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Waiting in Pain
April 12, 2007 • Volume 7, Issue 15For the victims of traumatic injury and those suffering from disabling disease, the lack of health coverage is a virtual guarantee of being forced to forgo expensive medical treatment and accumulating medical bills that cannot be paid. For many, it is a death sentence.
Those are the lessons of a new report from the Commonwealth Fund authored by the Medicare Rights Center. The report tracks 21 individuals with disabilities as they wait two years—from the time they receive their first Social Security disability check until they became eligible for Medicare—to obtain reliable, affordable health care coverage.
The U.S. health care system has a lot of holes—there are nearly 47 million uninsured, including over eight million children, according to the last census. But one of the most glaring failures is the gaping hole in coverage for people with severe disabilities. People who are deemed by the Social Security Administration to have a debilitating disability that makes continuing to work impossible wait five months to get their Social Security Disability Insurance (SSDI) benefits but must then wait another two years for their Medicare coverage to begin. This senseless delay, written into law, affects the Americans most in need of continuous, reliable and affordable health care. After all, that is why Congress extended Medicare to people with disabilities in 1972.
The two-year Medicare wait makes even less sense in 2007. The spiraling cost of private insurance means COBRA premiums are out of reach for individuals and families trying to get by on a monthly SSDI check. As a result, those most in need of continuous coverage cannot afford to maintain the employer health insurance they had before a disabling injury or disease put them out of work.
Medicaid does not fill the gap. SSDI income —the insurance Social Security provides to working people hit with a severe disability—often puts individuals above the income thresholds for Medicaid, yet it falls short of making COBRA insurance affordable.
Medicare is the answer, but Medicare coverage must begin once eligibility for SSDI is determined. There are 1.5 million people with disabilities in the waiting period; nearly 600,000 of them will go without insurance at some point during this two-year wait. Our elected representatives need to hear about the human cost of this senseless policy. Tell us the story of your struggle to stay healthy during the two-year waiting period, and tell your representative and senators to end the two-year waiting period for Medicare for people with disabilities.
Medical Record
“Throughout the waiting period Deborah’s joint and muscle pain became more acute. Her primary care physician attributed the pain to lupus and prescribed expensive prescription pain killers. Deborah tried to decrease her costs by taking ibuprofen, but as time passed this became less effective. In her last months in the waiting period, her body ached so much that often she could not stand up straight or walk. Her sleep apnea grew worse, but she could not afford the treatment her doctor recommended. Near the end of the waiting period, Deborah noticed her vision had become blurry, but she could not afford to see an ophthalmologist. ‘I am just waiting for Medicare,’ she said” (“Too Sick to Work, Too Soon for Medicare: The Human Cost of the Two-Year Medicare Waiting Period for Americans with Disabilities,” Medicare Rights Center, April 2007).
“Each year, tens of thousands of Americans like McCutchan find themselves disabled and unable to work. After going through the process to get Social Security disability income, most are shocked to discover that they have to wait two more years to be eligible for Medicare” (“Life in Medicare’s Waiting Period,” USA Today, April 11, 2007).
“The two-year Medicare waiting period affects more than those individuals who are now struggling to survive until their Medicare coverage begins. Every American is at risk of a severely disabling illness or accident. For individuals with progressive illnesses that all but guarantee that they will one day have to file for disability, this built-in gap in coverage is a virtual certainty” (Letter to U.S. Senate Finance Committee, April 11, 2007).
***** The Medicare Rights Center (MRC) needs to hear about all the problems with the Medicare Part D benefit, whether they happen to you or someone in your community. With this information, we will be armed with the needed evidence to push for a Medicare-administered drug benefit.
Fast Relief: Part D Monitoring Project
Submit your story at www.medicarerights.org/partdstories.html
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The Louder Our Voice, the Stronger Our Message 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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