by Ann Vining, NoHLA Senior Attorney
Medicare is health coverage, but having it does not mean a person can afford the care they need. Medicare is expensive. And it's hard to get help with those costs.
But, in case you missed it, there's some good news. Washington finally has a way to improve access to Medicare Savings Programs (MSP), which can help!
Background: What is Medicare?
Medicare is a health insurance program run by the U.S. federal government. It serves people who are age 65 and older, and people under 65 who have certain disabilities or health conditions. The program offers coverage in four "parts": A - Hospital insurance, B - Medical insurance, C - Medicare Advantage insurance plans, and D - Prescription drugs.
Did you know?
You might be thinking, "What about support from Apple Health (Medicaid)?" The truth is that the income and resource limits to get Medicaid for people eligible for Medicare are far less generous than the standards used for people who get Medicaid under Affordable Care Act Expansion programs.
Find additional resources under "Learn More" below.
Medicare Savings Programs
Many Medicare-eligible people with low incomes could be eligible for assistance with their medical costs through Medicare Savings Programs (MSPs).
Yet a large percentage of people who would be eligible for MSPs don't know about them -- so they never apply.
Advocates have raised this issue and called for solutions to address MSP underenrollment for many years.
Connecting More People with Savings
In 2010, the federal government passed a law to address underenrollment in MSPs. It provides for states to automatically process an MSP application whenever a person has applied for and received Low-Income Subsidy (LIS) support (also known as “Extra Help). LIS is a separate federal program that helps Medicare beneficiaries pay prescription drug costs.
Federal regulations to implement this law were not adopted until 2023, and states got some time to comply. Advocates, including NoHLA, have urged the state to implement the provisions as soon as feasible. But progress was slowed by technological hurdles and HR 1.
Kudos to the Health Care Authority
The good news is that HCA was able to ready Washington for implementation. This new, simplified process went into effect in January 2026.
Now, HCA uses LIS data to automatically initiate and process MSP applications for LIS recipients. The information is checked through the state’s Automated Client Eligibility System (ACES), and usually no additional verification is needed.
Many older adults and people with disabilities struggle with Medicare, lower incomes, and care they need but can’t afford. By connecting more people with Medicare Savings Program benefits, this change will improve lives.
Learn More
- Medicare Savings Program Info for Washingtonians
- Final Rule to Streamline Enrollment in Medicare Savings Programs (a Justice in Aging Issue Brief)
- What's Extra Help?