Perspective               

Low Income Assistance Program Underused

A new report by the Kaiser Family Foundation reveals that low-income assistance programs for people with Medicare are underused. Sixteen million people out of the 39 million people with Medicare are poor or low-income and are eligible to enroll in the Qualified Medicare Beneficiary program, also known as QMB. QMB is a Medicaid-based plan that helps protect poor people with Medicare from high out-of-pocket health care costs. It pays for the Part B premium of $45.50 a month, deductibles, and coinsurance. Yet more than 7 million people, more than half of those eligible for the QMB program, are not enrolled.

Why are these seven million plus people left out of this program? The report identifies several reasons. First, few states make an aggressive effort to let the public know about this program. Second, the enrollment process can be long and cumbersome. Applicants must provide supporting documentation for all information on their application, and enrollment locations are not easily accessible. Third, applicants are not screened automatically for QMB eligibility. The burden is left on the applicant to know and state exactly what program he or she wishes to apply for.

To make QMB and programs like it more accessible to those who need it, states should increase knowledge about these programs with coordinated and targeted outreach. They should make enrollment easier by using simpler forms and by placing workers in more convenient locations. They should reduce documentation requirements on applications. The federal government can also improve the enrollment rate by identifying potential applicants directly and helping to educate the public.

If you are single and your income is $960 a month or less, you may qualify for low-income assistance programs that help pay for your health care costs that Medicare does not pay for. If you are married, the limit is $1,286 a month. Your savings cannot be higher than $4,000, or $6,000 if you are married. If you have Medicare and you think you are eligible, call your State Health Insurance Assistance Program, or SHIP. You can get the number by calling the Medicare hotline at 1-800-MEDICARE, or 1-800-633-4227.

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