|
E-mail this page to a friend!
Medicare News
Federal Action Needed to Enroll More Elderly in
Medicare Savings Programs
June 12, 2006 - Federal action is needed to enroll more low-income
elderly and disabled people in the Medicare Savings Programs, which
help pay their Medicare premiums and other charges, according to a
report released today by an independent expert panel of the National
Academy of Social Insurance (NASI).
The roles and responsibilities of
federal and state governments need to be sorted out, the panel said, and
additional federal financing should be provided.
"Increasing enrollment in the Medicare Savings
Programs is vital in reducing financial barriers to health care for
low-income Medicare beneficiaries," said Jack Ebeler, chair of the study
panel and president of the Alliance of Community Health Plans.
"Better aligning the Medicare Savings Programs with
Medicare's low-income prescription drug subsidy offers an opportunity to
increase enrollment in both programs."
Fewer than one in three eligible low-income persons
is receiving benefits from the Medicare Savings Programs, which help pay
Medicare's premiums and cost sharing for hospital and physician
services. A separate subsidy helps with the premiums and cost sharing
for Medicare's prescription drug benefit.
The study panel identified the following as the top
barriers to enrollment:
> Lack of
awareness that the programs exist,
> An eligible
population that is hard to reach due to age, impairments, or language
barriers,
> A burdensome
application process,
> Reluctance to
apply for benefits through a state Medicaid agency, and
>
Misunderstanding the programs' limits on assets.
|
Medicare Savings Programs
By
Medicare Rights Center
Medicare Assistance Programs help people
with Medicare, who do not qualify for Medicaid, pay for some of
the costs of Medicare. There are three Medicare Assistance
Programs:
● Qualified Medicare
Beneficiary (QMB): Pays for Medicare's premiums, deductibles and
coinsurance
● Specified Low-income Medicare Beneficiary (SLMB): Pays for
Medicare's Part B Premium
● Qualifying Individual (QI-1) Program: Pays for Medicare's
Part B Premium |
|
Medicare Savings
Programs |
|
Program |
Federal Monthly Income Limits* |
Asset
Limits** |
|
|
Individual |
Couple*** |
Individual |
Couple*** |
|
|
|
QMB |
$837 |
$1,120 |
$4,000 |
$6,000 |
|
|
|
SLMB |
$1,000 |
$1,340 |
$4,000 |
$6,000 |
|
|
|
QI-1 |
$1,123 |
$1,505 |
$4,000**** |
$6,000**** |
|
|
|
* 2006 figures are
different in Alaska and Hawaii. Some states allow additional
income above the federal limits. Check with your local
Department of Social Services to confirm.
** Asset limits do not include your house or car. You and your
spouse can each set aside an extra $1,500 for a burial fund.
*** If there are more than two people in your household, the
income limits for these programs will be higher. Ask a Medicaid
counselor for the amount.
**** Some states, including New York, have no asset limits for
these programs.
Call 1-800-MEDICARE (1-800-633-4227) for more information.
|
The study panel offers several options for
increasing enrollment in the Medicare Savings Programs. The options
build on the Social Security Administration's ongoing efforts to enroll
people in Medicare's low-income prescription drug subsidy. One approach
would use the information gathered by Social Security to make the
current Medicare Savings Programs work better, without changing current
eligibility rules or administrative responsibilities. A more expansive,
and expensive, course of action would simplify and liberalize the
eligibility rules to provide greater uniformity between the Medicare
Savings Programs and the low-income drug subsidy. Still another
alternative is to adopt more limited changes that would facilitate a
gradual increase in the federal financial and administrative role.
The panel's conclusions are described in detail in
its final report, Improving the Medicare Savings Programs, which is
available for download free-of-charge from the NASI Web site at
http://www.nasi.org.
More information:
The National Academy of Social Insurance is a
nonprofit, nonpartisan organization made up of the nation's leading
experts on social insurance. Its mission is to promote understanding and
informed policymaking on social insurance and related programs through
research, public education, training, and the open exchange of ideas.
The Commonwealth Fund, a New York City-based private, independent
foundation, provided the primary financial support for this project.
Dissemination of the report is made possible by support from the W.K.
Kellogg Foundation.
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
