老年医疗保险受益人的补充健康保险覆盖情况。

Supplemental health insurance coverage among aged Medicare beneficiaries.

作者信息

Garfinkel S A, Corder L S

出版信息

Natl Med Care Util Expend Surv B. 1985 Aug(5):1-37.

DOI:
Abstract

The goal of the National Medical Care Utilization and Expenditure Survey (NMCUES) of 1980 was to improve the understanding of the ways in which Americans use and pay for health care. This report is one in a series of descriptive reports based on NMCUES data. Data concerning insurance coverage were collected from household respondents in NMCUES. These data included the kind of insurance in effect for each person, the services covered, and the amounts paid by each source. In addition, the administration of private insurance plans and the kinds of charges covered were identified. The purpose of this report is to provide descriptive information about supplemental insurance coverage among the aged Medicare population with special emphasis on private supplemental health insurance coverage. For this report, supplemental insurance is defined as coverage (i.e., Medicaid, private, or other) in addition to Medicare and is to be distinguished from the Supplementary Medical Insurance part of Medicare that is known as SMI or Part B of Medicare. The results presented are based on data collected about the civilian, noninstitutionalized persons in the NMCUES national household sample who at any time during the survey year of 1980: (1) were 65 years of age or over, and (2) reported having been covered by Medicare Hospital Insurance (HI), or Medicare Supplementary Medical Insurance (SMI), or both. This report uses time-adjusted estimates that assign a single individual to different categories of insurance coverage according to the proportion of the year that he or she was covered by each kind of insurance. Consequently, estimates are made for person-years of coverage although they are expressed as persons for convenience. Approximately 4 out of 5 aged Medicare beneficiaries reported having some kind of insurance coverage in addition to Medicare during 1980. Approximately 67 percent of the aged Medicare population are estimated to have had private insurance in addition to Medicare; an estimated 13 percent had Medicaid. (Both of these estimates include 2.5 percent who reported Medicaid and private insurance simultaneously.) About 21 percent of the aged Medicare beneficiaries reported that Medicare was their only source of third-party coverage. The percentage of the aged Medicare beneficiaries who reported Medicare as their only source of third-party coverage was consistently 20 percent regardless of health status. However, the distribution among insurance categories of the remaining 80 percent who reported supplemental coverage of some type varied by health status. Medicare beneficiaries who were in poor health were much more likely to have Medicaid than Medicare beneficiaries who reported being in excellent health.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

1980年全国医疗保健利用与支出调查(NMCUES)的目标是增进对美国人使用医疗保健及支付方式的了解。本报告是基于NMCUES数据的一系列描述性报告之一。有关保险覆盖范围的数据是从NMCUES的家庭受访者那里收集的。这些数据包括每个人有效的保险种类、涵盖的服务以及每个支付来源支付的金额。此外,还确定了私人保险计划的管理情况以及涵盖的收费种类。本报告的目的是提供有关老年医疗保险人群补充保险覆盖范围的描述性信息,特别强调私人补充医疗保险覆盖范围。在本报告中,补充保险被定义为除医疗保险之外的保险覆盖范围(即医疗补助、私人保险或其他),并应与医疗保险的补充医疗保险部分(称为SMI或医疗保险B部分)区分开来。呈现的结果基于在1980年调查年度的任何时间,在NMCUES全国家庭样本中收集的有关平民、非机构化人员的数据:(1)年龄在65岁及以上,(2)报告已参加医疗保险住院保险(HI)或医疗保险补充医疗保险(SMI),或两者都参加。本报告使用时间调整后的估计数,根据每个人在一年中被每种保险覆盖的比例,将单个个体分配到不同的保险覆盖类别。因此,虽然为方便起见以人数表示,但估计的是保险覆盖的人年数。在1980年,约五分之四的老年医疗保险受益人报告除医疗保险外还有某种保险覆盖。估计约67%的老年医疗保险人群除医疗保险外还有私人保险;估计13%的人有医疗补助。(这两个估计数都包括2.5%同时报告有医疗补助和私人保险的人。)约21%的老年医疗保险受益人报告医疗保险是他们第三方保险覆盖的唯一来源。无论健康状况如何,报告医疗保险是其第三方保险覆盖唯一来源的老年医疗保险受益人的比例始终为20%。然而,其余80%报告有某种补充保险覆盖的人在不同保险类别中的分布因健康状况而异。健康状况差的医疗保险受益人比报告健康状况极佳的医疗保险受益人更有可能拥有医疗补助。(摘要截断于400字)

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