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.
On February 9, Congress passed the Bipartisan Budget Act of 2018 (BBA of 2018). In addition to its budget provisions, the BBA extends and makes changes to several Medicare programs and provides funding for other health programs that support low-income older adults, people with disabilities, and their families.
Justice in Aging has prepared a summary of some of the major health provisions in the BBA of 2018, including funding for Community Health Centers and outreach to low-income Medicare beneficiaries, the Medicare therapy cap repeal, Part D “donut hole” closure, and authorization of Special Needs Plans and other Medicare Advantage changes. As these changes are implemented, Justice in Aging will continue to provide updates and analysis and identify advocacy opportunities.
On October 2, 2017, the Centers for Medicare and Medicaid Services (CMS) initiated changes in the Provider Remittance Advice and the Medicare Summary Notice (MSN) to show more clearly that Qualified Medicare Beneficiaries (QMBs) may not be charged for Medicare deductibles and co-insurance. Unfortunately, CMS will be temporarily suspending these system changes as of December 8 because of significant unforeseen issues affecting provider payments. CMS is working to address the problem and reinstate the new systems sometime in 2018.
The temporary suspension of the system improvements does not affect the rights of QMBs. QMBs do not owe deductibles and co-insurance for any Medicare Part A or Part B services.
The suspension also does not affect another change, instituted in November, that enables providers to confirm QMB eligibility before serving individuals, using the same systems through which they check other insurance coverage.
To learn more about these developments, read our fact sheet.
For more information on QMB protections, see the CMS QMB Program webpage. For tools that advocates can use to assist QMB clients who have been improperly billed, go to Justice in Aging’s Improper Billing page.
Republican leadership in both the Senate and House are pushing forward on tax proposals that would give a huge tax break to the wealthiest Americans and corporations and allow Congress to pay for it by cutting funding for critical programs needed by everyone else.
The Senate is expected to vote this week on its version of the plan.
Both Senate and House bills would explode the deficit and make it harder for older adults to afford health care—all while benefitting the wealthiest 1% and big corporations. We created a new fact sheet, Republican Tax Bills Will Hurt Older Adults, for advocates to use this week in their advocacy. The fact sheet outlines how exploding the deficit will force cuts to programs and health coverage for older adults, and how the wealthy 1% and corporations will benefit at the expense of older adults. Please use this fact sheet in your conversations with partners and policy makers and share widely.
Now is also the time to call your Senators and tell them to vote NO on this tax plan. Dial 202-224-3121 and ask to be connected.
Today, Justice in Aging and Center for American Progress are holding a joint briefing on what the tax bills mean for seniors. There’s also a National Call-in Day on Wednesday focused on people with disabilities and their families.
Congress is moving very quickly, aiming to have a bill signed into law by the end of the year. Advocates’ voices are needed to stop this reckless process that jeopardizes health care for millions. Our new fact sheet outlines the threats to health care for older adults and their families in both the House and Senate bills.
Leadership in the House of Representatives is moving forward with its version of a tax bill that calls for enormous tax cuts for the wealthiest Americans and will drive up the deficit to the tune of $1.5 trillion.
Such a deficit will necessarily lead to cuts in programs that low-income older adults need, including Medicaid and Medicare. Justice in Aging created a short Fact Sheet: 4 Ways the Tax Cuts & Jobs Act Threatens Health Care for Older Adults to outline for advocates what’s at stake for older adults with Medicare and Medicaid and how the loss of the medical expense deduction could jeopardize the financial security of older Americans with high out-of-pocket health care costs or long-term care expenses.
Here’s what older adults need to know about this year’s Open Enrollment periods for both Medicare and Covered California.
Fall is open enrollment time for both Medicare beneficiaries and enrollees in Covered California purchasing coverage in 2018.
Justice in Aging’s California open enrollment fact sheet reveals who is impacted by fall open enrollment, covers critical dates for each group, and provides key information on actions to take to ensure continuous coverage.
- Medicare Part C and Part D enrollees should review their coverage options each year as Medicare Advantage and Prescription Drug plans can change their cost-sharing, provider networks, and drug formularies.
- Medicare’s open enrollment period is from October 15-December 7, 2017.
- Covered California open enrollment is from November 1-January 31, 2018.
- Open enrollment periods have been extended for victims of natural disasters like the California wildfires.
Here’s what older adults need to know about this year’s Open Enrollment periods for both Medicare and the Affordable Care Act Health Insurance Marketplaces.
Fall is open enrollment time for both Medicare beneficiaries and enrollees in the Affordable Care Act Health Insurance Marketplaces for coverage in 2018.
Justice in Aging’s open enrollment fact sheet reveals who is impacted by fall open enrollment, covers critical dates for each group, and provides key information on actions to take to ensure continuous coverage.
- Part C and Part D enrollees should review their coverage options each year as Medicare Advantage and Prescription Drug plans can change their cost-sharing, provider networks and drug formularies.
- Medicare’s open enrollment period is from October 15-December 7, 2017.
- The Marketplace enrollment period has been cut in half from 12 weeks to 6 weeks.
- The Marketplace enrollment period is from November 1-December 15, 2017.
- Open enrollment periods have been extended for victims of some natural disasters.
Two new fact sheets explain two facets of the In-Home Supportive Services (IHSS) program—Eligibility and the Application Process, and IHSS Services: Basics. These fact sheets provide a simplified starting place to understand how the eligibility and application process work, what services are available, and how the county determines eligibility for specific services.