The cost of eliminating the 24-month Medicare waiting period for Social Security disabled-worker beneficiaries.

OBJECTIVE

The objective of this study was to estimate the cost of eliminating the 24-month waiting period for Medicare entitlement for Social Security disabled-worker beneficiaries. There is concern that the waiting period could currently result in reduced access to health care.

DATA

: The study linked Social Security and Medicare administrative records.

METHODS

Social Security records were used to identify a 20% sample of disabled workers aged 61 or less and newly entitled to Social Security Disability Insurance (SSDI) in 1995 (n = 105,328). These records were linked to Medicare enrollment and claims data for 1997-2000. Cost prediction models were developed from the linked data to predict monthly Medicare costs. The prediction models were then used to estimate what Medicare costs would have been in the first 24 months of SSDI entitlement if the waiting period had been eliminated.

RESULTS

Among the sample of new SSDI entitlees in 1995, 11.8% died during the waiting period, 2.1% recovered, and 86.1% became entitled to Medicare. For the first 24 months of SSDI entitlement, Medicare costs were predicted to be 10,055 US dollars per disabled worker in year 2000 dollars. Costs varied substantially by diagnostic group and whether the person died or recovered during the waiting period.

CONCLUSIONS

Extrapolating from the study sample, predicted Medicare costs for the 24-month waiting period were 5.3 billion US dollars (inflation-adjusted to year 2000 dollars) for all disabled workers aged 61 or less and newly entitled to SSDI in 1995.