Medicare Savings Programs: New Estimates Continue to Show Many Eligible Individuals Not Enrolled

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August 2017

Under the 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 adults over age 65 and adults with disabilities.

In 2013, Medicaid paid for approximately 8.8 million beneficiaries to receive assistance with their Medicare costs through the MSPs, but historically, not everyone eligible for an MSP actually has enrolled. Low enrollment in the MSPs is of concern because cost-sharing assistance can affect access to care. Although payment policies are only one of several factors affecting access, prior work by MACPAC found as the Medicaid contribution towards Medicare cost sharing increases, beneficiaries are more likely to use selected outpatient services.

In this brief, MACPAC presents new data on MSP participation rates, updating prior studies that are now somewhat dated. We also seek to fill in gaps in the existing research by comparing characteristics of MSP enrollees with those eligible but not enrolled, and indicating which segments of the eligible but not enrolled population could benefit from increased outreach efforts.

To read the full analysis, prepared under contract by the Urban Institute, visit Medicare Savings Program: Enrollees and Eligible Non-Enrollees.

Publication Type: Issue Briefs

Tags: adults over age 65, cost sharing, dually eligible beneficiaries, enrollment, income threshold, Medicare Savings Programs, people with disabilities, premiums