Understanding LIS and MSP Eligible Beneficiaries

Amanda Simpson - Medicare Director
When can MSP and LIS beneficiaries enroll or change plans?
Beneficiaries who qualify for MSP or LIS can make a change once each quarter during the first 3 quarters of the year. These are the 3 quarters outside of AEP. A change for any given quarter is based on the submission date, and not the effective date for the quarter. So, if a beneficiary submits an enrollment application for a plan change in April with a May 1st effective date, then they would have to wait until July to submit a new enrollment application with an August 1st effective date. During the last quarter of the year, MSP and LIS eligible members can make their normal election choices during Medicare’s AEP from October 15 to December 7th with a January 1st effective date.

Aside from these quarterly changes, this group of eligible members can also add or change a plan if they have any change in their MSP or LIS status. This includes if they lose eligibility, gain eligibility, or if their eligibility level moves up or down the following benefit levels. 
 
Understanding the MSP/LIS demographics Low-income demographics: 
MSP and LIS help low-income beneficiaries reduce their Medicare expenses. This means this is a low-income demographic, so learning the income levels for each program and level will help you determine where and how to market. The maximum income limits to qualify for partial assistance through both LIS and the Medicare Savings Program for listed below. Keep in mind, that full dual (D-SNP) and full LIS beneficiaries have considerably less income resources than stated below. For example, the average income for full D-SNP eligible beneficiaries is only $8,000 to $11,000 per year. 
 
Why is this important? This group of beneficiaries must make ends meet on limited income. This means that any extra benefits, such as extra money per month for the Healthy Food Benefit or the Over-the-counter products, will really help them out and your marketing message can be tailored to address these benefits. It will also affect where you are marketing to reach this customer demographic since they would be more likely to live in low-income housing areas and utilize local food banks.
 
D-SNP & Disabilities: D-SNP eligible consumers are 3x’s more likely to live with a disabling condition and approximately 30% of them live alone

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