Participation in Medicare Savings Programs (MSPs) remains incomplete, potentially leaving low-income Medicare beneficiaries exposed to avoidable cost sharing. This study provides updated national estimates of Medicaid participation among individuals eligible for MSPs and identifies factors associated with enrollment.

Using the 2022–24 panels of the Survey of Income and Program Participation, we simulate eligibility for the Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualifying Individual (QI) programs and measure self-reported Medicaid coverage as a proxy for MSP participation. Averaged over December 2021–23, Medicaid participation among MSP-eligible adults was 64.3 percent for QMB eligibles, 62.5 percent for SLMB eligibles, and 55.9 percent for QI eligibles; differences across programs are not statistically significant.

Participation is higher among individuals receiving Supplemental Security Income (SSI) and Supplemental Nutrition Assistance Program (SNAP) benefits and in states with more generous asset rules, and lower among those with greater assets, higher education, private insurance, and who are age 65 or older—patterns consistent with greater participation among individuals with higher financial need. Overall participation appears higher than estimates from a decade earlier, though substantial gaps in participation for those who may benefit remain, suggesting both individual circumstances and state policy design influence take-up.