Medicare Watch

Medicare Consumers with Disabilities Have More Difficulty Accessing Care

People under 65 who have Medicare as a result of a disability are more likely to experience difficulties in accessing and paying for care, according to a study conducted by the Kaiser Family Foundation and published in Health Affairs. Fifty percent of Medicare consumers under 65 who participated in the study reported problems paying for health services in 2008, versus 18 percent of participants over 65. Over the same period, 46 percent of participants with Medicare who were under 65 reported delaying or forgoing care because of cost concerns, as opposed to 16 percent of the over-65 Medicare population who participated in the study. Furthermore, about one in four respondents with disabilities said they had no type of supplemental insurance to cover gaps in Medicare benefits.

People with disabilities must receive Social Security Disability Insurance for 24 months before they become eligible for Medicare. One third of study participants with disabilities reported having no insurance coverage for at least part of the 24-month waiting period. However, the Affordable Care Act (ACA) may increase access to health coverage for people in the waiting period. In the short term, the ACA creates state-based high-risk insurance pools for people with pre-existing conditions who have been uninsured for six months or longer. The ACA also expands Medicaid to non-Medicare eligible individuals with incomes up to 133 percent of the poverty level and establishes health exchanges in 2014. The report, however, underscores the importance of evaluating benefit packages offered through the exchanges to ensure they adequately cover services that people with disabilities need.

Read the article, Medicare Doesn’t Work As Well For Younger, Disabled Beneficiaries As It Does For Older Enrollees.

 

Rebate Checks, Round Three

On Tuesday, August 10, the Department of Health and Human Services (HHS) sent the third round of $250 rebate checks to Medicare consumers who have entered the prescription drug coverage gap, also known as the “doughnut hole.” To date, 750,000 people with Medicare have received the one-time rebate check. The rebate is the first step in phasing out the doughnut hole by 2020, which is required by the health reform law. Beginning in 2011, people who enter the doughnut hole will receive a 50 percent discount on brand-name drugs and a 7 percent discount on generic drugs. These discounts will gradually increase over the following 10 years until consumers’ share of costs while they are in the doughnut hole reaches the standard 25 percent for both brand-name and generic drugs.

Read the HHS press release about the most recent round of rebate checks.

Learn more about the $250 rebate checks and what eligible consumers should expect.

Learn more about the coverage gap phaseout.

There are no forms to fill out in order to receive the rebate, and all people with Medicare should be aware of potential fraud. Medicare will mail checks automatically to eligible individuals. Consumers should not give out personal information, such as Social Security and Medicare numbers, to anyone who contacts them about the rebate.

Learn more about Medicare fraud, how to identify fraud, and how to report fraud in your community to Medicare.

Medicare Reminder

If you are under 65 and have a disability, you may qualify for Medicare. To be eligible for Medicare, you must be a U.S. citizen or have your resident visa and have lived in the U.S. for five years in a row. You must also have been receiving Social Security Disability Insurance (SSDI) for more than 24 months.

You will become eligible for Medicare during the month you receive your 25th SSDI check. You do not need to contact anyone. Social Security should automatically mail you your Medicare card three months before you become eligible.

Learn more about Medicare eligibility for people who are under 65.

Learn about health coverage options for people with disabilities at www.HealthCare.gov.

Find answers to your Medicare questions at www.MedicareInteractive.org.

Spotlight

Over the past month, Medicare Rights Center President Joe Baker has been answering questions about Medicare on the New York Times’s Bucks blog. The final installment of this “Ask an Expert” series was posted over the weekend, and all of the installments are now available online.

Read the final installment.

Read the original post, which includes links to each installment.