Medicare and MIPPA: What You Need to Know
- MIPPA helps organizations provide outreach and education to low-income Medicare enrollees. Learn more about Medicare, MIPPA and resources for beneficiaries.
For seniors with limited income and assets, the cost of Medicare may be prohibitively high. The Medicare Improvements for Patients and Providers Act of 2008, which is commonly referred to as MIPPA, was implemented to help states and tribes provide assistance to Medicare beneficiaries who may need help paying premiums and deductibles. Keep reading to learn more about Medicare, MIPPA and the resources available to beneficiaries struggling to pay for health care.
Medicare and MIPPA: An Overview
The Medicare Improvements for Patients and Providers Act (MIPPA) was implemented in 2008 to provide funding to organizations that help Medicare beneficiaries who have trouble paying for their health care. Funding is delivered through federal grants, which are administered by the Administration for Community Living. Grants are allocated to all 50 states, plus the District of Columbia, Puerto Rico and Guam, and funding may be used for outreach, education and benefits enrollment assistance. MIPPA places a special focus on Medicare beneficiaries who live in rural areas, speak English as a second language or who are under 65.
Organizations That Receive MIPPA Grants
Several organizations receive targeted funding through MIPPA:
- Area Agencies on Aging (AAA): These nonprofit organizations aim to address the needs of older Americans, offering resources, counseling and other services that can help seniors remain independent.
- Aging and Disability Resource Centers (ADRC): ADRCs address the needs of seniors and people with disabilities, offering information, counseling and assistance. These organizations often direct eligible individuals to public and private benefit programs that can address their specific needs.
- State Health Insurance Assistance Programs (SHIP): SHIP was created to educate and assist Medicare-eligible individuals and their caregivers so they can make informed decisions about health care and benefits. These state programs offer outreach, counseling and training.
- National Center on Benefits Outreach and Enrollment (NCBOE): The NCBOE was established through the Administration for Community Living to coordinate the outreach and education of individuals who may need financial support and to enroll these individuals in relevant programs. The NCBOE also supports ADRC and other community programs that serve as benefits enrollment centers.
These organizations may use MIPPA funding to educate and enroll low-income Medicare beneficiaries in programs that can make Medicare more affordable. Because MIPPA aims to reach Native American Elders who qualify for Medicare, federally recognized tribes may receive small grants through MIPPA to fund community outreach.
Medicare Assistance Programs
In most states, help is available for beneficiaries having trouble paying for Medicare. MIPPA grants provide the funding so AAA, ADRC and SHIP can help eligible Medicare beneficiaries apply for two types of available assistance programs, depending on which one suits their individual needs.
The Low-Income Subsidy (LIS) Program
Jointly funded by the Social Security Administration and the Centers for Medicare & Medicaid Services, LIS helps low-income Medicare beneficiaries cover their Part D premium. This program, which is sometimes referred to as Part D Extra Help, may also reduce the cost of prescription medications at the time of purchase.
Medicare Savings Programs (MSPs)
Designed for beneficiaries who have limited financial resources, MSPs offer four categories of benefits:
- Qualifying Individual (QI) Program
- Qualified Medicare Beneficiary (QMB) Program
- Qualified Disabled and Working Individuals (QDWI) Program
- Specified Low-Income Medicare Beneficiary (SLMB) Program
Each program provides a different level of benefits, which may include helping qualified individuals pay for Medicare-related expenses such Part B premiums, Part A and B copayments, coinsurance and deductibles. Eligibility for these benefits, which are administered by state Medicaid programs, is typically contingent upon income, and some levels may be approved on a first come, first served basis. All applicants must reside in the United States.
Enrollment in an MSP may also grant a Medicare beneficiary automatic eligibility for Part D Extra Help, which helps enrollees pay for prescription medications.
Medicare Preventative Services
If you’re enrolled in Medicare, MIPPA grantee organizations can also help you learn valuable information about promoting wellness through Medicare’s available preventative benefits, which may include:
- A “Welcome to Medicare” preventive visit
- Yearly wellness appointments
- Exams and screenings (including heart and cancer screenings)
- Flu shots
Additional Resources and Assistance
If you get health care coverage through Medicare, MIPPA grantees can connect you with additional resources to ease financial burdens. Depending on your specific circumstances, available programs may include:
- Medicaid: Medicare beneficiaries who meet certain requirements may be eligible for medical coverage through Medicare and Medicaid simultaneously, eliminating costs for health care altogether.
- Supplemental Security Income (SSI): SSI is a federal program that helps low-income aged, blind and disabled people pay for basic needs such as food, clothing and shelter.
- Low-Income Home Energy Assistance Program (LIHEAP): LIHEAP helps low-income families manage costs associated with heating and cooling their homes. The program may supply funding for weatherization and minor repairs of energy-related systems.
- State Pharmaceutical Assistance Program (SPAP): Some states offer pharmaceutical assistance programs that help residents cover the cost of prescription drugs. These programs, which sometimes work alongside Medicare Part D, may be aimed at seniors, Medicare beneficiaries or individuals with specific illnesses such as HIV or end-stage renal disease.
- Supplemental Nutrition Assistance Program (SNAP): This USDA-administered program, which is often referred to as food stamps, helps needy families purchase healthy food.
Current MIPPA Funding
After the passing of a legislative package in 2020, MIPPA funding was extended through 2024. Annual funding for the program increased to $50 million, so AAA, SHIP and NCBOE each currently receive $15 million in grants each year, and $5 million is issued to ADRC.