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Section 118 – Model Application Translation

Section 118 of MIPPA amended section 1905(p)(5)(A) of Act to require CMS to translate the MSP model enrollment form into at least the 10 languages, other than English, that are most often spoken by those applying for Medicare. The new model application is available in Arabic, Chinese, Creole, Farsi, French, Korean, Russian, Spanish, Tagalog, and Vietnamese and can be found at: http://www.cms.hhs.gov/DualEligible/03_ModelApplicationforMedicareSavings Programs.asp#TopOfPage.

Opportunities for Alignment with Other Programs

Many low-income Medicare beneficiaries will qualify for a number of additional programs, such as full Medicaid benefits, Supplemental Nutrition Assistance Program (SNAP), Low-Income Home Energy Assistance Program (LIHEAP), and others that can help them make ends meet and improve their overall health. We urge States to consider strategies for improving and streamlining opportunities for eligible seniors to enroll in these other benefits in coordination with the Medicaid eligibility process.

Defining Family Size

The income standards for both MSP and LIS are expressed as various percentages of the Federal poverty level (FPL) “applicable to a family of the size involved.” States have the option of defining what “family of the size involved” means for their MSPs, although most States follow the approach of the Supplemental Security Income (SSI) program under which either the standard for an individual or the standard for a couple is used.

For the purposes of making LIS determinations, SSA defines a “family of the size involved” as the individual and the individual’s spouse, whether or not the spouse is applying for LIS, and includes any relatives of the individual and/or the spouse who are living in the same household and who are dependent on the individual and/or spouse for at least one-half of their support.

The LIS definition of a “family of the size involved” is more expansive than the SSI-based approach most States use when determining eligibility for MSPs. Because States have the option of defining “family of the size involved” differently for MSPs, a State could elect to use SSA’s LIS definition of that term when determining eligibility for MSP. This would not only allow more individuals to be eligible as MSPs, it would reduce the administrative burden for States when making MSP determinations based on the LIS application information SSA will be transmitting to States under section 113 of MIPPA. We encourage States to seriously consider making this change for their MSP groups.