Cognition and Take-up of the Medicare Savings Programs.

The Medicare Savings Programs (MSPs) are limited Medicaid benefits that reduce out-of-pocket costs in Medicare Parts A and B for individuals with low income and assets. Despite the substantial financial assistance the MSPs offer, fewer than one-half of eligible individuals are enrolled.

The complexity of the application and reattestation process for the MSPs, which requires individuals to provide detailed documentation of their income and assets at least annually, has been identified as one explanation for the low take-up of these benefits.2 Individuals with cognitive impairments, such as dementia, which 6.5 million elderly Americans experience, may face particular challenges navigating the MSP benefit. Prior research identified poor cognition as a contributor to the low take-up of insurance benefits other than the MSPs.

In this study, we examined the association between cognition and MSP enrollment among elderly Medicare beneficiaries who qualify for these programs. We also examined enrollment in the Low-Income Subsidy (LIS), a separate program that provides premium and cost-sharing assistance in Medicare Part D that Medicare beneficiaries automatically receive if they are enrolled in an MSP.