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December 15, 2020

The COVID-19 pandemic has been particularly devasting to people with disabilities. Recent studies indicate that they are three times as likely to die from the virus as the general population.

But as the pharmaceutical industry moves closer to obtaining approval for one or more COVID-19 vaccines, questions continue about whether the vaccines will be allocated in a way that does not discriminate against people with disabilities, and how affordable they will be.

Vaccines developed by Pfizer and Moderna were both more than 90 percent effective in large clinical trials.  Both companies are now gathering safety data necessary for emergency approval by the Food and Drug Administration. Numerous other vaccines are in various stages of development.

Even if a vaccine is approved, however, there will not be sufficient doses immediately to provide to every American. As a result, government agencies and health care providers will have to make difficult decisions about whom to prioritize when administering the vaccine.

At the request of the Centers for Disease Control and Prevention, in September 2020 the National Academies of Science, Engineering and Medicine issued a preliminary framework for the distribution of a COVID-19 vaccine. The framework prioritizes essential and front-line health care workers, as well as people living in group homes and other congregate settings.

Echoing concerns earlier in the COVID-19 pandemic about ventilator rationing, disability advocates have pointed out the absence of any express mention of people with developmental disabilities, who they fear will receive lower priority based on outdated assumptions and stereotypes about their ability to survive COVID-19.

In a September 9 letter to the Office of Civil Rights in the Department of Health and Human Services, the Consortium for Citizens with Disabilities (CCD) implored the Department to ensure that the distribution of any COVID-19 vaccine complies with federal anti-discrimination laws.

“Disability status and age should not be used to deny or deprioritize people for a vaccine, such as categorically excluding people with certain disabilities or functional impairments or prioritizing people based on projections of long-term survivability,” the CCD wrote.

The National Council on Disability and the Autistic Self Advocacy Network also submitted comments to the National Academies, expressing similar fears about its framework.

In addition to distribution concerns, there are questions about whether health insurers will provide vaccine coverage, and if it will be affordable.

As part of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) , Congress mandated in March 2020 that Medicare cover the full cost of any COVID-19 vaccine for Medicare beneficiaries. However, Medicare regulations currently only permit the federal government to cover the costs of vaccines approved through the standard approval process, as opposed to through an emergency use authorization (EUA), which appears to be how the Trump Administration anticipates approving vaccines in the next two months.

On October 28, the Centers for Medicare and Medicaid Services (CMS) released interim final regulations requiring Medicare to cover the full cost to patients of any COVID-19 vaccine, regardless of whether it is approved through an EUA. Coverage will also be free for Medicaid recipients, under the announced policy.

CMS also announced a partnership on October 16 with retail pharmacies CVS and Walgreens to provide vaccines at no cost to seniors and staff in long-term facilities


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September 26, 2020

Medigap policies that supplement Medicare’s basic coverage can cost vastly different amounts, depending on the company selling the policy, according to a new study. The findings highlight the importance of shopping around before purchasing a policy.

When you first become eligible for Medicare, you may purchase a Medigap policy from a private insurer to supplement Medicare’s coverage and plug some or virtually all of Medicare’s coverage gaps. You can currently choose one of eight Medigap plans that are identified by letters A, B, D, G, K, L, M, and N (If you were eligible for Medicare before January 1, 2020, but not enrolled, you may also be able to purchase Plans C and F, but those plans  are no longer available to people who are newly eligible for Medicare). Each plan package offers a different menu of benefits, allowing purchasers to choose the combination that is right for them.

While federal law requires that insurers must offer the same benefits for each lettered plan–each plan G offered by one insurer must cover the same benefits as plan G offered by another insurer–insurers set their own prices for each plan. This means that the price of each plan varies considerably depending on the insurance company.

The American Association for Medicare Supplement Insurance compared costs of plans in the top 10 metro areas and found huge cost differences. Using the most popular plan–Plan G–for comparison, the association found that in Dallas the lowest price for a 65-year-old woman to purchase a plan was $99 a month while the highest price was $381 a month. This is a yearly difference of more than $3,000 for the exact same plan.

The association also found that no one company consistently offered the lowest or highest price. In their study, investigators discovered that 13 different companies had either the lowest or highest price. This means you can’t rely on just one company to always have the better price.

When looking for a Medigap policy, make sure to get quotes from several insurance companies. In addition, if you are going through a broker, check with two or more brokers because one broker might not represent every insurer. It can be hard work to shop around, but the price savings can be worth it.


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