Medicare Watch

Celebrating 47 Years of Medicare

Next Monday, on July 30, Medicare celebrates its 47th birthday. Many do not remember a time without Medicare, but one year before it was signed into law, almost half of older Americans did not have health coverage. In 1973, the program was expanded to cover people with disabilities, and now this essential program gives millions of Americans health and financial security.
 
Policymakers in Washington, DC, continue to look to Medicare as a way to reduce the federal government’s budget deficit. Recent proposals to increase the Medicare eligibility age, restructure the benefit and increase cost-sharing would save the federal government money only by shifting costs to beneficiaries and decreasing their access to care. In contrast, Medicare’s promise is to provide access to affordable, high-quality health care for a population that has complex health needs and lives on a fixed income; nearly half of all people with Medicare earn $22,000 or less annually and cannot afford higher health care expenses.
 
Most importantly, proposals that cut Medicare benefits and increase out-of-pocket costs for beneficiaries ignore the underlying problem: growing costs in the health care sector overall. The Affordable Care Act (ACA) seeks to address this problem through delivery system reforms, as well as many other improvements to Medicare. For instance, the ACA closes the prescription drug coverage gap (also known as the doughnut hole), strengthens Medicare’s long-term financing and provides new preventive services to individuals at no cost. In all, the law will save the program money while improving the health care experiences of the Medicare population.
 
In honor of Medicare’s birthday, the Medicare Rights Center has compiled stories from the beneficiaries and caregivers it serves every day into “Medicare Voices: Celebrating 47 Years of Medicare.” Medicare Rights also joined the Congressional Taskforce on Seniors this week to celebrate Medicare’s birthday. At the event, Representative Jan Schakowsky (pictured above) popped “myth” balloons representative of common misinformation about the ACA, and Representative John Dingell, who was present at Medicare’s passage in 1965, spoke to the dire need to protect and strengthen Medicare for today’s beneficiaries and for those of future generations.

Read Medicare Rights’ “Medicare Voices: Celebrating 47 Years of Medicare.”

Medicare Beneficiaries Report Having Better Health Insurance Experiences

Compared to people with employer-sponsored insurance, people with Medicare report fewer problems with medical bills and with accessing care because of costs. These findings were part of a Commonwealth Fund study that was recently published in Health Affairs. According to the article, “Medicare Beneficiaries Less Likely to Experience Cost- and Access-Related Problems than Adults with Private Coverage,” Medicare beneficiaries have lower out-of-pocket health care expenses as a share of income and fewer financial problems because of medical bills compared to people who are privately insured.
Researchers used the Commonwealth Fund 2010 Health Insurance Survey to compare the experiences of Medicare beneficiaries over the age of 65 to younger adults enrolled in private, employer-sponsored insurance. Researchers also compared the experiences of people with traditional fee-for-service Medicare to those with Medicare private health plans, also known as Medicare Advantage plans. Researchers found that while Medicare beneficiaries have more health problems and lower incomes than people with employer insurance, beneficiaries are less likely to pay 10 percent or more of their incomes on out-of-pocket health costs. Researchers attributed this difference to the fact that 83 percent of Medicare beneficiaries surveyed had additional coverage in the form of a retiree plan, a Medigap policy or Medicaid. However, just having insurance comes at a cost: other studies have shown that people with Medicare spend two-thirds of all their health care expenses on premiums. Paying to retain supplemental coverage allows beneficiaries to protect themselves against unexpected, catastrophic medical bills.
 
The study also found that Medicare beneficiaries are more satisfied with their health insurance compared to people with private insurance. According to the study, only eight percent of Medicare beneficiaries rated their insurance as fair or poor, compared to 20 percent of people with employer-sponsored insurance and 33 percent of people who purchased private insurance on the individual market. Researchers also found that Medicare beneficiaries are more likely to have regular access to a doctor or a place of care with knowledge of their health history, and access to a doctor who coordinates their care with other providers.
According to the article, policymakers looking for ways to reduce costs in the Medicare program should acknowledge that Medicare beneficiaries have more positive experiences with their health coverage than do people with private insurance. Recent premium support proposals would convert Medicare into a program under which beneficiaries would receive cash vouchers to purchase private health insurance. These plans could leave beneficiaries at increased risk for problems obtaining needed care and shift more costs to people with Medicare as plan premiums and out-of-pocket expenses rise.

Read the article, “Medicare Beneficiaries Less Likely to Experience Cost- and Access-Related Problems than Adults with Private Coverage.”

Medicare Reminder

If you have been diagnosed with End-Stage Renal Disease (ESRD) and are getting dialysis treatments or have had a kidney transplant, you are eligible for Medicare.

When you get Medicare because of ESRD, there is a period of time when your employer group health plan will pay first and Medicare will pay second. This is called the 30-month coordination period, and it starts when you first qualify for Medicare coverage, even if you haven’t signed up for it yet. At the end of the 30-month coordination period, Medicare will pay first for all Medicare-covered services, and your employer group health plan will pay second.
 
When your condition improves, your Medicare coverage may end. If you no longer need dialysis, your Medicare coverage will end 12 months after the month in which you had your last dialysis treatment. If you had a successful kidney transplant, your Medicare coverage will end 36 months after you had the transplant.

Learn more about Medicare coverage when you have ESRD at www.medicareinteractive.org, or call our helpline at 800-333-4114.

Spotlight

Making Medicare musical. That’s what N. H. Derwyn Holder—bassist, pianist and composer—has done with his new orchestral work, Symphony No. 1, Medicare. Holder composed the piece in four movements to express his gratitude for Medicare, which has provided him with health coverage through a series of medical procedures.

Watch a video of Holder explaining why he composed Symphony No. 1, Medicare.

Read more about Holder and his work