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Affordable Care for People with Disabilities

January 14, 2010 � Volume 10, Issue 2

People call the Medicare Rights Center hotlines with all kinds of health care problems. Their drug plan has denied coverage of an important medicine, for example, or they are confused about how Medicare works with their employer insurance. For these types of calls, our volunteers and caseworkers can help.

Other problems do not have a straightforward solution. Right now, people with disabilities who are stuck waiting for their Medicare coverage to begin have few options. Many receive just a little too much in their disability check to qualify for Medicaid. Others cannot afford the premiums, deductibles and copayments under the COBRA plans they have from a former employer. Those without coverage are denied insurance on the private market because of their pre-existing conditions. People use free drug samples from their doctors or appeal for charity care from their hospitals to get by, or go into debt paying for treatments out of pocket. Even then, many people with disabilities go without care during their two-year wait for Medicare.

If Congress passes health reform, that will change.

When health reform takes effect, people with disabilities will have options that do not exist today. Insurers will no longer be able to deny coverage based on pre-existing conditions and people with low and moderate incomes can receive assistance paying for coverage.

The biggest issue facing congressional leaders now trying to blend the House and Senate bills is how affordable that coverage will be.

More than half of the people with disabilities in the two-year wait for Medicare are over 50, so it is crucial that the final bill incorporate the lower limit on age rating—how much more insurers can charge for coverage based on the age of consumers—that is in the House bill.

The vast majority of people with disabilities also have low incomes—two-thirds earn less than twice the federal poverty level. That makes it essential that lawmakers adopt the House bill’s broader expansion of Medicaid, and the more affordable limits on copayments and premiums for low-income people who receive coverage through plans sold over a new health insurance exchange.

We need to make sure Congress knows how important these affordability provisions are for people with disabilities. The Coalition to End the Two-Year Wait for Medicare wrote congressional leaders this week. We need you to write your senators and representative as well and tell them to make coverage affordable for people with disabilities.

Medical Record

“The burden of the waiting period is greatest for those living in or near poverty: they are the least likely to have health coverage from their former employer or the employer of their spouse and the most likely to be unable to afford the medical care they need. As you work to reconcile the House and Senate legislation, we urge you to make sure that people with disabilities in the waiting period have access to health insurance that provides affordable medical care.” (Letter to Speaker Pelosi and Majority Leader Reid, Coalition to End the Two-Year Wait for Medicare, January 2010)

Learn More About Health Reform and Medicare


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Medicare Part D Appeals Help for Advocates Is Here!

Medicare Rights Center�s new Medicare Part D Appeals: An advocate�s manual to navigating the Medicare private drug plan appeals process offers an easy-to-understand, comprehensive overview of the entire appeals process, including real-life case examples, a glossary of important appeals terms, a sample protocol for advocates, and links to important resources.

Register for a FREE copy of this great resource.

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Medicare Part D Monitoring Project

The Medicare Rights Center would like to hear about your experience, or that of someone you know, enrolled in a private drug plan. With information about what the issues are with Medicare Part D, we will be able to demand that those problems be fixed.

Submit your story at

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The Louder Our Voice, the Stronger Our Message

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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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The Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs and public policy initiatives.

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