Justice in Aging has learned that approximately 17,000 Medicare enrollees nationally have recently had their Medicare placed in “suspension” on the basis of their immigration status. This means that they continue to be enrolled in Medicare, but do not have access to any Medicare benefits. The majority of those affected had previously qualified for Medicare coverage based on either their own or another’s work history, but are currently in undocumented immigration status so are barred from Medicare paying for any covered service. Many of these individuals learn of this change in Medicare coverage when they obtain care and receive notice that Medicare will not reimburse the service on the basis that they were not lawfully present in the United States. Other individuals learn of the suspension when they visit the pharmacy or are disenrolled from their Medicare Advantage or Prescription Drug Plan. | |
What Advocates Can Do to Help those Impacted - Immigration Assistance. Connect your client with an immigration advocate to attempt to reestablish immigration status. Visit the National Immigration Legal Services Directory to find an immigration advocate in your state.
- State-Funded Medicaid Coverage. Some of these affected individuals may be able to rely on state-funded Medicaid coverage. California provides state-based Medicaid coverage to adults 50 years of age or older regardless of immigration status. All adults in California, regardless of immigration status, will obtain access to state-based Medicaid coverage effective January 1, 2024. Illinois also provides state-funded Medicaid coverage to adults age 55 and over. New York will begin providing state-based Medicaid coverage to adults 65 and over on January 1, 2023.
- Other State-Funded Coverage. Some states offer other state-funded health coverage to adults regardless of immigration status. Oregon provides coverage to all low-income adults regardless of immigration status and Colorado intends to do so in 2023.
Advocates are reporting that providers, including pharmacies, are refusing to bill Medicaid in states where it is available since Medicare enrollment continues to be displayed in the billing system. Since Medicare is primary, providers believe that they must receive a denial from Medicare before they can bill other secondary or third-party insurance. Justice in Aging has alerted the Centers of Medicare & Medicaid Services of this issue. If you are seeing this issue in your state, please contact info@justiceinaging.org. | |
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