Medicare waiting period leaves over 1.2 million seriously disabled without secure health insurance

July 16, 2003

New York City, July 16, 2003--Over 1.2 million seriously disabled Americans under age 65--including as many as 400,000 without health insurance--are currently in the two-year waiting period for Medicare coverage, according to a new report from The Commonwealth Fund. Eliminating this two-year waiting period would provide stable health insurance to a vulnerable group of adults who are unable to work. Some disabled adults in the waiting period qualify for state Medicaid programs. The report finds that dropping the two-year Medicare wait would save cash-strapped states an estimated $1.8 billion a year in Medicaid costs.

"At a time when Congress is considering major reforms to Medicare they should not forget some of the most vulnerable of all potential beneficiaries--seriously disabled adults who are unable to work," said Karen Davis, president of The Commonwealth Fund. "Individuals in the waiting period for Medicare suffer from a broad range of debilitating diseases and are in urgent need of appropriate medical care to manage their conditions. Eliminating the two-year wait would ensure access to care for those already on the way to Medicare."

Currently, 1.26 million seriously disabled Americans are in the waiting period for Medicare coverage, and as many as one-third of them (400,000) have no health insurance, according to the report, Expanding Health Coverage for Seriously Disabled Adults by Eliminating Medicare's Two-Year Waiting Period, by Stacy Berg Dale and James M. Verdier of Mathematica Policy Research, Inc. These disabled adults under age 65 must first qualify for Social Security Disability benefits by satisfying the work history requirements and proving that they are too disabled to work, wait five months for these benefits to begin, and then wait an additional two years for Medicare. Adults under 65 who qualify for Medicare based on disability suffer from a range of chronic illnesses: more than nine of 10 have one or more chronic diseases including arthritis, heart conditions, lung disease, cancer, and severe mental illness. All are unable to work. By the time they reach Medicare, most (77%) are poor or nearly poor.

Based on reports from several states, the authors estimate that 40 percent of those in the waiting period are enrolled in Medicaid programs, having qualified as disabled and poor. Eliminating the two-year waiting period for Medicare would benefit states by reducing their costs for Medicare-covered services. The report finds that states would save an estimated $1.8 billion per year if the Medicare waiting period were eliminated. Federal Medicaid expenditures for the disabled would also be reduced, by $2.5 billion, offsetting some of the $8.7 billion increase in federal Medicare expenses that would result from the change.

"At a time when states are considering steep cuts in essential services, eliminating this hurdle to Medicare could make a real difference in states' ability to maintain insurance coverage," said Verdier. "Our analysis illustrates that savings could help states maintain Medicaid coverage for children and families or the safety net for elderly and disabled for services not covered by Medicare. If Medicare included prescription drugs, state Medicaid savings could potentially be even greater."

In addition to insuring as many as 400,000 uninsured disabled adults, eliminating Medicare's waiting period would improve the financial security of disabled adults paying high premiums to maintain private coverage after losing jobs due to disability. The report notes that, to the extent that disabled adults rely on coverage through their prior employer or their spouse's employer, eliminating the waiting period would also produce savings to employers who provide this coverage.
The Commonwealth Fund is a private foundation supporting independent research on health and social issues. To read or download publications, visit our website at

Commonwealth Fund

Related Health Insurance Articles from Brightsurf:

Examining health insurance nondiscrimination policies with mental health among gender minority individuals
A large private health insurance database was used to examine the association between between health insurance nondiscrimination policies and mental health outcomes for gender minority individuals.

How common for cancer survivors to stay at jobs for health insurance?
This survey study looked at how often cancer survivors in the United States and their spouses or partners stay in their jobs because of concerns about losing their health insurance.

New health insurance insights
MIT economists analyze how patients and health care providers value Medicaid.

New health insurance benefit at U-M led to increased rates of IVF
In a new research letter appearing in JAMA detailing a first-of-its-kind study, a University of Michigan team compared the use of IVF among university employees before and after the addition of an insurance coverage benefit, finding a marked increase in the rate of use.

Financial hardship in cancer: The role of health insurance literacy
A new American Cancer Society study links health insurance literacy with medical financial hardship as well as non-medical financial sacrifices among adult cancer survivors in the United States.

Health insurance rule could help millions spend less for the care they need
Millions of Americans with chronic conditions could save money on the drugs and medical services they need the most, if their health insurance plans decide to take advantage of a new federal rule issued today.

Health insurance idea born at U-M could help millions of Americans spend less
New federal rule could reduce out-of-pocket costs for key drugs and services for people with chronic conditions in high-deductible health plans with health savings accounts.

Health insurance is not assurance of healthcare
Because of high out-of-pocket expenses, Ohioans who purchase subsidized health-exchange insurance often can't afford the care they need when they need it.

Study details poverty, lack of health insurance among female health care workers
A study carried out by researchers at Massachusetts General Hospital and the Perelman School of Medicine at the University of Pennsylvania finds that low wages and poor benefits leave many female health care workers living below the poverty line.

Is TV advertising for health insurance worth the expense? A new study says, 'maybe not'
A new study to be published in the INFORMS journal Marketing Science has revealed that health insurance has a small effect on brand enrollments, raising the question of whether health insurance television advertising is worth the expense.

Read More: Health Insurance News and Health Insurance Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to