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The Buy-In Programs

Still Struggling After All These Years

By Patricia Nemore

Buy-in programs, which mandate that states pay certain Medicare premiums, deductibles, and coinsurance through Medicaid, are designed to protect low-income beneficiaries from paying out-of-pocket health care costs. To a large extent these programs have not reached the nearly four million people eligible. This article reports the results of the National Senior Citizens Law Center's 50-state survey that examined issues of outreach, eligibility and qualifying processes, cost sharing, provider participation, and managed care. It concludes that taking applications at social security offices, using short application forms, giving annual notice of the programs' existence, and coordination of outreach would help individuals receive available benefits.

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