Health Care for Low-income Coloradans

• Publication year: 1998
• Pages: 29
• Citation: Vol. 27 No. 3 Pg. 29

27 Colo.Law. 29 Colorado Lawyer 1998.

1998, March, Pg. 29. Health Care for Low-Income Coloradans

---

29

Vol. 27, No. 3, Pg. 29

The Colorado Lawyer
March 1998
Vol. 27, No. 3 [Page 29]

Departments
Legal Services News
Health Care for Low-Income Coloradans
by Peter Komlos-Hrobsky

Medicare, Medicaid, and the Colorado Resident Discount program are currently the principal sources of health care for low-income Coloradans. In general, Medicare is tied to Social Security, while Medicaid is tied to "need-based" poverty programs, such as the Supplemental Security Income ("SSI") program. The Colorado Resident Discount program is a free-standing state program that provides services to low-income persons who do not qualify for Medicare or Medicaid. The Child Health Insurance Program ("CHIP") is a new program for low-income children who do not qualify for Medicaid or other insurance. Colorado's CHIP is expected to begin providing services later this year. This article presents an overview of these programs, their eligibility criteria, and the services they cover

Medicare and Social Security

Medicare is a federally administered health insurance program for recipients of Social Security and Railroad Retirement benefits, as well as for federal employees who retire after 1983. Medicare is divided into Parts A and B. Part A covers hospital costs and is provided without charge to qualifying Social Security or other recipients. Part B covers doctors' charges and other services and is available for a premium, currently $43.80 per month.1

Medicare coverage is broad, with three serious limitations (1) high co-payments and deductibles; (2) no coverage of out-patient medications; and (3) limited nursing home coverage.2 In recent years, some HMOs have been offering medication coverage to patients who agree to receive their Medicare services through that HMO

Social Security recipients represent the largest group of Medicare users. Social Security is a federally administered "quasi-insurance" program for workers who retire or are disabled, and their survivors and dependents.3 However, the Social Security Act does not extend Medicare to many Social Security recipients. Most recipients of dependents' and survivors' benefits do not qualify. Workers with a sufficient earnings record can opt to retire and receive Social Security benefits as early as age 62. Early retirement does not entitle recipients to Medicare until they reach age 65, thus leaving a three-year gap between Social Security and Medicare eligibility. Moreover, most Social Security disability beneficiaries must wait two years before Medicare begins.4

Medicaid and Public Benefits

Medicaid provides, subject to many exceptions, health benefits to persons receiving "need-based" public benefits.5 Medicaid is funded with a combination of state and federal funds. Colorado's Medicaid program is administered by the Colorado Department of Health Care Policy and Financing and the Colorado Department of Human Services, which in turn contract with county social services departments and other agencies. Medicaid recipients must use available Medicare and private insurance coverage before using Medicaid.6

Unlike Medicare, Medicaid covers long-term care and medications, and is subject to only small co-payments Services not currently provided to adults include: hearing...