A new Justice in Aging fact sheet details how they can enroll in the Qualified Medicare Beneficiary (QMB) Program to get their Medicare premiums paid through their state Medicaid program. Enrolling in QMB can be confusing for people without Part A coverage and often requires visits to both the Social Security Administration office and the state’s Medicaid program offices. A further complication is that many Social Security offices have used conflicting and incorrect procedures or provided misinformation to applicants. Read More
Caring.com: How to Access Care for a Senior Who Doesn’t Speak English (Aug. 2, 2018) For older adults who don’t speak English, accessing the health care they need can be difficult. However, seniors have the legal right to interpretation and translation services from health care providers that receive federal dollars through a provision of the Affordable Care Act. The problem is, seniors often do not know they have this right or how to exercise it. Justice in Aging attorney, Denny Chan lays out for this article what rights LEP seniors have, while the adult day care provider, On Lok Lifeways offers an good illustration of what culturally competent care for seniors with limited English can look like. “It’s an anxious time for people who don’t speak English as their primary language because there’s been a number of efforts to chip away at the protections they have,” said Chan.
States require managed care plans who serve Medicaid enrollees to establish and maintain an internal grievance and appeal and fair hearing system. As states begin to incorporate new federal regulations into their Medicaid rules, there’s opportunity for advocates to help shape those rules to ensure that older adults and people with disabilities have equal access to the grievance and appeal and state fair hearing systems, as mandated by Section 504 of the Rehabilitation Act (“Rehab Act”), the Americans with Disabilities Act (“ADA”), and Section 1557 of the Affordable Care Act (“ACA”).
Disability Rights Education and Defense Fund (DREDF), Justice in Aging and National Health Law Program (NHeLP) collaborated on a new Advocates Guide to Accessibility in Medicaid Managed Care Grievances, Appeals, and State Fair Hearing. This new Advocates’ Guide, provides guidance on how the federal framework can be made fully accessible to Medicaid beneficiaries who are older and/or have disabilities.
Links to three accessible versions of the guide can be found below.
Washington, DC 2018 – Justice in Aging, along with a diverse group of partners, released a white paper, An Oral Health Benefit in Medicare Part B: It’s Time to Include Oral Health in Health Care. This white paper is an interprofessional, collaborative effort written and published by leaders in the consumer, healthcare and dental fields, including the American Dental Association, Center for Medicare Advocacy, the Dentaquest Foundation, Families USA, Justice in Aging, Oral Health America and the Santa Fe Group.
With an expected 72.1 million seniors living in the United States by 2030, An Oral Health Benefit in Medicare Part B: It’s Time to Include Oral Health in Health Care, outlines the need for oral health care coverage for Medicare recipients and the importance of it being integrated with, and elevated to, the same importance as the rest of health care in Medicare. Read More
Oral health is an integral part of overall health. Oral health problems can adversely affect one’s ability to maintain optimal nutrition, self-image, social interactions, and mental and physical health. Oral health problems can lead to chronic pain, tooth loss and serious infections. Poor oral health can even worsen chronic medical conditions such as heart disease and diabetes.
Older adults need timely and affordable access to dental care in order to maintain their health and well-being, yet, there is currently no mechanism for most older adults to access care. Contrary to what many believe, Medicare does not include an oral health benefit. Most older adults cannot afford to purchase private oral health insurance or pay out-of-pocket for the care they need. As a result, 70 percent of Medicare recipients have limited or no dental coverage, and fewer than half see a dentist each year.
A new White Paper, An Oral Health Benefits in Medicare Part B: It’s Time to Include Oral Health in Health Care discusses how a Medicare Part B dental benefit would close disparities in dental use and expense between the uninsured and insured and among older adults with few financial resources and limited oral health education. The paper also details how such a benefit could be structured and the legislative changes that would need to happen before such a benefit could be established.
New Advocacy Guide: Oral Health for Older Adults in California
Oral health affects overall health – this is particularly true for older adults. Yet, access to oral health treatment is limited and complicated by factors such as lack of dental coverage, complicated rules, and lack of dental providers. To assist California advocates in connecting their clients with oral health treatment, Justice in Aging has developed an Advocacy Guide for Oral Health for Older Adults in California.
The Guide includes a summary with advocacy tips on the following topics:
- Why oral health matters
- The state of oral health for older adults in California today
- Health insurance coverage options for older adults including Medicare, Denti-Cal, and other forms of coverage
- Unique barriers sub-populations of older adults encounter in accessing oral health including dual eligibles and nursing facility residents
- Treatment alternatives for individuals without dental coverage
- Additional resources
It is our intention that this Guide will help advocates navigate the system and empower them to identify and address systemic barriers to care.
Visit Justice in Aging’s Oral Health page for additional resources and help us celebrate #OralHealthMonth by forwarding this resource to your networks.
The Centers for Medicare & Medicaid Services issued guidance allowing states to condition Medicaid eligibility on fulfilling work and “community engagement” requirements. Under this policy, states can require adults to work in order to receive Medicaid if they are under age 65 and not disabled under the Social Security Administration’s strict definition. Although states are required to exempt some individuals who cannot work based on their health conditions, and encouraged to allow caregiving hours to count as work, all of these individuals will still be subject to onerous reporting requirements. This presents a significant barrier to health care access for many of the nearly 9 million adults ages 50 to 64 who rely on Medicaid, as well as nearly 5 million people with disabilities and chronic health conditions who do not receive Social Security Disability or Supplemental Security Income, and family caregivers. Learn more with our factsheet!
Older adults and their families strive each day to pay for health care and medicine, keep food on the table, have a roof over their heads, and have enough cash on hand to pay the utilities, get where they need to go and meet other basic needs. As families work together to meet these challenges, they are supported by a broad range of federal programs that provide Americans with the means to thrive as they grow older and remain at home and in their communities.
This issue brief discusses how these various programs work, who is eligible for them, and how they support the health and economic well-being of older Americans. For a quick overview, check out the fact sheet.
The Centers for Medicare & Medicaid Services (CMS) published a major revision of federal nursing facility regulations on October 4, 2016, providing new and expanded requirements for nursing facilities that participate in Medicare or Medicaid. This was the first major revision since the regulations were issued more than 25 years before. This article provides a comprehensive guide to the revised regulations, focusing on care planning and person-centered care; admission, transfer, and discharge procedures; grievance procedures; resident rights, choice, safety, and self-determination; staffing, medications, and quality of care; and protections from abuse, neglect, and exploitation. The article also discusses advocacy and enforcement issues raised by the new rules and subsequent CMS rulemaking activities under the administration of President Donald Trump, which are likely to result in modification of the rules. Read the article by Justice in Aging’s Eric Carlson and the National Consumer Voice for Quality Long-Term Care’s Lori Smetanka and Nancy Stone in the Spring 2018 issue of National Academy of Elder Law Attorneys (NAELA) here.Read the article