Hundreds of thousands of New Yorkers who have a limited income may be newly eligible to receive help with their health care costs through a Medicare Savings Program in 2023. Currently, people who enrolled in Medicaid at the beginning of the COVID-19 pandemic are largely still enrolled. In 2020, Congress put limits on states curtailing it for those individuals, but that requirement ends in April 2023, at which point states will begin or continue recertifying Medicaid eligibility. Those who no longer qualify will lose coverage, and enrollees who have difficulties navigating these burdensome administrative processes are also at risk. As part of this shift, Medicaid enrollees who first became eligible for Medicare during the pandemic but did not sign up will have to do so, and apply for an MSP.

Importantly, the BENES Act final rules establish a new Medicare Special Enrollment Period (SEP) that will allow Medicare-eligible individuals who lose Medicaid to enroll more easily. While this will improve timely access to Medicare, the MSP application and enrollment process remains complex. This contributes to MSPs being widely underenrolled, which in turn means many people who need help are not getting it.

Starting Jan. 1, eligibility for the Medicare Savings Program (MSP) in New York expanded to individuals with Medicare who have an income up to $2,107 per month and couples with monthly incomes up to $2,839. There are no asset limits for the MSP in New York.

The Medicare Savings Program (MSP), helps older adults and people with disabilities living on low incomes by paying their Medicare Part B monthly premium which is taken directly out of the beneficiaries Social Security Check ($164.90 each month). It also automatically enrolls them in the Extra Help program which is the federal government’s prescription drug subsidy program that the Social Security Administration estimates is worth about $5,100 per individual per year. This financial assistance can be a lifeline, allowing enrollees to maintain their Medicare coverage, access needed care, and afford other necessities, like food and rent. The Chautauqua County Office for Aging Services staff calls the MSP program “The Golden Ticket” because of the benefits it offers to enrollees.

To qualify for an MSP, a beneficiary must have Medicare Part A and meet the income guideline stated earlier in this article. If a beneficiary cannot afford the monthly Part A premium, their state may have a process to allow them to enroll in premium-free Part A if they are eligible for the MSP called Qualified Medicare Beneficiary (QMB). Many states allow this throughout the year, but others limit when beneficiaries can enroll in Part A.

If a beneficiary’s income seems to be above the MSP guidelines, they should still apply if they need help. For MSP enrollment assistance, call the Chautauqua County Office for Aging Services’ NY Connects Helpline at: 716.753.4582 or Medicare Rights Center helpline at 800-333-4114 or visit www.medicareinteractive.org/mspny.