Needy aren’t getting available financial help
Needy aren’t getting available financial help
Programs not reaching people
About half of all eligible low-income Medicare beneficiaries 65 years and older have failed to enroll in federal and state programs that can help pay Medicare’s Part B premium and cost-sharing expenses, according to a study by the American Association of Retired Persons (AARP).
The situation could be remedied by better out-reach programs alerting older Americans about the benefits that are available to them, says AARP.
The study, titled "Bridging the Gaps Between Medicare and Medicaid: The Case of QMBs and SLMBs," is the first in-depth look at what states are doing to implement Medicare assistance programs — and the barriers they face.
The Qualified Medicare Beneficiary (QMB) and Specified Low-Income Medicare Beneficiary (SLMB) programs are designed to help protect low-income people by paying Medicare’s premium and cost-sharing requirements. The researchers investigated state variations in Medicaid QMB and SLMB enrollment of low-income Medicare beneficiaries and identified best practices in 10 states: California, Florida, Massachusetts, Michigan, Minnesota, Mississippi, New Mexico, New York, Tennessee, and Texas. The study was conducted by Margo L. Rosenbach, vice president of Mathematica Policy Research, Princeton, NJ, in collaboration with AARP’s Public Policy Institute.
Because the government insurance programs evidently are reaching only a fraction of those who are eligible, out-of-pocket health care costs remain a particular burden for lower-income Medicare enrollees, especially those with no supplemental health insurance, according to the report.
For people age 65 and over living in or near poverty, out-of-pocket health costs can consume more than a quarter of their annual income. These two assistance programs help put needed money back into a person’s pocket to pay for food, rent, or prescription drugs.
However, other states are doing little to assure that Medicare beneficiaries receive QMB or SLMB benefits. "The programs are run through state Medicaid," states Jo Ann Lamphere, senior policy advisor at AARP. "Therein lies the oversight challenge for federal Medicare officials. "
The study also found:
• Grass-roots outreach is the most effective way to educate people about, and enroll people in, the QMB and SLMB programs.
• The eligibility determination process is too complex, causing confusion among Medicaid beneficiaries and Medicaid eligibility workers.
• Coordination with the Social Security Administration needs to be improved.
"Until states have better data, they will not know how many people they are reaching and who is eligible but not enrolled," says Rosenbach. "This information is critical."
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