State Profiles Highlight Variations in How Many Low-Income Medicare Beneficiaries Get Additional Help with Their Medicare Costs

Medicare beneficiaries with low incomes and modest assets can qualify for additional financial help with Medicare premiums and cost sharing through both the Medicare Savings Programs and Medicare’s Part D Low-Income Subsidy for prescription drug coverage.

A new analysis and collection of interactive profiles highlight variations across states in the number and characteristics of beneficiaries who receive this additional financial assistance, including race and ethnicity, gender, and age. These findings reflect differences between states such as varying poverty rates among Medicare beneficiaries and higher asset thresholds for the Medicare Savings Program in some states.

Each profile highlights state-level eligibility requirements for the Medicare Savings Programs, which are administered by state Medicaid programs that can choose to adopt more generous income and asset requirements. Eligibility for the Part D Low-Income Subsidy program does not vary by state because it is run by the federal Medicare program.

Key takeaways include:

• More than 10 million Medicare beneficiaries (16% of beneficiaries) were enrolled in the Medicare Savings Programs. The share of Medicare beneficiaries enrolled in the Medicare Savings Programs varies from a low of 7% in North Dakota to a high of 33% in the District of Columbia.
• Among the nine states and the District of Columbia that have the highest share of Medicare beneficiaries enrolled in the Medicare Savings Programs, eight either do not have an asset test to qualify or have a higher asset limit than the federal guidelines.
• About 14.1 million Medicare beneficiaries were enrolled in the Part D Low-Income Subsidy in 2019, including 1.6 million who didn’t receive full Medicaid benefits and weren’t enrolled in the Medicare Savings Programs. About 1.1 million met the eligibility requirements for the Medicare Savings Programs, but were not enrolled, due in part to the administrative enrollment policies that vary from state to state.
• Compared to Medicare beneficiaries overall, the Medicare Savings Programs and Part D Low-Income Subsidy disproportionately serve beneficiaries in communities of color, beneficiaries under 65 with disabilities, and women, who tend to have lower incomes and modest savings.