong, because there are two types of TANF grants, and one of them doesn’t factor in your income at all.

A child-only TANF grant is based solely on the grandchild’s needs and income, not yours. If you’re drawing Social Security or have a pension, none of that counts against the child’s eligibility. You don’t have to be employed. You don’t have to meet work requirements. The grant goes to the child, not you, and it’s available in all 50 states, plus D.C., Puerto Rico, the Virgin Islands, and Guam.

Benefit amounts vary by state, but child-only grants average roughly $8 per child per day at the national level. That’s not a windfall, but for a grandparent on a fixed income, it adds up. In Pennsylvania, for example, grandparents can receive $205 a month for one grandchild, $316 for two, or $403 for three. Some states have gone further. Georgia runs a separate Grandparents Raising Grandchildren program on top of TANF that provides additional monthly payments per child. Apply through your state’s social services agency, not the federal government.

You also don’t need legal custody to apply. Physical custody, meaning the child lives in your home and you’re providing their daily care, is typically enough to get started. If you’re ever told otherwise, ask the caseworker to show you that policy in writing.

Social Security benefits for grandchildren

If a grandchild’s parent has died, become severely disabled, or is no longer able to work, that child may qualify for Social Security survivor or dependent benefits based on the parent’s work record. This is a meaningful benefit that a lot of families don’t know to pursue. Social Security will pay benefits to grandchildren when the grandparent retires, becomes disabled, or dies, if certain conditions are met.

The more common scenario for grandparents raising grandchildren is survivor benefits. If the child’s parent worked and paid into Social Security before dying, the child may be eligible to receive a monthly payment equal to up to 75% of the deceased parent’s benefit amount. The grandparent typically becomes the child’s representative payee, meaning they manage the funds on the child’s behalf.

The eligibility rules are specific. For a grandchild to receive benefits on a grandparent’s own work record (rather than a parent’s), the child’s biological parents must generally be deceased or disabled, and the grandchild must have lived with you before age 18 and received at least half of their support from you for the prior year. If you’ve formally adopted the grandchild, the rules simplify considerably. Either way, it’s worth calling Social Security at 800-772-1213 or visiting a local office to check eligibility, because the monthly benefit can be significant depending on the parent’s earnings history.

SNAP benefits: the household food budget gets bigger

When a grandchild moves into your home, your household size increases, and so does your potential SNAP benefit. Food costs are one of the most immediate financial pressures grandparents face, and SNAP is one of the fastest ways to address it.

The rules here are straightforward: you do not need legal custody or guardianship to apply for SNAP for a grandchild living in your home. There are no caps on participation and no waitlists. If your combined household income falls within the eligibility limits, you can apply immediately. For households with at least one member aged 60 or older, the countable resource limit is $4,500, which is higher than the standard $3,000 limit, meaning more seniors qualify.

Grandchildren under 22 living with grandparents are typically counted as part of the same SNAP household, which is important because benefit amounts scale with household size. If your household is already enrolled in TANF or SSI, you may be categorically eligible for SNAP automatically. Apply through your state’s social services agency or online through benefits.gov, and report the new household member right away rather than waiting for the next renewal period.

Health coverage through Medicaid and CHIP

Getting a grandchild onto health insurance is urgent and often confusing, especially if the child arrives without any existing coverage. Medicaid and the Children’s Health Insurance Program are the two main routes, and grandparents can apply for grandchildren in their care without being the child’s legal guardian in most states.

Medicaid covers children in lower-income households, and in expansion states the income thresholds are broad. CHIP fills the gap for children whose families earn too much for Medicaid but can’t afford private insurance. CHIP eligibility can extend to families earning between 170% and 400% of the federal poverty level depending on the state. Coverage is comprehensive, including doctor visits, dental, vision, mental health services, and prescriptions.

A common misconception is that grandparent income counts against the child’s eligibility. In most states, if you haven’t legally adopted the grandchild, only the child’s own income is factored in for Medicaid eligibility. Your income is only counted if you have legally adopted the grandchildren. That distinction matters enormously for grandparents on Social Security or pension income. Apply through your state Medicaid office, healthcare.gov, or by calling 1-800-318-2596. If you’re told the child doesn’t qualify, ask about CHIP before leaving.

