Key Takeaways

  • States are allowed flexibility in setting eligibility requirements for Medicare Savings Programs.

  • This official memo from the Centers for Medicare & Medicaid Services outlines 10 strategies for streamlining MSP enrollment.

Over 12 million individuals are concurrently enrolled in Medicaid and Medicare. Such dually eligible individuals may either be enrolled first in Medicare by virtue of age or disability and then qualify for Medicaid on the basis of income, or vice versa.

This memo to state Medicaid directors from the Centers for Medicare & Medicaid Services (CMS) explains the various policy options and flexibilities that states have to streamline eligibility for MSPs. These include:

  • Integrating care through dual eligible special needs plans
  • Reducing the administrative burden in accessing Medicare data for use in care coordination
  • Improving the timing of sending files of dually eligible individuals to CMS
  • Improving the Medicare Part A buy-in process