Eligibility

The CMS National Training Program provides save the dates for their Medicare Program basics webinars. These webinars help those who assist people with Medicare make informed decisions about their 2024 health care coverage. The webinars will include different topics each day. Participants can attend one or both days, and space is limited. The webinars will be held on Tuesday, April 16 from 1:00 p.m. to 3:30 p.m. E.T and Wednesday, April 17 from 1:00 p.m. to 3:30 p.m. E.T.

On February 9, the Centers for Medicare & Medicaid Services (CMS) issued updated instructions for states to implement policies for the Medicare Savings Programs (MSPs) in the Streamlining Medicaid; Medicare Savings Program Eligibility and Enrollment Final Rule (CMS 2421-F) in advance of upcoming compliance dates. MSPs, also known as Medicare Buy-In programs or Medicare Premium Payment Programs, help individuals qualify for assistance with payment of Medicare premiums, and in some cases, Medicare cost-sharing...

The Social Security Administration (SSA) recently posted a blog highlighting the upcoming changes to Achieving a Better Life Experience (ABLE) programs following the signing of the ABLE Age Adjustment Act in December 2022. These programs serve as financial empowerment tools for Americans living with disabilities, allowing individuals to save money and build financial independence without affecting eligibility for important benefits, like those administered by Social Security. The amendment, effective in 2026, expands ABLE program access to an additional six million Americans, including one million veterans...

Recently, the Centers for Medicare & Medicaid Services (CMS) released the 2024 Supplemental Security Income (SSI) and Spousal Impoverishment Standards, and the 2024 Medicare Savings Program resource standards. Certain Medicaid income and resource standards are adjusted beginning each January in accordance with changes in the SSI federal benefit rate (FBR) and the Consumer Price Index (CPI). The MSP groups are mandatory Medicaid eligibility groups that provide coverage of some or all Medicare Part A and B premiums and cost-sharing for low-income Medicare beneficiaries. The resource standards for the MSP groups are based on the SSI resource standard, which is set forth in statute...

On September 18, the Centers for Medicare & Medicaid Services (CMS) issued a final rule to streamline enrollment in the Medicare Savings Programs (MSPs), helping to increase participation in the MSPs by an estimated 860,000 people. The MSPs, run by state Medicaid programs, cover Medicare premiums and, in most cases, cost-sharing for more than 10 million older adults and people with disabilities who have limited incomes. Only about half of eligible people are currently enrolled, in part due to cumbersome application and verification processes. CMS also estimates the final rule will save older adults and people with disabilities nearly 19 million hours in paperwork each year and reduce state administrative burden by over 2 million hours...

This publication finds meaningful variation in disenrollment and churn across Medicaid beneficiary categories. Specifically, beneficiaries with Supplemental Security Income-related eligibility have low rates of disenrollment and high rates of reenrollments. In this research, Mathematica uses data from the Transformed Medicaid Statistical Information System Analytic File to examine rates of disenrollment, churn, and continuous coverage among categories of children and adult Medicaid beneficiaries whose eligibility is related to a disability.

On January 5, 2023 CMS released an Informational Bulletin providing further guidance on the Medicaid eligibility provisions in the recently-enacted Federal budget (Consolidated Appropriations Act of 2023). The CAA permits states to begin terminating Medicaid eligibility for current recipients on April 1, 2023 and provides gradually-decreased FMAP increases through December, 2023. This IB is the first in a series of written guidance from CMS on these provisions, focusing first on revised key due dates for certain state eligibility redetermination deliverables and activities.