Tax credits that can mean real money at filing time

Federal tax law offers several significant credits to grandparents who are raising grandchildren as dependents. These are worth understanding before tax season, not after, because the difference between claiming them correctly and missing them entirely can run into the thousands.

The Child Tax Credit is worth up to $2,200 per qualifying child for the 2025 tax year. To claim a grandchild as a qualifying child, the child generally needs to be under 19, live with you for more than half the year, and receive more than half of their financial support from you. Grandchildren qualify under the IRS definition of a qualifying child since they are descendants of you. To qualify, the child must be your son, daughter, stepchild, or a descendant of one of these, which includes grandchildren.

Beyond the Child Tax Credit, you may also qualify for the Child and Dependent Care Credit if you’re paying for childcare while you work, the Earned Income Tax Credit if your income falls within the limits, and head of household filing status if you’re unmarried and paying more than half the household costs. That last one matters because it comes with a higher standard deduction and lower tax rates than filing as single. If you’ve legally adopted the grandchild, there’s also an Adoption Tax Credit of up to $16,810 per child. These credits can stack. A tax professional who handles kinship care situations is worth the cost if your situation is at all complicated.

School meals, Head Start, and low-income energy assistance

Beyond the major federal programs, a cluster of smaller benefits can meaningfully reduce household costs. Most grandparents don’t know to ask for these, and they rarely get mentioned by caseworkers unless you push.

The National School Lunch Program and the Summer Food Service Program provide free or reduced-price meals for grandchildren based on household income. Grandparents caring for a grandchild can apply for these meal programs, and income is the primary factor for eligibility. Apply through the school when the child enrolls, not at a separate agency.

If you have young grandchildren, Head Start provides free early education and childcare for children from low-income families. Eligibility is based on the child’s household income, not yours separately. For energy costs, the Low Income Home Energy Assistance Program (LIHEAP) helps with utility bills and is worth applying for if you’ve taken on the additional load of a child in the home. These programs all run through different agencies, which is why calling 211 is often the fastest way to get a single point of contact for your area. The 211 hotline connects callers to local social services and can help identify programs you may have missed.

Kinship navigator programs and legal guardianship subsidies

One of the more practical resources available in many states is a kinship navigator program. These are specifically designed to help grandparents and other relative caregivers figure out what they’re entitled to and how to access it. A navigator can walk you through the full landscape of state and federal benefits, help with applications, and connect you with legal assistance if you’re considering formalizing your custody arrangement.

Legal guardianship or custody isn’t required to access most of the programs described in this article, but it does open additional doors. Some states offer guardianship subsidies, which are monthly payments to grandparents who obtain legal guardianship of grandchildren who would otherwise be in foster care. These subsidies can be comparable to foster care payment rates, and they don’t count against SNAP eligibility. The trade-off is that obtaining guardianship takes time and often involves legal fees, though many areas have legal aid organizations that handle kinship care cases at no cost.

The federal Supporting Grandparents Raising Grandchildren Act created a national resource to connect grandparents with federally funded assistance and support. The Administration for Community Living runs this program and can point you toward your state’s specific resources. AARP also maintains a grandfamilies resource guide, and Generations United tracks benefits and policy changes that affect kinship caregivers nationwide.

What to do first

The programs are real, but the system isn’t organized around making them easy to find. Start with the biggest items: TANF child-only grant, Medicaid or CHIP for health coverage, and SNAP. Those three are the foundation. Then contact your state’s Area Agency on Aging, call 211, or search for a kinship navigator program in your county. Many families in this situation are leaving hundreds of dollars a month on the table simply because no one told them to apply.

You didn’t plan for this, but you showed up. The least the system can do is meet you partway.

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If you’re enrolled in a Medicare Advantage plan and it hasn’t been working for you this year, you don’t have to wait until fall to do something about it. The Medicare Advantage Open Enrollment Period runs January 1 through March 31 every year, and the deadline is eight days away. This window lets you make one coverage change, whether that’s switching to a different Advantage plan or dropping Advantage entirely and returning to original Medicare.

