Depending on Medicare More Challenging for
Nonelderly Than Senior Citizens
Half of young disabled reported problems paying for
health care in previous 12 months, versus 18% of elderly population
finds Health Affairs study
Aug. 13, 2010 - A new study released today by
Health Affairs focuses on an often-neglected segment of Medicare
enrollees: people ages 18-64 with permanent disabilities, a group that
currently numbers eight million, or roughly one-sixth of the total
number of Americans in Medicare.
The 2008 survey of a nationally
representative survey of non-institutionalized Medicare beneficiaries
was designed and conducted by researchers at the Kaiser Family
Foundation to assess how well Medicare is working for this group.
National Council on Aging launches educational
campaign after finding even among older adults who considered themselves
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July 27, 2010
The nonelderly disabled beneficiaries were twice as
likely to have five or more chronic medical conditions, more than twice
as likely to have felt sad or depressed during the previous year, and
four times as likely to have experienced severe pain in the previous
four weeks.
"Compared to less than 20 percent of the elderly,
roughly half of nonelderly disabled Medicare beneficiaries reported
problems paying for health care services, and put off or did not get
care because of cost concerns, according to the report authors Juliette
Cubanski and Patricia Neuman.
For both nonelderly and elderly beneficiaries,
cost-related barriers were most frequently cited for dental services,
followed by prescription drugs, over-the-counter medications, and visits
to doctors. ... Moreover, among those who reported delays or not getting
services due to costs, a larger share of nonelderly beneficiaries
reported experiencing negative consequences as a result," such as "the
worsening of existing medical problems, physical pain, and stress or
anxiety."
The article also describes differences between the
beneficiaries in health care use, access to prescription drugs through
Medicare Part D, and experiences with supplemental coverage (Cubanski
and Neuman, 8/12).
Some of the major findings:
Half of the nonelderly beneficiaries reported
problems paying for health care services in the previous twelve months,
versus 18 percent of the elderly population. Similarly, 46 percent of
the nonelderly group reported delaying or not getting health care
services because of cost, compared to 16 percent of senior enrollees.
Nearly one in three Medicare beneficiaries with
disabilities reported that they were uninsured for at least part of the
two-year waiting period before qualifying for Medicare.
Nearly one in four nonelderly disabled
beneficiaries lacked supplemental coverage, about twice the proportion
of the elderly group.
For nonelderly Medicare beneficiaries, Medicaid
is the most likely supplemental coverage option; this group has nearly
four times the rate of Medicaid supplemental coverage of the senior
group.
Nonelderly disabled enrollees in Medicare Part
D drug plans were almost three times as likely to report difficulty in
obtaining a medication because it was not covered by the plan (37
percent versus 13 percent of the elderly) and more than twice as likely
to skip or take smaller doses because of the cost (26 percent versus 12
percent).
This year's health reform is expected to address
some of the problems highlighted by this study.
"One of the less-heralded but important aspects of
the Affordable Care Act is its potential to help people with
disabilities, including those in Medicare's waiting period, by
broadening access to public and private health insurance coverage,
improving Medicare Part D coverage, and introducing reforms designed to
improve the coordination and quality of care," conclude the authors.
"As policy makers focus their attention on reforms
designed to increase insurance coverage and reduce health care costs,
evaluating how well the implementation of the Affordable Care Act
improves coverage and care for people with disabilities will provide an
important test of its impacts."
The authors, Juliette Cubanski and Patricia Neuman,
are affiliated with the Medicare Policy Project at the Kaiser Family
Foundation, in Washington, D.C.; Cubanski is the project's associate
director, and Neuman is its director and a Foundation vice president.
The sample survey of 3,913 beneficiaries used for
this study was drawn from administrative data provided by the Centers
for Medicare and Medicaid Services (CMS) and included 2,288 people ages
18-64 with permanent disabilities and 1,625 respondents age 65 and
older.
Health Affairs, published by Project HOPE, is the
leading journal of health policy. The peer-reviewed journal appears each
month in print, with additional Web First papers published weekly at
http://www.healthaffairs.org/. The full text of each Health Affairs
Web First paper is available free of charge to all Web-site visitors for
a two-week period following posting, after which it switches to
pay-per-view for nonsubscribers. Web First papers are supported in part
by a grant from The Commonwealth Fund.
Keep up with the latest news for senior citizens, baby
boomers
Aug. 13, 2010 - A new study released today by
Health Affairs focuses on an often-neglected segment of Medicare
enrollees: people ages 18-64 with permanent disabilities, a group that
currently numbers eight million, or roughly one-sixth of the total
number of Americans in Medicare. 
