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Excerpts from Ourselves Growing Older

THINGS YOU CAN DO NOW TO GET HEALTH AND MEDICAL CARE

GOVERNMENT PROGRAMS

Many eligible people are not enrolled in government programs of health and medical care and are not receiving what they are entitled to. If you have become disabled due to mental or physical illness or an accident you may be eligible for Social Security benefits.

If your income is low or you are having special medical problems, you may be eligible for Medicaid coverage and not realize it. Ask to speak to a senior services social worker in your community or at the hospital or health center where you receive care. You must visit your state welfare office to determine for sure whether not you or your family members are eligible to receive Medicaid coverage for medical care. The welfare office can tell you what you must do in order to become eligible. Come prepared to take notes on what you are told; many states will not give out any of their policies in writing because of frequent changes.

If you are nearing Social Security eligibility age, be sure to go to you nearest Social Security office soon to obtain Your Medicare Handbook as well as Social Security information and any other available publications that discuss current benefits, advice about purchasing Medigap insurance, or explain health benefits for working retirees. Donít wait! Premiums will rise if you delay. If you are disabled, your Social Security office also arranges benefits.

 Both individual states and the federal government are focusing increasingly on Medicaid and Medicare programs as places to make cuts, to increase taxes, and to make other big changes. Because costs of these publicly funded programs are the fastest-rising in the whole health and medical care system, we can be sure that something will be done about them. In some states Medicare and Medicaid have already contracted with HMOs and other prepaid group plans to care for the elderly or poor for a flat annual rate. These rates are roughly equivalent to Medicare premiums or a negotiated annual Medicaid fee. Meanwhile, Medicaid costs continue to rise, so cuts and program changes will continue in most states.

You can keep up with proposed changes through the media and join consumer organizations concerned with womenís health, the elderly, and other relevant issues. Attend meetings that explain these programs and the proposed changes, and call your state and federal representatives. These are some of the ways we have to keep track and try to make changes that will be fair to the poorest and most vulnerable of us. The time is now!

WORKING WOMENíS OPTIONS:
NOT POOR ENOUGH, NOT OLD ENOUGH

If you do not fit into any government categories of poverty or medical need or age, and are working, you have several options:

  • If you are a widow or a divorcee of a man who had insurance you may continue your benefits for a limited period, if you can afford to pay the premiums.
  • If you work part-time you may be eligible for coverage; some states do require employers to provide health-insurance coverage for part-time worker; be sure to ask.
  • If your partner or husband is employed and has health insurance you may be covered through that plan as a dependent.
     
  • You may be insured as part of and employee group (prepaid or indemnity plan) through an employee benefit that pays the premiums for you. Most group coverage is for full-time workers.
  • If you do not work full-time or are self-employed, you might get group insurance rates by becoming a member of a professional organization that offers group insurance.
  • You may purchase individual private insurance through paying your own insurance premiums under an individual indemnity plan or prepaid HMO.
  • You may pay as you go for medical care out of pocket.

Be sure to check all policies carefully; they may not cover your needs. Premiums for individuals in any of these systems are now exorbitant, and are still rising rapidly. Becoming part of a group is the only way most single working women not poor enough or old enough for a government program can afford health insurance. Prepaid plans like health maintenance organizations (HMOs) and preferred provider organizations (PPOs) are the only other alternatives to conventional health insurance but these are only cheaper when employer based groups subscribe. Some states require employers providing health benefits to offer a choice between prepaid group plans and conventional indemnity coverage. These are just some of the reasons why commercial health insurance and reform systems tied to employment are not good for women.


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