This useful resource was initially revealed Could 2025 by the Georgetown College Middle for Youngsters and Households.
Most individuals are aware of Medicare as a significant supply of well being protection for seniors. Nevertheless, Medicaid additionally offers essential protection for hundreds of thousands of older adults. Over 7 million seniors age 65 and up, including 4.2 million older adults of coloration, depend on Medicaid to entry long-term care and make Medicare extra reasonably priced. Medicaid additionally offers different important providers not coated by Medicare for hundreds of thousands of low-income seniors and offers major well being protection for almost 1 in 5 Individuals aged 50-64.
Medicaid Improves Entry to Care and Outcomes for Low-Earnings Seniors
Medicaid’s worth to older adults is demonstrable. Solely 7% of individuals age 65 and older who’re dually enrolled in Medicaid and Medicare report having unmet wants, about half the speed of seniors with Medicare alone. Solely 4% of older individuals with each Medicare and Medicaid have incapacity to pay well being care payments, in comparison with 8% of seniors with Medicare alone. Medicaid additionally improves well being outcomes for individuals on Medicare.
Analysis reveals that older adults who had been enrolled in Medicaid previous to turning into eligible for Medicare and had been in a position to maintain their Medicaid protection have fewer power situations and limitations on actions of each day dwelling, and decrease charges of despair in older age in comparison with individuals who lose Medicaid at age 65. Most significantly, continued Medicaid protection considerably reduces mortality at age 75 for low-income older adults.
Medicaid Makes Medicare Extra Inexpensive
Medicare is the federal medical insurance program for individuals 65 and older, receiving Social Safety incapacity advantages, or who’ve sure power situations like end-stage renal illness. In contrast to Medicaid, Medicare has no earnings limits.
Nevertheless, Medicare shouldn’t be free. Folks with Medicare are accountable for month-to-month premiums and cost-sharing. Medicaid helps over 10 million Medicare enrollees with restricted earnings pay for some or all of those prices.
The Medicare Financial savings Packages (MSP) are Medicaid packages that pay Medicare Half A and/or B premiums, and out-of-pocket prices. Some MSP enrollees are additionally protected towards improper steadiness billing the place suppliers attempt to cost the person for some Medicare bills. As a result of the MSP earnings and asset limits are greater than most states’ full-benefit Medicaid eligibility limits, some Medicare enrollees are solely eligible for an MSP and never eligible for full Medicaid well being protection.
Medicaid Covers Important Companies Not Lined by Medicare, Together with Lengthy-Time period Care
Though Medicare offers protection for acute care like hospitalizations and medical appointments, there are nonetheless many gaps in this system. For low-income older adults enrolled in full-benefit Medicaid, their Medicaid protection can fill in these gaps left by Medicare for providers like dental, imaginative and prescient, listening to, non-emergency medical transportation (NEMT) and long-term care.
For instance, long-term care is restricted below Medicare, solely offering a most of 100 days of expert nursing facility protection. Medicare’s home-based protection for help with Actions of Each day Residing (ADL) like consuming, mobility, and bathing can be troublesome to entry and doesn’t present the total array of providers many older adults want to stay dwelling at dwelling.
Medicaid, alternatively, affords long-term protection for nursing dwelling residents and older adults who need assistance with ADLs dwelling in the neighborhood past what is on the market in Medicare. Because of this, Medicaid is the first payor for all long-term providers and helps in america, together with over 60% of nursing dwelling residents and 70% of home-based care.
Medicaid Allows Older Adults to Age in Place
Tens of millions of older adults depend on Medicaid to entry Residence and Group- Based mostly Companies (HCBS) like expert remedy, private care, and respite. Each state and DC supply HCBS regardless of it being an non-obligatory program, as a substitute for institutional care. Some states additionally use HCBS waivers to pay household caregivers for his or her caregiving providers, which offers essential monetary assist for households.
Medicaid Helps Older Adults Who Are Not But Eligible for Medicare
Medicaid can also be essential for older adults below age 65 who aren’t but eligible for Medicare and infrequently lack entry to different reasonably priced insurance coverage. Of adults aged 50-64, half who depend on Medicaid have a incapacity and eight in 10 who’re unable to work have two or extra power situations.
Many adults over the age of fifty depend on the Medicaid growth particularly, together with people with disabilities who don’t meet the restrictive Social Safety incapacity standards or who’re ready for his or her SSI eligibility to be authorized.
Analysis reveals that getting older adults age 50-64 who’ve protection by means of Medicaid growth, have fewer out-of-pocket healthcare bills, use the hospital much less and have improved well being outcomes. It’s no shock that Medicaid growth below the ACA saved the lives of at the very least 19,200 adults aged 55 to 64 over the four-year interval from 2014 to 2017.
Medicaid, together with the Medicaid growth, is a vital lifeline for older adults, together with their households and caregivers. Low-income older adults want each Medicaid and Medicare to entry well being and long-term care.
With out Medicaid, well being care could be unaffordable for hundreds of thousands of low-income older adults and long-term care would even be inaccessible for hundreds of thousands of people, together with seniors. Because the inhabitants continues to age, it’s crucial that Medicaid funding and assist is restored and strengthened to satisfy the wants of older Individuals and their households.
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