Younger people enrolled in Medicare due to long-term disabilities report greater challenges with access and affordability than seniors who receive Medicare coverage do, according to a new study.
Millions of people under age 65 are on Medicare due to disability, the Kaiser Family Foundation researchers noted in the study, which was published in Health Affairs' April issue. The study sample included data on 53.6 million Medicare beneficiaries, 7 million of whom are younger than age 65 and qualified because of a long-term disability.
Of these younger beneficiaries, 4.3 million were enrolled in traditional Medicare and 2.7 million were enrolled in Medicare Advantage.
The study found that 18% of younger beneficiaries struggled to access care in the past year, and 15% said they experienced a medical challenge a doctor should see but did not seek treatment. By comparison, 6% of seniors reported challenges with access and 6% said they had a medical issue they did not seek treatment for.
Disabled people enrolled in Medicare Advantage plans did not fare better or worse than those in traditional Medicare in terms of access or affordability, according to the study.
"The similarity in findings about the experiences of beneficiaries in traditional Medicare and Medicare Advantage is noteworthy, given the flexibility accorded to private plans to provide additional benefits and coordinate care, both of which could be helpful to people with disabilities," the researchers wrote. "Given the role that Medicare plays in providing health insurance coverage to people with disabilities, our analysis suggests that the current system does not always meet the needs of this often-overlooked segment of the Medicare population."
Younger beneficiaries were also more likely to report that they did not receive a drug they were prescribed, which was reported by 9% of people with long-term disabilities and 5% of seniors.
Nearly a quarter (24%) of younger beneficiaries said they were unhappy with their out-of-pocket spending on care, compared to 15% of older beneficiaries. A similar number (23%) of younger beneficiaries said they had to delay care due to cost, while 8% of seniors said the same.
A larger number of younger beneficiaries also said they were unsatisfied with the quality of care they received, according to the study.
The researchers said these findings should raise questions about the effectiveness of Medicare in providing coverage to this population as policymakers weigh reforms to benefits and coverage.
"Our findings raise questions as to the adequacy of the current Medicare program to meet the physical and mental health needs of beneficiaries with disabilities," they wrote. "For example, policy makers are considering reforms that would improve Medicare coverage of substance use disorders, which are more common among younger beneficiaries."