Budget cuts and limited resources can leave state offices understaffed, sometimes resulting in delays in processing client applications. Recognizing the negative impact this can have on low-income seniors, the Delaware State Health Insurance Assistance Program (SHIP) created an innovative partnership with the Delaware Medicaid and Medical Assistance (DMMA) office to streamline the application process for Qualified Medicare Beneficiary (QMB), one of the Medicare Savings Programs.

In September 2011, the SHIP signed a Memorandum of Understanding with DMMA that enables the SHIP to follow up with QMB leads and submit complete applications to DMMA for more efficient processing.

How does it work?

Staff members within DMMA have direct access to a SHIP liaison. Referrals are made to a designated, secure mailbox which is checked every hour for new applications. The email subject line reads “QMB Referral.” The email contains information about the client, including their name, address, and telephone number.

The designated SHIP liaison then phones the beneficiary directly. Within two business days, an intake interview takes place to learn more about the client’s personal situation, including their health benefits and finances. The client is then screened for both the Medicare Part D Low-Income Subsidy and the Medicare Savings Program.

If the client qualifies, the SHIP works with the Social Security Administration (SSA) and the client to obtain a copy of their current SSA benefit amount, proof of Medicare, and all current monthly Earned and Unearned Income for themselves and their spouse if applicable. The SHIP then signs the SHIP-stamped application and sends it via state mail to the designated DMMA office by zip code split provided by DMMA on a daily basis. DMMA prefers a fully completed application which includes income verification; however, if after 15 calendar days the application is not fully complete, the SHIP liaison will still send the application to the designated DMMA office. DMMA then sends the SHIP Director a monthly email stating the total number of SHIP applications received and number of approved applications.

What was the result?

In the year since the partnership began, the Delaware SHIP completed 514 applications, and 290 clients began to receive their Medicare Savings Program benefits. The partnership with DMMA represented a significant part of the state’s success in helping low-income Delaware seniors apply for more than $7 million in benefits that make Medicare affordable.