Miss the deadline and you’re locked in until October 15, when the fall Annual Enrollment Period opens. Any plan you pick during that fall window doesn’t take effect until January 1, 2027. That’s a long time to stay in a plan with a network that doesn’t include your specialist, or drug coverage that doesn’t cover your medications.

Whatever change you make before March 31 takes effect on the first of the following month. So a switch made by March 31 means new coverage starting April 1.

Medicare Advantage vs. original Medicare: what’s actually different

Original Medicare is the federal program. It consists of Part A, which covers hospital stays, and Part B, which covers doctor visits and outpatient care. You can see any doctor or visit any hospital in the country that accepts Medicare, with no referrals and no network restrictions. The standard Part B premium is $202.90 per month in 2026, and most people pay nothing for Part A if they worked and paid Medicare taxes for at least 10 years.

The downside of original Medicare is that there’s no cap on what you can owe out of pocket. Part A has a hospital deductible of $1,736 per benefit period, and Part B covers 80% of approved costs after you meet the annual deductible, leaving you responsible for the remaining 20% with no yearly limit. A serious illness can run up real costs fast. Most people on original Medicare buy a separate Medigap supplemental policy to cover those gaps, plus a standalone Part D plan for prescription drugs. That adds monthly premiums but provides much more predictable spending.

Medicare Advantage, also called Part C, is sold by private insurance companies approved by Medicare. These plans must cover everything original Medicare covers, and most bundle in Part D drug coverage as well. Many also include extra benefits that original Medicare doesn’t touch, like routine dental, vision, and hearing care. In 2026, 98% of individual Medicare Advantage plans offer some vision, dental, or hearing coverage. The trade-off is that you’re working within a specific provider network. Most plans require referrals to see specialists, and going out of network can mean significantly higher costs or no coverage at all depending on the plan type.

Advantage plans also come with an annual out-of-pocket maximum, which original Medicare doesn’t have. In 2026, that cap is $9,250 for in-network care and $13,900 for combined in- and out-of-network spending. Once you hit it, the plan covers 100% of covered services for the rest of the year. Whether that ceiling feels like a safety net or a scary number depends entirely on your health situation and the specific plan you’re in.

The four types of Medicare Advantage plans

Not all Advantage plans work the same way. The most common type is the HMO, or Health Maintenance Organization. HMO plans generally require you to choose a primary care physician who coordinates your care, get referrals before seeing specialists, and stay within the plan’s network to receive coverage. In most cases, going out of network means paying the full bill yourself. These plans often have the lowest premiums of any Advantage plan type, which is part of why they’re popular.

PPO plans, Preferred Provider Organizations, give you more flexibility. You can see out-of-network providers and usually don’t need a referral to see a specialist. You’ll pay less if you stay in-network, but out-of-network visits are covered at a higher cost rather than being excluded entirely. PPO plans typically carry higher premiums than HMOs. They’re a reasonable choice if you travel frequently, have providers you want to keep who may not be in every network, or just prefer not to route everything through a gatekeeper.

Private Fee-for-Service plans, or PFFS, work differently from both. Rather than a traditional network, the plan sets its own payment rates. You can see any Medicare-approved doctor who agrees to the plan’s payment terms, but not all providers will. PFFS plans don’t require you to pick a primary care physician or get referrals, but the trade-off is uncertainty about which providers will actually see you. These plans are less common than HMOs and PPOs and tend to cost more.

Special Needs Plans, or SNPs, are designed for people with specific circumstances: a chronic condition like diabetes, heart disease, or HIV/AIDS; eligibility for both Medicare and Medicaid; or residence in a long-term care facility. All SNPs must include Medicare prescription drug coverage as part of the plan. If you qualify for a SNP, the benefits are often more precisely tailored to your condition than a standard Advantage plan would be, including access to the relevant specialists and more targeted drug coverage.

