Asclepios
An End to the Wait
May 21, 2009 • Volume 9, Issue 20
The Senate Finance Committee, which is writing legislation designed to extend affordable health care coverage to all Americans, has put forward four options to deal with the two-year delay in Medicare coverage for people with disabilities.
Option One shortens the waiting period to 12 months.
Option Two phases out the waiting period in six-month increments, with total elimination by April 2011.
Option Three has a slower phase-out, ending the waiting period in July 2015.
Option Four maintains the waiting period for people with access to private insurance (not including COBRA coverage from a former employer) and phases it out for everyone else.
The Medicare Rights Center believes that the sooner we completely end the waiting period for all people with disabilities, the better. Option Two achieves that goal.
New research shows that over 20 percent of people in the first year of the waiting period delay care because of the cost, twice the rate for adults who are too young for Medicare. Lack of insurance is the primary, but not the only, reason for forgoing care. Many have insurance that is inadequate to meet their health care needs, which spike around the time they become eligible for SSDI. Some 13 percent never make it through the waiting period, never accessing the Medicare benefit their taxes funded during their working years.
The statistics match the accounts of people who struggle to survive the waiting period. They put off care until Medicare coverage begins; they go into debt to pay for treatment; they file for bankruptcy because of medical bills. Once Medicare coverage begins, the picture changes. Health care becomes accessible and the future brightens for many people with disabilities.
Medicare has provided health security to generations of older adults and people with disabilities. As Congress tackles health reform, it must build on that success, ending the unjustifiable delay in coverage for people with disabilities, improving access to care for low-income people with Medicare and fixing the Part D drug benefit. Please write your representative and senators and remind them to “Remember Medicare” as they work on reforming our health care system.
Medical Record
“While in the waiting period Jo said she ‘was counting down the days until Medicare.’ She still has roughly $3,000 in medical bills accrued during her wait, but hopes to pay them soon. ‘This year is so much better, my spirits are better, and now that I have Medicare I can breathe. It's like a weight off my shoulders,’ she said. Of the 24-month waiting period, Jo concluded, ‘Declared disabled and not given health care—what an oxymoron.’” (Jo Henderson in Too Sick to Work, Too Soon for Medicare: The Human Cost of the Two-Year Medicare Waiting Period for People with Disabilities, Medicare Rights Center, April 2007)
“The findings diminish some of the arguments justifying the Medicare waiting period. They suggest that private insurance crowd-out due to the extension of public coverage would be limited to a minority of beneficiaries: those with inferior private coverage and those for whom COBRA, with its high premiums, was the only coverage option—less than one-third of all beneficiaries in the waiting period.” (Health Insurance and Health Care Access Before and After SSDI Entry, Commonwealth Fund, May 2009)
“The U.S. is the only developed country that does not guarantee health coverage for all its citizens, with 46 million uninsured and another 25 million underinsured. . . . A high-performing health system would guarantee all Americans affordable, quality coverage regardless of age, health status, or medical history.” (Expanding Health Care Coverage: Proposals to Provide Affordable Coverage to All Americans, Senate Finance Committee, May 2009)
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Medicare Part D Appeals Help for Advocates Is Here!
Medicare Rights Center’s new Medicare Part D Appeals: An advocate’s manual to navigating the Medicare private drug plan appeals process offers an easy-to-understand, comprehensive overview of the entire appeals process, including real-life case examples, a glossary of important appeals terms, a sample protocol for advocates, and links to important resources.
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Medicare Part D Monitoring Project
The Medicare Rights Center would like to hear about your experience, or that of someone you know, enrolled in a private drug plan. With information about what the issues are with Medicare Part D, we will be able to demand that those problems be fixed.
Submit your story at http://www.medicarerights.org/issues-actions/tell-your-story.php.
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The Louder Our Voice, the Stronger Our Message
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Asclepios—named for the Greek and Roman god of medicine who, acclaimed for his healing abilities, was at one point the most worshipped god in Greece—is a weekly e-newsletter designed to keep you up-to-date with Medicare program and policy issues, and advance advocacy strategies to address them. Please help build awareness of key Medicare consumer issues by forwarding this action alert to your friends and encouraging them to subscribe today.
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The Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs and public policy initiatives.
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