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NY senior advocates see advantages to dual-use special needs plans

Senior and older adult advocates in New York are pointing to certain health care plans to help people get the best bang for their buck.

Dual-use special-needs plans offer Medicare and Medicaid coverage together for eligible people, although the plans are designed for people who have low incomes, have certain medical conditions, and have unique health care requirements. In New York, 42% of residents were registered for the plans in 2021.

Heather Leddick, Counseling and Assistance Program health insurance information coordinator at the New York State Office for the Aging, described how the plans help those with chronic illnesses.

“They may have access to a network of providers who again specialize in their condition, and offer better coverage for prescription drugs used to treat their condition,” Leddick outlined.

She added because the programs offer both Medicare and Medicaid coverage, they have preventive benefits such as exams, shots, lab tests and screenings. Along with Medicare Parts A and B coverage and Medicaid benefits, the plans can have other lifestyle benefits. Some include coverage for glasses and hearing aids, as well as allowances for daily items such as healthy foods and other over-the-counter products.

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The pandemic has bolstered concerns about being insured, though a Centers for Disease Control and Prevention report found the uninsured rate dropped 18% during those years.

Dr. Gina Williams, associate medical director for UnitedHealthcare, said people should be better informed about preventive care post-pandemic.

“Everybody’s kind of going into a phase where they’re not only thinking about acute illness, but they’re thinking about overall care,” Williams observed. “What was the impact of the pandemic from a psychological standpoint? Do you need more support and then you also need more coordination of benefits?”

More people have been losing coverage because the public health emergency ended. The Commonwealth Fund reported as of midsummer 2023, close to 4 million people lost their Medicaid coverage. Overall estimates show nearly 15 million people will lose their coverage as the process continues.