Maryland Alliance for the Poor
Of the more than 630,000 Marylanders 65 and older, about 85,600 people — or 14% — lived in poverty in 2003, according to US Census data analyzed by the Kaiser Family Foundation. In 2005, that meant that a single senior living in poverty had less than $9,600 in income. [The Center for Budget and Policy Priorities calculates that 31%, or 196,000 seniors were lifted from poverty by Social Security.]
With the pending launch in January 2006 of the Medicare Part D prescription drug program, many low-income Medicare-eligible seniors will have the option to receive substantial coverage for needed medications. (There are about 560,000 Medicare beneficiaries over 65 in
The most pressing needs of seniors living in or near poverty remain (1) a paucity of affordable housing with services that help individuals remain in their homes and community-based settings, and (2) a lack of viable transportation options. The risk of failing to meet these service and housing needs is a rapidly increasing population of seniors forced to live in high-cost institutionalized settings.
At the same time, more and more seniors are remaining in or returning to the workforce. The share of workers in
Medicaid is a jointly funded State/federal program that covers health services to certain individuals and families with low incomes. People over age 65 generally are eligible for Medicaid if their income is no higher than $350 a month for individuals ($392 for couples), and their assets do not exceed $2,500 ($3,000 for couples), or if they receive benefits from the federal Supplemental Security Income (SSI) program. Financial criteria for skilled nursing care are higher if an applicant is deemed medically eligible. Seniors make up about 8% of
Medicaid also pays for some of the out-of-pocket costs of Medicare Part A (hospital coverage) and B (physician coverage) for those eligible for the federal Medicare program, but whose income and assets are somewhat above the Medicaid limits. These programs are known as the Qualified Medicare Beneficiary Program (QMB) and the Special Low-Income Medicare Beneficiary Program (SLMB).
Senior Prescription Drug Program. This program, funded by the value of CareFirst Blue Cross Blue Shield’s premium tax exemption serves Medicare beneficiaries with incomes up to 300% of the FPL who have no other drug coverage. It also will cease to exist soon after the launch of Medicare Part D, and $14 million of the $23 million in the program will be redirected to offset some of the out-of-pocket costs for lower-income Part D members.
Mental Health Care
Low-income seniors who receive Medicare but not Medicaid are responsible for a co-pay of 50% of the Medicare allowable reimbursement for any outpatient mental health treatment. The required co-pay is usually prohibitive and serves as a significant barrier to treatment for this vulnerable population.
For many with both Medicare and Medicaid, the Medicaid benefit covers an additional 12.5% of the allowable Medicare rate, but the client is still responsible for a co-pay of up to 37.5%, still a substantial and often prohibitive amount.
Next to prescription drug costs, the most commonly cited concern among many seniors is the lack of affordable transportation, especially for frail seniors for whom mass transit is not viable. The State took a positive step with the creation of the Maryland Senior Rides Demonstration Program, a grant program intended to foster the creation of assistive ride programs for frail low- to moderate-income seniors. At $100,000 in funding, it will reach only a limited pool of eligible seniors.
Gaps and Challenges
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