On December 6th, 2017, the Connecticut Department of Social Services (DSS) announced that it would be postponing the implementation of eligibility reductions in the Medicare Savings Program (MSP). After a tremendous outpouring of concerns from beneficiaries, legislators, and health care advocates, the DSS decided to delay the start of the cuts to the MSP that were outlined in the state budget passed in October 2017.
Over the next two months (January – February 2018), the DSS will be reviewing different coverage alternatives to the MSP for beneficiaries who stand to lose their coverage if the legislative cuts go into effect. With this brief delay, state legislators are also hoping that they can find a way to stop these cuts permanently.
As we wait to see what the DSS finds in its review, there are still many lingering questions regarding the Medicare Savings Program and the state budget cuts. Below, we have put together a list of frequently asked questions that may help you to better understand the situation.
What is the Medicare Savings Program?
The Medicare Savings Program (MSP) is designed to help individuals pay for their Medicare Part B Premiums, deductibles, and co-insurance. In CT, the MSP has three levels of coverage: Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Additional Low-Income Beneficiary (ALMB). Depending on income level, individuals will fall into one of these categories and receive different assistance from the State. However, the State pays the Medicare Part B premium for all three of these levels and all MSP recipients are automatically enrolled in the federal Extra Help/ Low Income Subsidy program.
What are the changes being made to the MSP?
Due to the State budget legislation (Public Act 17-2, Section 50), the income eligibility levels for MSP were set to match the minimum federal income limits by January 1st, 2018. However, as of December 6th, 2017, it was determined that the current MSP income eligibility levels are to stay in place until February 28th, 2018.
What does these mean for those using the MSP?
Those individuals who meet the new income eligibility levels will be able to remain on MSP. Some may have to change their level of MSP coverage, but many stand to lose their coverage altogether. In fact, the State Department on Aging estimates that 82,000 CT residents will lose their MSP coverage due to this income eligibility level change. Also, according to the DSS, up to 113,000 seniors and residents with disabilities may be affected with full or partial benefit loss.
For those losing their MSP coverage, the State of CT will stop helping to pay their Medicare Part B premium, but will continue to provide Extra Help prescription assistance in 2018. Loss or changes to MSP should not impact Medicaid benefits.
How do I know if my MSP coverage is changing or if I am losing my MSP coverage?
The DSS is sending notices to MSP recipients who are affected by the legislation change. Recipients should have received an informational mailing at the end of November. A personal Eligibility Determination Decision notice will also be sent to inform recipients if they need to change their MSP or if they will be losing their MSP. The date of this mailing is unknown at this time due to the DSS delaying the implementation of the new income limits.
What should I do if I am losing my MSP coverage?
If you are losing your MSP coverage, exploring other possible coverage options is the best way to proceed. Other coverage options include:
Is there someone that I can talk to about losing my MSP coverage?
The State Department on Aging and local Area Agencies on Aging are working to help those affected by this legislative change. The State Department on Aging’s CHOICES program has trained counselors that are prepared to answer any questions that you may have about MSP and can help you figure out what Medicare coverage option is best for your situation. Also, you can visit the State Department on Aging’s website for more information on MSP and Medicare coverage options.
What should I do while the DSS is reviewing the changes to the MSP?
DSS is expected to conduct their review of the changes to MSP in the next two months (January – February 2018). They will notify recipients on the progress of their review and their hope is to reduce the financial loss for some recipients.
While the DSS is conducting their review, it is in your best interest to be proactive and have a plan in place if you stand to lose your MSP coverage or if your MSP coverage will change.
Please note that we will provide more information and updates on the Medicare Savings Program changes on this website as it becomes available.