Medically Uninsured Older Americans

  • Lynne Tomasa


America is becoming a more diverse nation. Older Americans are increasing in number at a rapid rate, and we are living longer. With these changes come an increasing demand for health care services and the increasing costs of care. This chapter identifies the importance of focusing on our uninsured, and often underinsured, older Americans, and the issues surrounding their access to health insurance coverage. Due to the overall small percentage of uninsured older Americans aged 65 years and above, this population is easily ignored. To appreciate the need for a closer examination, this chapter provides an overview of several issues and topics. The chapter begins with an overview of the changing demographics of America’s older adults; identifies the uninsured in this population; provides a review of Medicare Parts A, B, and C; describes the role of Medicare Part D; investigates the issue of health insurance for the group of adults aged 50–64; and concludes with how some states are moving forward in providing expanded health care insurance and access to their uninsured. Older Americans, also referred to here as older adults, are defined in the chapter and in national datasets as persons 65 years and older.


Federal Poverty Level Medicare Part Kaiser Family Foundation Doughnut Hole Monthly Premium 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Aratani L (2008, September 30) Howard health initiative ready to enroll uninsured. Washington Post. Accessed 6 Jan 2009
  2. Baker DW, Sudano JJ (2005) Health insurance coverage during the years preceding Medicare eligibility. Arch Intern Med 165:770–776CrossRefPubMedGoogle Scholar
  3. Baker DW, Feinglass J, Durazo-Arvizu R et al (2006) Changes in health for the uninsured after reaching age-eligibility for Medicare. J Gen Intern Med 21:1144–1149CrossRefPubMedGoogle Scholar
  4. CMS/Centers for Medicare and Medicaid Services (2008, Sepember) Medicare and You 2009. Accessed 6 Jan 2009
  5. CMS/Centers for Medicare and Medicaid Services (2008, November) Dual eligibility overview. Accessed 6 Apr 2009
  6. CMS/Centers for Medicare and Medicaid Services/DHHS (2005) Medicaid at a Glance: 2005. GenInfo/. Accessed 6 Jan 2009
  7. Cohen RA, Martinez ME (June 2007, Corrections August 2007) Health insurance coverage: early release of estimates from the National Health Interview Survey, 2006. National Center for Health Statistics. Accessed 6 Jan 2009
  8. DeLia D (2006) Caring for the new uninsured: hospital charity care for older people without coverage. J Am Geriatr Soc 54:1933–1936CrossRefPubMedGoogle Scholar
  9. Federal Interagency Forum on Aging-Related Statistics (2008, March) Older Americans 2008: key indicators of well-being. Federal Interagency Forum on Aging-Related Statistics Washington, DC: U.S. Government Printing Office. Accessed 7 Jan 2009
  10. Fowles DG, Greenberg S, Administration on Aging (AoA), U.S. Department of Health and Human Services (2008). Profile of older Americans: 2008. Accessed 15 Apr 2009
  11. Gray BH, Scheinmann R, Rosenfeld P, Finkelstein R (2006) Aging without Medicare? Evidence from New York City. Inquiry 43(3):211–221PubMedGoogle Scholar
  12. Greenberg A (2007) Available at: Accessed 4 Ap 1009
  13. Hoadley J, Thompson J, Hargrave E, Cubanski J, Neuman T (2008, November) Medicare Part D, 2009, Data spotlight: premiums. Accessed 10 Jan 2009
  14. Hoffman ED, Klees BS, Curtis CA (2008, November) Brief summaries of Medicare & Medicaid Title XVIII and Title XIX of the Social Security Act. Office of the Actuary, Centers for Medicare and Medicaid, DHHS. Accessed 6 Jan 2009
  15. Holahan J, Kaiser Commission on Medicaid and the Uninsured (2004, July) Health insurance coverage of the near elderly. Accessed 6 Jan 2009
  16. Institute of Medicine (2002, May) Report brief. Care without coverage: too little too late. Accessed 7 Apr 2009
  17. Institute of Medicine (2002, September) Report brief. Health insurance is a family matter. Accessed 7 Apr 2009
  18. Kaiser Commission on Medicaid and the Uninsured (2008, March) Healthy San Francisco. Accessed 6 Jan 2009
  19. Kaiser Commission on Medicaid and the Uninsured (2008) States moving toward comprehensive health care reform. Accessed 6 Jan 2009
  20. Martinez ME, Cohen RA, Division of Health Interview Statistics, National Center for Health Statistics (2008, December) Health insurance coverage: early release of estimates from the National health Interview Survey, January–June 2008. Accessed 6 Jan 2009
  21. McWilliams JM, Meara E, Zaslavsky AM, Ayanian JZ (2007). N Engl J Med 357:143–153Google Scholar
  22. Miller CC (2009, January 6) Doctors will make web calls in Hawaii. The New York Times. Accessed 6 Jan 2009
  23. Mold JW, Fryer GE, Thomas CH (2004) Who are the uninsured elderly in the United States? J Am Geriatr Soc 52:601–606CrossRefPubMedGoogle Scholar
  24. Monheit AC, Vistnes JP, Eisenberg JM (2001) Moving to Medicare: trends in the health insurance status of near-elderly workers, 1987–1996. Health Aff 2:204–213CrossRefGoogle Scholar
  25. National Conference of State Legislatures (2009, January 2) State pharmaceutical assistance programs. Accessed 6 Jan 2009
  26. Okoro CA, Young SL, Strine TW et al (2005) Uninsured adults aged 65 years and older; is their health at risk? J Health Care Poor Underserved 16:453–463CrossRefPubMedGoogle Scholar
  27. Sered S, Kaiser Commission on Medicaid and the Uninsured (2004, August) At the edge: Near-elderly Americans talk about health insurance. Accessed 6 Jan 2009
  28. Spencer DL, Richardson S, McCormick M (2007) Inpatient hospital utilization among the uninsured near elderly: Data and policy implications for West Virginia. Health Serv Res 42(6 Pt II):2442–2457CrossRefPubMedGoogle Scholar
  29. The Henry J. Kaiser Family Foundation (2007, February) Medicare at a glance fact sheet. Accessed 6 Jan 2009
  30. The Henry J. Kaiser Family Foundation (2008, November) Medicare part D prescription drug plan (PDP) availability in 2009. Accessed 10 Jan 2009
  31. The Henry J. Kaiser Family Foundation (2008) Medicare at a glance fact sheet. Accessed 6 Jan 2009
  32. The Henry J. Kaiser Family Foundation (2008) The Medicare prescription drug benefit. Accessed 6 Jan 2009
  33. The Henry J. Kaiser Family Foundation (2009) Medicare at a glance fact sheet. Accessed 6 Jan 2009
  34. The Henry J. Kaiser Family Foundation (2009) Medicare: a primer. Accessed 6 Jan 2009
  35. The University of Arizona, College of Pharmacy (2007) UA pharmacists to train others in patient counseling. Accessed 10 Jan 2009
  36. Xu X, Patel DA, Vahratian A, Ransom SB (2006) Insurance coverage and health care use among near-elderly women. Womens Health Issues 16:139–148CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Lynne Tomasa
    • 1
  1. 1.Department of Family and Community MedicineUniversity of Arizona, College of MedicineTucsonUSA

Personalised recommendations