Press Release             

FOR IMMEDIATE RELEASE
Contact: Nathan Heggem
Policy and Communications Associate
212-204-6214

February 10, 2011

Consumer Group Publishes Recommendations to Improve New York State’s Medicare Part A Buy-In Program
-- Reforming Enrollment Processes Would Allow New Yorkers with Limited Income to Access Medicare --

New York, NY—In a report published today, the Medicare Rights Center explores New York State’s efforts to help people with limited means who are eligible for—but cannot afford—Medicare to enroll in the program through the state’s Part A buy-in benefit. The report, Streamlining Medicare and QMB Enrollment for New Yorkers: Medicare Part A Buy-In Analysis and Policy Recommendations, was made possible by a grant from the United Hospital Fund.

In the report, the consumer advocacy group describes how New York State’s Part A buy-in program helps Medicare-eligible consumers of limited means who do not qualify for premium-free Part A to simultaneously enroll in Medicare Part A and the Qualified Medicare Beneficiary (QMB) program. Medicare Part A is free for people who have worked and paid Social Security taxes for at least ten years.

The QMB program is the most generous Medicare Savings Program (MSP), and is designed to help eligible consumers with their Medicare Part A and B premiums (including the Part A premium when it is owed), deductibles, copays and coinsurance, but also requires that consumers be enrolled in Part A before they can enroll in QMB. This last requirement has put Medicare out of reach for some Medicare-eligible consumers because of the cost of enrolling in Part A. To address this problem, some states, including New York, have “Part A buy-in” agreements with the federal government, which allows states to enroll eligible people in Part A and QMB at the same time.

“New York State’s Part A Buy-In program has the potential to help many more people than it currently does,” said Joe Baker, president of the Medicare Rights Center. “By streamlining and reforming the buy-in process and improving data-sharing among multiple systems, the state could help tens of thousands more vulnerable New Yorkers who desperately need access to Medicare. Our report identifies concrete steps for the state to consider, and we look forward to working with the state and other advocates to help more people access the Medicare benefits they are entitled to receive.”

The paper explains how New York State has automated Part A buy-in enrollment for people who receive Supplemental Security Income (SSI), but points out how it could better meet the needs of eligible people who do not have SSI. The report identifies systemic barriers to enrollment, and suggests steps to improve the enrollment process, including screening for Part A buy-in no matter where people apply, improving data-sharing among multiple government computer systems, and thorough training of frontline workers, who sometimes turn away eligible applicants simply because they are not aware of the buy-in benefit.

Finally, the report suggests that other states could benefit from the lessons learned, and the advances made, by New York State, particularly in light of new federal initiatives to coordinate care and health care financing for people with both Medicare and Medicaid. “These delivery system reforms will be undermined,” says the report, “unless low-income older adults who qualify can obtain Medicare and MSPs to help pay their expenses.” The report also calls for states to retool enrollment systems that serve this population as they revamp and streamline systems under health reform.

The report is available at: http://www.medicarerights.org/pdf/Part-A-Buy-In-Analysis.pdf

 

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Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives.

 

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