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Estimates of Potential Eligibility for Low-Income Subsidies Under Medicare Part D

Cover: Estimates of Potential Eligibility for Low-Income Subsidies Under Medicare Part D

By: Erik Meijer, Lynn A. Karoly, Pierre-Carl Michaud

The 2003 Medicare Prescription Drug Improvement and Modernization Act (Pub. L. No. 108-173) added a new prescription drug benefit to the Medicare program known as Part D (prescription drug coverage), as well as the Low-Income Subsidy (LIS) program to provide “extra help” with premiums, deductibles, and copayments for Medicare Part D beneficiaries with low income and limited assets. This analysis was designed to provide an independent estimate of the LIS-eligible population as of 2006, to examine the robustness of the estimate against alternative assumptions and estimation methods, to examine the characteristics of the LIS-eligible population, and to project the size of the LIS-eligible population to 2008. An estimated 12 million persons, or 29 percent of Medicare beneficiaries, were potentially eligible for the LIS in 2006 and most were eligible for the full subsidy. The eligibility rate is higher for the under-age-65 population and for those in nursing homes. There is considerable uncertainty around the estimated number of LIS eligibles, however, due to differences in the two main data sources employed, the Survey of Income and Program Participation and the Health and Retirement Study.

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Contents

Chapter One:
Introduction

Chapter Two:
Methodology

Chapter Three:
Estimates of Medicare Part D LIS Eligibility

Chapter Four:
Conclusions

Appendix A:
Analysis of Attrition, Nonresponse, and Selective Matching

Appendix B:
Medicaid/Medicare Savings Model

Appendix C:
Eligibility Regulations

Appendix D:
Methods for Eligibility Determination

Appendix E:
Comparison of Countable Income and Resource Distributions in the SIPP and the HRS

Appendix F:
LIS Eligibility Status by Population Group

The research described in this report was sponsored by the Social Security Administration and was conducted by RAND Labor and Population, a division of the RAND Corporation.

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