Medicare Watch

Medicare Rights Center Testifies from the Beneficiary's Point of View

This week, the Medicare Rights Center shared the experiences of the thousands of older adults, people with disabilities, family caregivers and service providers who call our helpline every year in testimony before both the U.S. Senate and the House of Representatives. Medicare Rights was enlisted to speak about proposals to shift costs to people with Medicare as well as first-hand experiences with the Part D prescription drug benefit.

On Tuesday, Medicare Rights Center President Joe Baker testified before the Subcommittee on Health of the U.S. House of Representatives Committee on Ways and Means about proposed policies to increase the Medicare Part B deductible, introduce copayments for home health services, and further income-relate Medicare Part B and Part D premiums. . Mr. Baker testified that the burden of added cost sharing would leave many beneficiaries with no choice but to self-ration needed health care services. . In addition, Mr. Baker illustrated that increasing already higher premiums on so-called wealthy beneficiaries translates to a premium hike on the middle class. Mr. Baker presented several alternatives to sustain Medicare without shifting costs to people with Medicare, including advancing delivery and payment system innovations, restoring Medicare drug rebates, and eliminating wasteful overpayments to Medicare Advantage (MA) plans.

On Wednesday, Margaret Woerner, a volunteer on the Medicare Rights Center helpline, testified before the U.S. Senate Special Committee on Aging. Dr. Woerner shared her personal experience with Part D as a Medicare beneficiary, as well as stories she has heard from Medicare Rights helpline callers during her eight years as a volunteer. Dr. Woerner acknowledged the positive impact that access to prescription drug coverage under the Part D benefit has had for so many people with Medicare. She also discussed opportunities to strengthen Medicare Part D, including improving the Part D appeals process and simplifying Part D plans.

Read Mr. Baker's testimony.

Read Dr. Woerner's testimony.

Seniors May Be Even Poorer Than Assumed

Poverty rates among seniors aged 65 and older are higher under the supplemental poverty measure than under the official poverty measure, according to an issue brief released by the Kaiser Family Foundation (KFF). The share of seniors living in poverty is higher in every state under the supplemental poverty measure, and is at least twice as high in twelve states.

In 2011, the Census Bureau released the supplemental poverty measure in response to growing consensus that the official poverty measure, created in the 1960s, was outdated and insufficient. Using the supplemental poverty measure, KFF found that at least 10 percent of seniors live in poverty in all but one state, whereas under the official measure, poverty rates are below 10 percent in most states.

Policymakers continue to discuss proposals that shift added health care costs to older adults. Under the supplemental poverty measure, which deducts health spending from income, poverty rates among older adults would increase if seniors were made to pay more for their Medicare coverage. The average Medicare household already spends three times more on health care-related costs compared to the average non-Medicare household—15 percent vs. 5 percent as a share of total income.

Read the KFF issue brief

Medicare Reminder

Medicare helps pay for inpatient mental health services in either psychiatric hospitals (hospitals that only treat mental health patients) or in general hospitals. Your doctor will determine which hospital setting you need.

If you receive care in a psychiatric hospital, Medicare helps pay for up to 190 days of inpatient care in your lifetime. After you have reached that limit, Medicare may help pay for mental health care at a general hospital.

Your out-of-pocket costs are the same in a psychiatric hospital as they are in any hospital.

If you enter a psychiatric hospital within 60 days of being an inpatient at a different hospital, you are in the same benefit period and do not have to pay the deductible again. A benefit period begins the day you start getting inpatient care and ends when you've been out of the hospital or skilled nursing facility for 60 days in a row.

Learn more about Medicare's coverage of mental health services at www.medicareinteractive.org.

Spotlight

Last week, the Kaiser Family Foundation (KFF) released a report entitled, Medicare's Role for Older Women. According to the KFF report, more than half (56 percent) of all older Medicare beneficiaries are women—22.4 million women ages 65 and older are enrolled in the Medicare program, and many of them have significant health needs. Women live longer than men with higher rates of multiple chronic conditions, and, as a result, they experience higher cost sharing than men. According to the KFF report, out-of-pocket spending by women ages 85 and older was 30 percent higher than out-of-pocket spending by men. Additionally, older women are also more likely to live alone, and they receive lower Social Security and pension benefits than men.

Medicare is a critical source of retirement security for older women, but policies to shift costs to Medicare beneficiaries threaten that security, making it more difficult for older women to afford health coverage.

Read the KFF report