Changes to a state program that helps Medicare recipients pay for their health insurance, proposed as a way to save money in the state budget, are now getting attention from elderly and disabled Connecticut residents, senior advocates and state legislators who say the Jan. 1 changes could be "life or death."

The two-year state budget, signed Oct. 31 after a 123-day delay caused by an impasse between legislators, included a provision that changed the requirements for people receiving benefits from the Medicare Savings Program — a state-issued subsidy to help low-income seniors and disabled people pay for their health insurance.

The change could mean that starting Jan. 1, at least 86,000 people could become totally ineligible for benefits from the program, and an additional group of about 27,000 people could lose part of their coverage, according to a spokesman for the state Department of Social Services.

The department issued letters this month informing people who could lose the program's help paying for their health insurance, promising more specific information by Dec. 15.

Cynthia Suntup, 86, received the letter at her New London home Monday. Her only income is from Social Security, she said, and the Jan. 1 changes could mean she won't be able to afford medical care. She can't afford to buy supplemental insurance from a private company, she said.

The letter also left her uncertain whether she would get help paying the premiums for her upcoming cataract surgery.

"I don't know who's going to be covering this," she said.

The program delivers money through Medicaid — a joint federal-state health plan for the poor — to low-income and disabled Medicare recipients in the form of a subsidy included in their monthly Social Security checks.

The income eligibility for the program varies from state to state, and Connecticut has a relatively high bar for income requirements; it's one of five states with an income eligibility level greater than the federal minimum.

But advocates for elderly and disabled residents of the state say people with the lowest incomes depend on the program to pay for their medical care, and the change could mean they will not be able to afford doctor visits or medicine next year.

"We have seniors who are just barely making it," said Kathleen Doherty-Peck, director of Montville's Senior and Social Services departments. "This cut does not work here."

The DSS letter's suggestion that people buy supplemental insurance to cover the medical changes is unrealistic, Doherty-Peck said.

"These people are not going to be able to afford a supplemental plan," she said.

Since Medicare recipients started receiving letters this week telling them the Medicare premiums could start coming out of their Social Security checks, Doherty-Peck said, they have been calling the town's Senior Services department asking for answers.

"They're saying 'What's going on?' and 'Can you explain this?'" Doherty-Peck said. "It's so hard for someone in my position to tell them, 'You're losing this amount of money, you now have to pay this amount of money.'"

Connecticut Medicare recipients with a monthly income of $2,120 or less are eligible for the state's help paying for premiums for Medicare Part A — which covers inpatient hospital, skilled nursing facility and long-term hospital care — and premiums for Medicare Part B — which covers doctor visits, outpatient hospital care and lab tests — as well as Medicare deductibles and co-insurance.

Medicare recipients with an income of $2,321 or less a month are only eligible for the state's help paying for premiums for Medicare Part B.

The change cuts those income requirements essentially in half, eliminating those people with income levels above the new maximums from the Medicare Savings Program's benefits.

Those who lose the help from the program still will get help paying for their prescriptions through another program — called the Low-Income Subsidy, or "Extra Help" — until the end of 2018.

State legislature leaders held a news conference in Hartford on Tuesday, saying they recognized the problems that the changes would pose for low-income Medicare recipients.

State Rep. Kathleen McCarty, R-Waterford, said she was not aware of the change to the Medicare Savings program when she voted for the last version of the budget in October. But she said state Rep. Jay Case, R-Winchester, the ranking member on the state House Human Services Committee, told her Wednesday that the committee soon would be considering possible amendments to the eligibility requirements.

The provision cutting income eligibility for the program was part of Gov. Dannel P. Malloy's original budget proposal and was altered but not taken out by the legislature during the monthslong budget negotiation process, according to a spokesman for Malloy's budget office.

The change was anticipated to save the state $20.4 million in fiscal year 2018, and $61.5 million in fiscal year 2019.

Doherty-Peck, who also is the president of the Connecticut Association of Municipal Agents for the Elderly, said that group is organizing a campaign asking senior citizens to mail their prescription bags stamped with labels protesting the change to Malloy's office and to the offices of state legislators.

That tactic has worked in the past when the association wanted to protest similar cuts to aid for seniors, Doherty-Peck said, and she hopes it will work again.

"The message is just trying to get their attention," she said. "This cut is drastic and it really does affect somebody's life."

m.shanahan@theday.com