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ISSUE BRIEF

White Paper: An Oral Health Benefit in Medicare Part B: It’s Time to Include Oral Health in Health Care

By | Health Equity, ISSUE BRIEF, Medicare, Oral Health | No Comments

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.

Oral Health for Older Adults in California: Advocacy Guide

By | Advocate's Guide, Health Care, ISSUE BRIEF, Oral Health | No Comments

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.

Supporting Older Americans’ Basic Needs: Health Care, Income, Housing and Food

By | FACT SHEET, Health Care, Health Care Defense, ISSUE BRIEF, Medicaid, Medicare, SENIOR POVERTY, Social Security, Supplemental Security Income | No Comments

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.

SSI 101: A Guide for Advocates

By | Advocate's Guide, Economic Security, ISSUE BRIEF, Supplemental Security Income | No Comments

Supplemental Security Income (SSI)—a need-based program administered by the Social Security Administration – provides a very basic income to over 8.2 million people, including 2.2 million seniors age 65+. As more seniors struggle to make ends meet in today’s economy, getting access to SSI can help low-income seniors escape deep poverty and avoid or move out of homelessness. Justice in Aging’s Supplemental Security Income 101: A Guide for Advocates introduces advocates and individuals who provide assistance to older adults to the SSI program and focuses on the basics of the program for those who qualify based on age (65 years or older).

Released today, the Guide includes:

  • A description of the SSI program and benefits
  • An overview of the application and appeals processes
  • A discussion of key eligibility criteria, including examples

And in case you missed our SSI Basics webinar last month, the video is now available.

Advance Beneficiary Notices, Administrative Fees, and Dual Eligibles

By | ISSUE BRIEF, Medicare | No Comments

Federal law prohibits charging Qualified Medicare Beneficiaries (QMBs) with Medicare cost-sharing for covered services. Depending on state law, other beneficiaries who are fully eligible for both Medicare and Medicaid–full benefit dual eligibles–may also be protected from being billed for co-payments or other forms of cost sharing.

However, QMBs and other dual eligibles may still be responsible for certain charges or fees. A new Justice in Aging Issue Brief: Advance Beneficiary Notices, Administrative Fees, and Dual Eligibles explains for advocates the situations under which these types of beneficiaries may be responsible for charges.

Read the brief to learn what protections QMBs have and what charges they may have to pay.

Additional Justice in Aging resources on improper billing can be found here.

When Skilled Nursing Facilities Act as Representative Payees

By | ISSUE BRIEF, Nursing Homes, Social Security | No Comments

A representative payee is a third party who is authorized to receive and manage Social Security payments for a beneficiary who isn’t able to do so for themselves. Often, a creditor, such as a nursing facility or other residential facility can be appointed by the Social Security Administration (SSA) to act as a representative payee. When creditors perform this function, conflicts can arise and there must be adequate consumer protections in place to protect the best interests of the beneficiary and the Social Security system.

A new Justice in Aging issue brief, Skilled Nursing Facilities and Other Creditors Acting as Representative Payees, dives into some of the conflicts that can arise and proposes ways to strengthen the oversight and protections within the representative payee system.

Read the Brief

Why Many Nursing Facilities are Not Ready for Emergency Situations

By | Health Care, ISSUE BRIEF, Nursing Homes, REPORTS | No Comments

As Hurricanes Harvey, Irma, and Marie have shown us, nursing facility residents can be particularly at risk during natural disasters. The hurricanes resulted in death and injury in nursing facilities across the region, including 12 deaths in one Florida facility.

Justice in Aging created an issue brief, Why Many Nursing Facilities are Not Ready for Emergency Situations, which discusses existing federal and state law, and makes seven recommendations to address gaps in current law.

As the brief outlines, these deaths and injuries could have been prevented through advance planning and emergency preparedness.

Read the Brief

Health Savings Accounts Won’t Help Most Older Adults

By | Affordable Care Act, Health Care, ISSUE BRIEF, REPORTS | No Comments

Proposals to expand the use of Health Savings Accounts (HSAs) have been raised repeatedly in the health care debate. This new issue brief looks at how expanding HSAs would impact the affordability of health care coverage for low and moderate income older adults by examining how HSAs would have functioned under one proposal, the Better Care Reconciliation Act (BCRA), had it become law.

The paper finds that the combination of HSA contributions and premium costs can easily reach 20% to 30% of an older adult’s income. It concludes that HSAs are not a path to affordable health care for older adults. Read the brief.

How States Can Prevent Evictions When Implementing Federal HCBS Regulations

By | Health Care, Home & Community Based Services, ISSUE BRIEF, REPORTS | No Comments
This new issue brief discusses how states should implement the new federal Home and Community-Based Services (HCBS) regulations in order to prevent improper evictions.

In 2014, the Centers for Medicare and Medicaid Services (CMS) released regulations that set standards for the settings in which HCBS are provided. To implement these regulations, each state must have a transition plan approved by CMS by March 2019, with full compliance required by March 2022.
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Proposed Cuts to Medicaid Put Medicare Savings Programs At Risk

By | ISSUE BRIEF, Medicare, REPORTS | No Comments
For low-income older adults who are eligible for Medicare but can’t afford the premiums, co-pays, and deductibles, Medicare Savings Programs (MSPs) have been a lifeline–making it possible for millions to get Medicare-covered care. However, the huge cuts to Medicaid that both the House and Senate ACA-repeal plans propose could cause states to limit participation in the program, causing many to be priced out and lose access to care.

MSPs currently reach over 7 million people with Medicare. Many are too poor to afford Medicare but do not qualify for other Medicaid programs. This issue brief discusses how the program is structured and administered and outlines how cuts in Medicaid could force cuts to the program. Read More