The Problem

Although New Yorkers who are enrolled in Medicare are considered insured, evidence suggests that they are seriously underinsured. 

Original Medicare pays for only half of the health care costs; enrollees must obtain supplemental insurance to pay for high deductibles, and co-payments. They purchase “Medigap” policies from private health insurers, or contribute to those employer plans that are still offered to Medicare-eligible retirees.

Supplemental coverage is gradually decreasing and even disappearing. Employers are shifting costs to enrollees or are completely discontinuing retiree benefits. “Medigap” insurance is becoming more costly and is cutting back on the more comprehensive policies.

The basic issue is the high cost of medical care for an aging and sick population living on fixed incomes.

Large annual increases in premiums, deductibles and co-payments have appeared in all parts of senior health coverage from original Medicare to employer sponsored plans.

Out-of-pocket payments are also extracted through reductions in benefits, caps on coverage, and restrictive rules and regulations that are used to justify denials of coverage when not followed.

Health Care Reform

Although seniors are losing coverage and going into medical debt, most health care reform proposals do not even mention them. Reform should help seniors replace the supplemental coverage being lost, so that they can once again afford to seek the treatments that they need.

In many ways seniors’ needs for better health care are similar to those of younger people with modest incomes. People of all ages need health care coverage that:

• Is affordable
• Ensures access for all
• Contains costs
• Holds insurers accountable