In Elder Law News

Senior couple online together on laptop in home office.Many Medicare recipients struggle to make ends meet. Special savings programs administered by each state can help cover certain Medicare costs, such as premiums and deductibles. The criteria one must meet to qualify for this assistance, known as Medicare Savings Programs (MSPs), can vary by state.

According to AARP, MSPs could save low-income people who enroll in Medicare up to $7,000 annually. Yet roughly half of the millions of individuals who are eligible for MSPs have not enrolled in these programs. Some people may be unaware of their MSP coverage options. Others have opted to avoid the complicated yearly application and renewal processes altogether.

Four Main Types of Medicare Savings Program Coverage

There are four main type of MSPs available to people with limited means:

  • Qualifying Medicare Beneficiary (QMB) Program – This is the most comprehensive of the four types of coverage. The QMB Program helps cover the cost of Medicare Part A and Part B premiums, deductibles, coinsurance, and copayments.
  • Qualifying Individual (QI) Program – The QI Program offers financial assistance to qualifying individuals on their Part B premiums.
  • Specified Low-Income Medicare Beneficiary (SLMB) Program – The SLMB Program helps Medicare enrollees with Parts A and B by covering some of the costs for Part B premiums.
  • Qualified Disabled and Working Individuals (QDWI) Program – The QDWI Program helps support disabled individuals under 65 who work.

A Simpler Application

In Fall 2023, the Centers for Medicare & Medicaid Services (CMS) announced its plan to make access to MSPs easier for many more low-income seniors and people with disabilities. The agency estimates that nearly 900,000 more individuals across the country could come to benefit from MSP coverage as a result.

Qualifying individuals who wish to enroll in an MSP will be able to do so through a streamlined application process, starting in mid-November 2023. Those interested in re-enrolling in their MSP will also be able to follow a less complex process.

Other Improvements

In addition to a simplified application, other expected changes under this initiative include the following:

  • Individuals receiving Supplemental Security Income (SSI) who qualify for Medicare will get automatic enrollment in the QMB Program. Enrollees in this MSP receive financial assistance with Medicare Part A and B premiums as well as other costs.
  • States will be seeking to enroll people who are part of the Medicare Part D low-income subsidy into the MSP coverage options for which they qualify.
  • Seniors and people with disabilities applying for these programs could save almost 19 million hours in paperwork annually. They may also save more than $87 million on transportation, postage, and other costs associated with applying for or renewing their MSP coverage.

The goal of the new rule, the CMS states, is threefold. It seeks to:

  1. finalize policies to streamline MSP eligibility and enrollment processes,
  2. reduce administrative burden on states and applicants,
  3. and increase enrollment and retention of eligible individuals.

Consult With an Expert

You may need further guidance on the Medicare Savings Programs available to you. Consider contacting your state State Health Insurance Assistance Program (SHIP) or a qualified elder law attorney in your area. 

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