Qualified Medicare Beneficiary Program: Enrollment Trends And Characteristics Of Low-Income Beneficiaries

To address low take-up of Medicare Savings Programs for low-income Medicare beneficiaries, the Centers for Medicare and Medicaid Services issued regulations in 2023 aimed at streamlining the enrollment process. We analyzed 2016-22 data from the Medicare Current Beneficiary Survey to examine recent take-up of the largest and most generous Medicare Savings Program, the Qualified Medicare Beneficiary (QMB) program. We compared beneficiary characteristics and cost-related barriers to care among QMB enrollees and beneficiaries who were eligible but not enrolled. QMB take-up rose from 62 percent in 2016 to 66 percent in 2022. QMB-eligible beneficiaries who were Asian or Hispanic were more likely than eligible White beneficiaries to enroll in the program. Eligible beneficiaries younger than age sixty-five were more likely to enroll than those ages sixty-five and older, and beneficiaries in Medicaid expansion states were more likely to enroll than those in nonexpansion states. QMB enrollees were less likely than Medicare beneficiaries who were eligible but not enrolled to report delaying care because of cost or having problems paying for care. These findings suggest that additional policies and programs may be needed to increase QMB take-up and to improve health care access and affordability for millions of low-income Medicare beneficiaries.

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Publication Details

Journal
Health Affairs
Published
2025-07-01
DOI
https://doi.org/10.1377/hlthaff.2024.01189
Primary Topic
Healthcare Policy and Management
Type
article
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article

Qualified Medicare Beneficiary Program: Enrollment Trends And Characteristics Of Low-Income Beneficiaries

Felippe O. Marcondes, Vicki Fung, Joseph P. Newhouse, David Cheng et al.
Health Affairs
Healthcare Policy and Management
article

Qualified Medicare Beneficiary Program: Enrollment Trends And Characteristics Of Low-Income Beneficiaries

Felippe O. Marcondes, Vicki Fung, Joseph P. Newhouse, David Cheng, John Hsu, Margarita Alegrı́a, J. Wyatt Koma, Zhiyou Yang, Mary Price, Kobi Khong
article en

Abstract

To address low take-up of Medicare Savings Programs for low-income Medicare beneficiaries, the Centers for Medicare and Medicaid Services issued regulations in 2023 aimed at streamlining the enrollment process. We analyzed 2016-22 data from the Medicare Current Beneficiary Survey to examine recent take-up of the largest and most generous Medicare Savings Program, the Qualified Medicare Beneficiary (QMB) program. We compared beneficiary characteristics and cost-related barriers to care among QMB enrollees and beneficiaries who were eligible but not enrolled. QMB take-up rose from 62 percent in 2016 to 66 percent in 2022. QMB-eligible beneficiaries who were Asian or Hispanic were more likely than eligible White beneficiaries to enroll in the program. Eligible beneficiaries younger than age sixty-five were more likely to enroll than those ages sixty-five and older, and beneficiaries in Medicaid expansion states were more likely to enroll than those in nonexpansion states. QMB enrollees were less likely than Medicare beneficiaries who were eligible but not enrolled to report delaying care because of cost or having problems paying for care. These findings suggest that additional policies and programs may be needed to increase QMB take-up and to improve health care access and affordability for millions of low-income Medicare beneficiaries.

Health AffairsVol. 44(7)
Harvard University Press (US), Massachusetts General Hospital (US)
No poverty
Openalex Percentile: Top 77%
Healthcare Policy and Management
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Qualified Medicare Beneficiary Program: Enrollment Trends And Characteristics Of Low-Income Beneficiaries — Felippe O. Marcondes, Vicki Fung, et al. · Health Affairs (2025) | TGRS Research Map | TGRS