THE WHITE HOUSE
Office of the Press Secretary
PRESIDENT CLINTON LAUNCHES NEW CAMPAIGN TO ENSURE THAT LOW-INCOME MEDICARE BENEFICIARIES RECEIVE PREMIUM ASSISTANCE July 6, 1998
Today, President Clinton announced a new outreach campaign to help millions of low-income seniors and people with disabilities get assistance in paying Medicare premiums. A study by Families USA reports that over 3 million low-income Medicare beneficiaries are not enrolled in the Qualified Medicare Beneficiary (QMB) and related programs that pay for Medicare premiums and (for some) copayments and deductibles. This assistance was expanded last year in the Balanced Budget Act. However, as this new report underscores, many eligible beneficiaries are not aware of these cost-sharing protections and others have difficulty accessing this critically needed assistance.
To address this problem, the President has requested that the Department of Health and Human Services (HHS) and the Social Security Administration (SSA) launch a multi-faceted effort to enroll eligible Medicare beneficiaries in QMB and related programs. These new initiatives, which build on existing efforts to help identify and enroll eligible beneficiaries and parallel the President's efforts on children's health outreach, include:
Launching major new initiatives to educate Medicare beneficiaries about premium assistance programs. HHS and SSA will make unprecedented efforts to ensure that beneficiaries know about these programs by distributing clear, plainly written information about these programs by:
Encouraging the use of a simplified application process. In July, the Health Care Financing Administration (HCFA) will send a letter to State Medicaid agencies that includes a model, simplified application as well as examples of successful outreach and enrollment programs. HCFA will encourage states to adopt simple, user-friendly procedures such as a mail-in application.
Creating a Federal-State-consumer advocate task force to develop new strategies to enroll eligible beneficiaries. Beginning this month, HHS, SSA, the National Governors' Association, Administration on Aging and advocates of the elderly and people with disabilities will collaborate to identify and implement strategies to educate beneficiaries about this program and to make it easier to enroll.
Targeting eligible beneficiaries through direct mailings. This fall, HCFA will send a letter to a targeted group of beneficiaries who are likely to be eligible for these protections. The targeting population list will come from a list of beneficiaries supplied by SSA that the agency believes may be eligible. The letter will explain the program and encourage beneficiaries to apply.
Providing the State Insurance Counseling and Assistance Programs (ICAs) with materials to assist beneficiaries in enrolling in the premium assistance programs. ICAs provide assistance on insurance and benefits to millions of older and disabled Americans.
These new initiatives build on an ongoing commitment by HCFA and SSA to target and enroll these vulnerable, low income Americans. For example, HCFA has provided training materials on identifying and assisting potential beneficiaries to providers, advocates and States. SSA has included information on programs in SSA pamphlets and handouts that could reach potential candidates and conducted training for staff who interact with beneficiaries.
Background on the QMB and related programs. The following table shows eligibility for premium and cost sharing assistance programs, which are offered in all States.
| | | | | | Category | Income | Annual Income | Medicaid | | | (Poverty) | (1998) | Pays | | | | Individual | For: | | | | Couple | | | | | | | |__________________|___________|____________________|__________________| | | | | | | | QMBs: Qualified | 0 to 100% | Up to | Up to |Medicare Part A&B | | Medicare | | $8,290 | $11,090 | premiums, | | Beneficiaries | | | | deductibles, | | | | | | copayments | |__________________|___________|_________|__________|__________________| | | | | | | | SLMBs: Specified | 100-120% | $8,291 | $11,091 | Medicare Part B | | Low-Income | | to | to | premiums | | Medicare | | 9,900 | 13,260 | | | Beneficiaries | | | | | |__________________|___________|_________|__________|__________________| | | | | | | | QI-1s: Qualified | 120-135% | $9,901 | $13,261 | Medicare Part B | | Individuals 1 | | to | to | premiums | | | | 11,108 | 14,888 | | |__________________|___________|_________|__________|__________________| | | | | | | | QI-2s: Qualified | 135-175% | $11,109 | $14,889 | Part of Medicare | | Individuals 2 | | to | to | Part B premium | | | | 14,328 | 19,228 | |
Notes: Income guidelines include a $240 unearned income disregard; poverty thresholds are different in AK and HI. There is also an assets limit of $4,000 for individual and $6,000 for couples for all groups. QI programs are subject to the availability of capped funding allotments.