Medicare Savings Programs: Eligible But Not Enrolled

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April 2017

Under Medicare Savings Programs (MSPs), state Medicaid programs are required to help pay for Medicare premiums and in some cases, Medicare cost sharing for low-income seniors and adults with disabilities who are dually eligible for both programs. But not everyone who is eligible for one of the four MSPs—the Specified Low-Income Medicare Beneficiary (SLMB) program, Qualifying Individual (QI) program, Qualified Medicare Beneficiary (QMB) program, and Qualifying Disabled and Working Individuals (QDWI) program—actually enrolls.

Because of the lack of recent information on MSP participation rates—as well as little information about who enrolls in MSPs compared to who is eligible but not enrolled—MACPAC conducted a study to document current participation rates by program and state, and looked at characteristics of the beneficiaries who are eligible but not enrolled. The presentation concludes with several policy options to ensure that those who are eligible for MSPs enroll in them.

Publication Type: Presentations

From: April 2017 MACPAC Public Meeting

Tags: access, cost sharing, dually eligible beneficiaries, enrollment, Medicaid and other payers, Medicare, Medicare Savings Programs, payment