Dear Avisery Members, 

Do you work with Medicare beneficiaries who were approved for a Medicare Savings Program (MSP), but continue to have the monthly Part B premium of $164.90 deducted from their Social Security benefit every month? Or with beneficiaries who receive Medicaid and Medicare, but still pay the Part B premium because they were never screened for MSP?

If so, Avisery by AgeOptions has an important update regarding our MSP Referral Pathway with Legal Aid Chicago, Land of Lincoln Legal Aid, and Prairie State Legal Services. For cases where approved MSP benefits are not being processed, we are now accepting referrals when 60 days or more have passed since the notification of MSP approval (previously, we required a 5-month delay to refer cases on to legal assistance).

Background

Medicare Savings Programs (MSP) help eligible beneficiaries pay for their Medicare deductibles, co-pays, and /or premiums, saving them at least $1,970 a year. However, we know that sometimes beneficiaries applying for MSP experience issues with either the application or accessing the MSP benefit even after it has been approved.

The Avisery MSP Referral Pathway is dedicated to assisting older adults and people with disabilities in Illinois navigate issues related to MSP applications and benefits. The MSP Referral Pathway has helped a number of clients with issues including helping stop Part B premium deductions once eligible for MSP and securing Part B premium reimbursements ranging from $755 to $7,006.

To assist professionals with identifying these MSP issues, Avisery has created a MSP resource sheet that includes information about: 1) how MSPs work; 2) what the MSP income and asset limits are for 2023; and 3) how to submit a referral to the MSP Referral Pathway. The MSP issues that Avisery is currently screening for potential referral to our legal assistance partners across the state include:

• MSP applications that take 60 days or longer to process once all necessary information has been submitted to Medicaid;
• Beneficiaries who were approved for MSP, but continue to have the Medicare Part B premium deducted from their Social Security benefit 60 days after receiving a Department of Human Services (DHS) approval notice (had been a 5-months delay prior to February 2023);
• Individuals who become a dual-eligible (receive both Medicare and Medicaid) and are not screened for MSP automatically by DHS and continue to have the Part B premium deducted from their Social Security benefit;
• Beneficiaries who applied for the Extra Help Program through Social Security, but never received information about or screening for MSP from DHS; and
• Very low-income beneficiaries who are required to pay a premium to enroll in Part A and who need assistance coordinating their Part A enrollment with their application for QMB so as to avoid being charged the Part A premium (via the Part A “Conditional Enrollment” process).

Read on to learn about one of our success stories!

• Michael* was approved for MSP but continued to have the Part B premium deducted from his Social Security check five months later. He was referred to the Legal Referral Pathway by a professional assisting him at a local organization when he told them he was having a difficult time affording his rent and Medicare premiums. After being referred to and assisted by one of the partnering legal organizations, the Part B premiums stopped being deducted from his check and Michael received a reimbursement of $755 from the State. (*Client name has been changed to maintain confidentiality.)

We need your help in identifying clients who may benefit from the Avisery MSP Referral Pathway. To learn more about how Medicare Savings Program work and how to submit a client referral, please check out our Avisery MSP and Referral Pathway Resource Sheet here.

If you have any questions, please feel free to contact Avisery at avisery@ageoptions.org.