Summary: In 1995, premiums, deductibles, and coinsurance cost single persons at the federal poverty level 10 percent of income, and married couples, 15 percent. State Medicaid programs helped them bear their costs through the congressionally enacted Qualified Medicare Beneficiary (QMB) program, the Specified Low-Income Medicare Beneficiary (SLMB) program, and the Qualifying Individuals program. In 1996, about 43 percent of the potentially eligible Medicare beneficiaries were not enrolled in either QMB or SLMB. Enrollment in these programs is relatively low for Medicare beneficiaries who are white, widowed or married, or have Medicare coverage because of age rather than disability. Many potential recipients do not enroll because they do not know the programs exist, believe they are only for "poor people," fear that the state will try to recover payments made to them from a surviving spouse or children, or are unwilling to accept what they think of as welfare. Moreover, the application process is burdensome and complex, and the states' cost-sharing obligations limit their incentives to notify and enroll eligible individuals. Efforts to increase enrollment include a Social Security Administration demonstration project, state outreach and enrollment efforts through their State Children's Health Insurance Programs, and efforts by the Health Care Financing Administration under the Government Performance and Results Act.
