Key Takeaways
The Medicare Improvements for Patients and Providers Act (MIPPA) permits Social Security to send Extra Help applicant data to state Medicaid agencies to trigger an MSP application.
Many applicants need to provide additional information to the state about household members, assets, and income to complete the MSP application.
It is advantageous to not rely on this data transfer and instead help clients apply for both benefits at once.
The Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 included several provisions to help low-income Medicare beneficiaries access benefits that help make Medicare affordable, specifically the Part D Low Income Subsidy (LIS, or Extra Help), and the Medicare Savings Programs (MSPs). MIPPA legislation included:
- Funding to support benefits counselors to conduct outreach and help low-income Medicare beneficiaries enroll in LIS and MSP.
- A requirement for the Social Security Administration (SSA), which administers Extra Help, to send LIS application data to the state Medicaid office for initiating an MSP application, unless the individual checks a box on the LIS application to opt out of this information sharing.
Benefits counselors who screen low-income Medicare beneficiaries for LIS and MSP thus have two options for helping applicants with these programs:
- Simultaneously completing applications for both programs and submitting them at the same time, or
- Submitting an application for either program, and allowing one to trigger the other, either through leads data (LIS to MSP) or deeming (MSP to LIS).
Whenever possible and appropriate, counselors should submit applications for LIS and MSP simultaneously to help their clients access these benefits sooner, as this fact sheet explains.
