Medicare Beneficiaries

About 13 percent of Medicare beneficiaries receive some assistance from Medicaid. States “buy in” Medicare coverage for these low-income beneficiaries. For those eligible, states also provide benefits beyond those covered by Medicare. Buy-in beneficiaries are different from other Medicare beneficiaries in many ways. They have lower incomes, which is consistent with the policy intent. They use more health services in general but do not appear to receive timely, appropriate care relative to several disease-specific standards. As policymakers consider restructuring Medicare and Medicaid, careful attention needs to be paid to the effects of changes on these beneficiaries. N early f ive m ill i on Medi care beneficiaries (13 percent) received some assistance fromMedicaid at some point during 1993. States use Medicaid funds to “buy in” Medicare coverage for these low-income beneficiaries by paying Medicare premiums, deductibles, and copayments. For those eligible, states also provide broader benefits under Medicaid that exceed the scope of Medicare coverage. Although different categories of beneficiaries receive different types of assistance, Medicaid plays a crucial role in providing health care coverage for these Medicare beneficiaries. Even though beneficiaries covered by buy-in agreements may have health care needs and present challenges that are different from the broader Medicare and Medicaid populations, they typically are not considered separately when policy changes are considered. This DataWatch first briefly reviews the policies that affect these buy-in beneficiaries and then compares them with the general Medicare population with regard to demographic characteristics, use of health services, reported health status, and access to care. The basic information presented should help to inform ongoing policy debates on restructuring Medicare and Medicaid and provide some © 1997 The People-to-PeopleHealth Foundation, Inc. Katie Merrell is a senior analyst, David Colby is deputy director, and Chris Hogan is a principal policy analyst at the Physician Payment Review Commission in Washington. DATAWATCH 175 H E A L T H A F F A I R S ~ J a n u a r y / F e b r u a r y 1 9 9 7 M E D I C A I D B U Y I N on A uust 7, 2017 by H W T am H ealth A fairs by http://conealthaffairs.org/ D ow nladed fom baseline data against which to compare future analyses of these beneficiaries’ health status and use of health services.