Ending the Medicare Waiting Period

Senator Jeff Bingaman (D-NM) has introduced a bill called Ending the Medicare Disability Waiting Period Act of 2005. The bill would, over 10 years, completely phase out the two-year waiting period that Americans with disabilities must endure before receiving Medicare coverage. The legislation also creates a process by which the waiting period can be waived for people with life-threatening illnesses.

NORD is urging its members to contact their U.S. Senators and Representatives to ask them to cosponsor the Ending the Medicare Waiting Period Act of 2005. If you do not know the names of your congressional representatives, scroll down to the "Contact Your Congressperson" link on this page. If you need additional help, contact Diane Dorman in NORD's Washington Office at ddorman@rarediseases.org.

BACKGROUND
When Medicare was expanded in 1972 to include people who have significant disabilities, lawmakers created a Medicare Waiting Period. Before they can get Medicare coverage, people with disabilities must first receive Social Security Disability Insurance (SSDI) for 24 months. Generally, SSDI begins five months after an individual's disability has been certified. As a result, people with disabilities face three consecutive waiting periods prior to getting health coverage:

1) a determination of SSDI approval from the Social Security Administration
2) a five-month waiting period to receive SSDI and
3) an additional 24-month waiting period to get Medicare coverage

Because of the 24-month Medicare waiting period, an estimated 400,000 Americans with disabilities are uninsured, and many more are underinsured at a time in their lives when the need for health coverage is most dire (Dale and Verdier, The Commonwealth Fund, July 2003). In fact, various studies show that death rates among SSDI recipients are highest during the first two years of enrollment (Mauney, AMA, June 2002). For example, according to the Commonwealth Fund, 4 percent of these people die during the waiting period.

There is an important exception to the 24-month waiting period, and that is for individuals with amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, and for hospice services. The ALS exception passed the Congress in December 2000 and went into effect July 1, 2001.

"Ending the Medicare Waiting Period Act of 2004" would, over 10 years, phase out the waiting period and would also, in the interim, create a process by which others with life-threatening illnesses, like ALS, could get an exception to the waiting period.

The Medicare Rights Center, an independent source of healthcare information and assistance, has stated that: "By forcing Americans with disabilities to wait 24 months for Medicare coverage, the current law effectively sentences these people to inadequate health care, poverty or death. Since disability can strike anyone at any point in life, the 24-month waiting period should be of concern to everyone, not just the millions of Americans with disabilities today."

Read a message from NORD to its member organizations
Read a Mathematica Policy Research report on this topic

Have you or someone you know been adversely affected by this waiting period? If so, please contact Diane Dorman at ddorman@rarediseases.org.

Web site about the proposed legislation
Advocacy email on this topic
Supporting organizations