Medicare Savings Program Update

New York State Makes Changes to Improve Access to Low Income Beneficiaries

August 1, 2008

Author: Cathy Roberts

The Medicare Savings Program is more accessible than ever to low income elderly and disabled Medicare beneficiaries in New York State, thanks to two recent changes being implemented by the New York State Department of Health (DOH). 

The Medicare Savings Program or MSP is the generic "catch-all" term for the various Medicare Buy-In Programs – the programs that pick up the cost of the monthly Medicare Part B premiums for low income beneficiaries and automatically qualifies them for the Part D (prescription drug) low income subsidy.  (One of the MSPs, the Qualified Medicare Beneficiary (QMB) program, also covers  Part A and B coinsurance and deductibles.)

Medicare beneficiaries with gross incomes at or below 135% of the federal poverty level can qualify for MSP.  You apply for MSP at your local Medicaid office.

Here are the two major changes to the MSP in New York State:

(1) DOH has completely eliminated the interview requirement as of January 1, 2008.  This means that disabled and elderly Medicare beneficiaries can apply for MSP without having to travel to the local Medicaid office!  (Prior to January 1, MSP applicants had to appear at in-person interview or appoint an authorized representative to attend the interview in their place.)  DOH GIS message 07 MA 027 announces the new "no interview required" policy.  You can get the GIS message and its attachments, including a copy of the MSP application form, at http://onlineresources.wnylc.net/pb/docs/07ma027.pdf

(2) the asset test has been eliminated from all three MSPs (QMB, SLMB and QI-1) as of April 1, 2008, in accordance with statutory changes made to MSP as part of the 2008 NY state budget process.  So assets will no longer be considered in determining MSP eligibility in New York State.  DOH announced this change to the local districts through GIS message 08 MA 016 ("Elimination of the Asset Test for the QMB and SLIMB Programs"), available at http://onlineresources.wnylc.net/pb/docs/08ma016.pdf.

Here is a description of the various MSPs that pay for Part B premiums and their income criteria for 2008, courtesy of DOH:

Qualified Medicare Beneficiary Program (QMB)

QMB can pay for the Part A and/or Part B premium.  An individual can be eligible for QMB only or for QMB and Medicaid. QMB also pays for the Parts A and B coinsurance and deductibles.

Specified Low Income Medicare Beneficiary Program (SLIMB)

SLIMB pays for the Part B premium only. Individuals can be eligible for SLIMB only or for SLIMB and Medicaid (with a spenddown).  The applicant must have Medicare Part A in order to be eligible.

 Qualified Individual-1 (QI-1)

QI-1 pays for the Part B premium only. Individuals cannot be eligible for QI-1 and Medicaid.  The applicant must have Medicare Part A. States are allotted money for this program on a yearly basis.

For more information about the changes to the Medicare Savings Program, or other Medicare Part D related questions, please contact Cathy Roberts at 518 462-6831 x 112 or croberts@empirejustice.org.