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Individuals with early-onset Alzheimer’s (those under
age 65) face a unique set of challenges in obtaining access
to critical health care services. People under age 65 with
dementia who lose their jobs are also likely to lose employment-related
health insurance. Almost all people age 65 and older have
health insurance through Medicare, but that is not true
for people under age 65. Individuals eligible for Social
Security Disability Insurance (SSDI) payments also receive
Medicare, but only after a two-year waiting period.
Although some younger persons with Alzheimer’s have
health insurance through a private plan, employment-based
disability or early retirement benefits, others have no
health insurance at all. Data from the Health and Retirement
Survey (HRS) indicated that almost one-third (29 percent)
of people age 55-64 with disabling cognitive impairment
did not have health insurance. With or without health insurance,
many people with early-onset dementia and their families
are likely to face very high out-of-pocket expenditures
for long-term care or be forced to forego medical care.
HRS data also show that average out-of-pocket expenditures
for health- and long-term care services were higher for
people with disabling cognitive impairment than for those
with normal cognitive status ($205 versus $79 per month).
Average out-of-pocket expenditures for prescription drugs
alone were four times higher ($141 versus $33 per month).
The Alzheimer’s Association recommends that Congress
provide immediate access to Medicare for individuals who
are under age 65 by eliminating the two-year waiting period
for SSDI recipients with Alzheimer’s disease. This
measure could reduce the problem of a lack of health insurance
and high out-of-pocket expenditures for this population
and ensure access to critical health care services, including
prescription drugs, that can help manage their disease and
reduce excess disability.
Next: Better Options for End-of-Life Care
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Although some younger persons with Alzheimer’s have health insurance through a private plan, employment-based disability or early retirement benefits, others have no health insurance at all.
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