Article published April 21, 2007
Woman exemplifies woes of long wait for Medicare
Pamela Votava of Sylvania
Township waited for two
years before becoming eligible
for aid from Medicare.
(
THE BLADE/HERRAL LONG
)
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By JULIE M. McKINNON
BLADE STAFF WRITER
Pamela Votava spent roughly $50,000 on health-insurance premiums alone after retiring on disability and waiting two years to become eligible for Medicare.
Even then the Sylvania Township woman’s insurance didn’t cover the specialists and physical therapists she believes could have helped slow the weakening of her muscles associated with post-polio syndrome.
And after paying so much on premiums, which were about $2,000 a month last year, Mrs. Votava couldn’t afford to pay for treatment on her own too.
“Part of the problem with paying such high premiums is it uses all your discretionary spending,” said Mrs. Votava, who recovered from polio as a child but about a decade ago started noticing problems with muscles infected by the disease.
The 64-year-old’s experience is part of a recent Medicare Rights Center report illustrating the financial trials of an estimated 1.5 million Americans deemed disabled by the Social Security Administration who are waiting for federal health coverage to begin.
The consumer advocacy organization calls on Congress to eliminate the two-year waiting period, which began in 1973 when Medicare was extended to those with disabilities.
About 600,000 disabled people in dire need of health care spend at least part of the two-year waiting period without insurance, said Robert Hayes, president of the Medicare Right Center.
“In our view, the stories we’re reporting here kind of capture the most poignant part of uninsured America,” he said.
About 6.5 million disabled Americans receive Medicare, including more than 259,000 in Ohio and 249,000 in Michigan, the latest government statistics show.
People with either severe kidney disease or amyotropic lateral scloerosis, commonly known as ALS and Lou Gehrig’s disease, are exempt from the two-year waiting period.
The waiting period was instituted to help keep costs down, ensure that people had long-term disabilities, and verify they could not qualify for other coverage, government spokesmen said.
It would cost an estimated $8.7 billion a year to immediately provide Medicare to those certified as disabled by the Social Security Administration, according to the Medicare Rights Center.
That would be partially offset by $4.3 billion in reduced spending for Medicaid, which some individuals get during the waiting period, it said.
The Ability Center of Greater Toledo gets a couple of calls a week from people who are waiting for their Medicare coverage to begin, said Ken Mackowiak, a spokesman for the center.
Mrs. Votava, a former medical office manager, started receiving Medicare coverage in January and is starting physical therapy this week.
She was afraid to go without health insurance for two years, she said, and hadn’t thought getting coverage would be the struggle it was.
After calling various private insurance companies to no avail, Mrs. Votava finally secured a policy through her former employer’s insurance company as required by Ohio. Last year, she didn’t surpass the annual $750 deductible until mid-December, she said.
“It’s just a deteriorating condition, so I really didn’t consider myself sick or uninsurable,” Mrs. Votava said.
Contact Julie M. McKinnon at:jmckinnon@theblade.comor 419-724-6087.
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