Willink Amber, Davis Karen, Schoen Cathy, Wolff Jennifer
Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
New York Academy of Medicine, New York, NY, USA.
J Urban Health. 2016 Oct;93(5):840-850. doi: 10.1007/s11524-016-0078-1.
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.
虽然医疗保险为65岁以上的人群提供医疗保险，但仍有许多人保险不足，其自付费用在收入中占比很高，无论是已涵盖服务还是未涵盖服务都是如此。利用健康与退休研究（HRS），本研究发现，在16年的时间里，保险不足是进入医疗补助覆盖范围的一个重要预测因素。与未保险不足的人相比，保险不足且有身体和/或认知障碍的人进入医疗补助的比例几乎高出一倍，而补充医疗保险使进入医疗补助的比例降低了30%。通过传统的医疗保险计划提供更全面的保险，包括设定自付费用上限或针对有身体或认知障碍者的定向支持，可以推迟进入医疗补助覆盖范围，并节省医疗补助费用。
