Physical and/or Cognitive Impairment, Out-of-Pocket Spending, and Medicaid Entry among Older Adults

J Urban Health. 2016 Oct;93(5):840-850. doi: 10.1007/s11524-016-0078-1.

Abstract

While Medicare provides health insurance coverage for those over 65 years of age, many still are underinsured, experiencing substantial out-of-pocket costs for covered and non-covered services as a proportion of their income. Using the Health and Retirement Study (HRS), this study found that being underinsured is a significant predictor of entering into Medicaid coverage over a 16-year period. The rate of entering Medicaid was almost twice as high for those who were underinsured and with physical and/or cognitive impairment than those who were not, while supplemental health insurance reduced the rate of entering Medicaid by 30 %. Providing more comprehensive coverage through the traditional Medicare program, including a ceiling on out-of-pocket expenditures or targeted support for those with physical or cognitive impairment, could postpone becoming covered by Medicaid and yield savings in Medicaid.

Keywords: Cognitive impairment; Disability; Health care costs; Medicaid; Medicare.

MeSH terms

  • Aged
  • Cognitive Dysfunction*
  • Delivery of Health Care / economics*
  • Disabled Persons*
  • Eligibility Determination
  • Female
  • Financing, Personal* / statistics & numerical data
  • Humans
  • Insurance Coverage / statistics & numerical data
  • Insurance, Health / statistics & numerical data
  • Male
  • Medicaid / statistics & numerical data*
  • Middle Aged
  • United States