What to check before you switch plans

The most important thing to verify before enrolling in any plan is whether your current doctors and hospitals are in-network. This sounds obvious, but networks change from year to year. A plan that covered your cardiologist in 2025 may not cover the same doctor in 2026. Call the plan directly to confirm, not just the provider’s office. The provider may say they take Medicare but not know which specific Advantage plans they’re currently contracted with.

Prescription drug coverage is the second thing to check. If your plan includes Part D, pull up the plan’s formulary and look up every medication you take regularly. The formulary lists which drugs are covered and at what tier, which affects your copay. If a medication you depend on moved to a higher tier or was dropped from the formulary entirely this year, that affects your out-of-pocket costs significantly. The 2026 annual out-of-pocket cap for prescription drugs is $2,100 under both standalone Part D plans and Medicare Advantage plans with drug coverage.

Total cost matters more than the monthly premium.

If you’re planning ahead for next year’s coverage, reviewing Medicare Advantage Plans 2027 can be a useful starting point for comparing available options. Be sure to check each plan’s provider network, prescription drug coverage, and potential out-of-pocket costs before making a decision.

Plans with $0 premiums frequently have higher deductibles, copays, and out-of-pocket limits. A plan with a modest monthly premium might cost you less overall if you use healthcare regularly. Add up the premium, your likely copays based on how often you visit the doctor, and what your medications will cost under each plan you’re considering before making a comparison.

The catch when switching back to original Medicare

Returning to original Medicare is allowed during this enrollment period, but there’s a complication that trips up a lot of people. Original Medicare has no annual out-of-pocket cap, so most people leaving Advantage want to pick up a Medigap supplemental policy to limit their exposure. The problem is that outside of specific protected windows, Medigap insurers can refuse to sell you a policy based on your health history.

Federal law gave you a one-time, six-month window when you first enrolled in Medicare Part B to buy any Medigap plan without medical underwriting. If that window has closed, you generally no longer have a guaranteed right to Medigap coverage. The list of conditions Medigap insurers may deny coverage for includes Alzheimer’s disease, asthma, cancer, diabetes with complications, high blood pressure, and stroke. Insurers are increasingly checking prescription drug history as the primary driver of underwriting decisions, meaning your medication list may matter as much as your diagnosis history.

There are some exceptions. People who enrolled in Medicare Advantage when they first became eligible at 65 can switch to original Medicare within that first year and still purchase a Medigap plan, a protection sometimes called the trial right. If your Advantage plan leaves the Medicare program or stops serving your area, you also have guaranteed-issue rights to a Medigap plan. And residents of Connecticut, Massachusetts, and New York can buy a Medigap policy at any time without underwriting. Everyone else should contact Medigap insurers in their state to understand their options before they disenroll from Advantage. If you need unbiased help, the State Health Insurance Assistance Program, known as SHIP, offers free counseling in all 50 states. You can find your local SHIP office at shiphelp.org.

How to make a change before March 31

You can only make one coverage change during this window. That means switching to a different Advantage plan, or dropping Advantage and returning to original Medicare with or without a Part D plan. You cannot use this period to move from original Medicare into an Advantage plan.

The easiest way to make a switch is through Medicare’s Plan Finder tool at medicare.gov, which lets you compare plans in your area by premium, network, and drug coverage. Changes made this way have an added protection in 2026: if you enrolled based on plan directory information that turned out to be incorrect, you’ll qualify for a Special Enrollment Period to make another change. Calling 1-800-MEDICARE (1-800-633-4227) is also an option if you prefer to work with someone directly.

If you contact a plan directly rather than through the official Medicare channels, submit your disenrollment from the old plan and enrollment in the new one at the same time. Doing one without the other can create gaps in coverage.

Whatever change you make, coverage starts April 1. After March 31, you’re locked in until the fall enrollment period opens in October.

More benefits advice and news from Wealthy Single Mommy:

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SNAP in 2026: New max benefits, rule changes, and the exact moves to raise your payout — For the 2026 fiscal year, the caps go up in most places, deduction amounts change, and other changes affect how much you receive. Below you’ll find the new numbers in plain English, a quick way to estimate your own benefit, and how to maximize your sum.

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