TY - JOUR T1 - Physical and/or Cognitive Impairment, Out-of-Pocket Spending, and Medicaid Entry among Older Adults. JF - J Urban Health Y1 - 2016 A1 - Willink, Amber A1 - Davis, Karen A1 - Schoen, Cathy A1 - Jennifer L. Wolff KW - Aged KW - Cognitive Dysfunction KW - Delivery of Health Care KW - Disabled Persons KW - Eligibility Determination KW - Female KW - Financing, Personal KW - Humans KW - Insurance Coverage KW - Insurance, Health KW - Male KW - Medicaid KW - Middle Aged KW - United States AB -

While Medicare provides health insurance coverage for those over 65 years of age, many still are underinsured, experiencing substantial out-of-pocket costs for covered and non-covered services as a proportion of their income. Using the Health and Retirement Study (HRS), this study found that being underinsured is a significant predictor of entering into Medicaid coverage over a 16-year period. The rate of entering Medicaid was almost twice as high for those who were underinsured and with physical and/or cognitive impairment than those who were not, while supplemental health insurance reduced the rate of entering Medicaid by 30 %. Providing more comprehensive coverage through the traditional Medicare program, including a ceiling on out-of-pocket expenditures or targeted support for those with physical or cognitive impairment, could postpone becoming covered by Medicaid and yield savings in Medicaid.

VL - 93 UR - https://link.springer.com/article/10.1007%2Fs11524-016-0078-1 IS - 5 U1 - http://www.ncbi.nlm.nih.gov/pubmed/27653385?dopt=Abstract ER -