By Judith Graham of KFF Health News
Republished by Travels With The Post
WASHINGTON DC – What weighs most heavily on older adults’ minds when it comes to health care? The cost of services and therapies, and their ability to pay for them, according to new research.
The University of Michigan, in a first-quarter 2024 National Poll on Healthy Aging, asked people age 50 and older about 26 health-related issues. Their top three areas of concern dealt with costs: of medical care in general, of long-term care, and of prescription drugs. More than half of 3,300 people surveyed indicated they were “very concerned” about those issues.
Tens of millions of seniors seem similarly anxious about being able to afford health care. In a multitude of forums they mention its expense, as well as rising costs for housing, food, and other essentials.
In fact, several of the university poll’s top 10 issues identified by respondents as “very concerning” were cost-related. Beyond the top three, people cited:
- Financial scams and fraud (53% very concerned);
- The cost of health insurance and Medicare (52%); and
- The cost of dental care (45%).
- Of apparently lesser concern were issues that otherwise receive considerable attention, including social isolation, obesity, and age discrimination.
During an election year, the University of Michigan poll results send “a very clear message that older adults are worried about the cost of health care,” says John Ayanian, director of the university Institute for Healthcare Policy and Innovation. They “will be looking to candidates to discuss what they have done or plan to do to contain those costs,” he adds.
Behind the ‘health care affordability squeeze’
There seem to be a variety of reasons prompting elderly worries.
- One in 10 seniors (about 6 million people) have incomes below the federal poverty level;
- About 1 in 4 rely exclusively on Social Security payments, which average $1,913 a month per person;
- Although inflation has moderated since its 2022 peak, prices haven’t come down, straining seniors who live on fixed incomes; and
- Traditional Medicare doesn’t cover several services that millions of older adults need, such as dental care, vision care, or help at home from aides. While private Medicare Advantage plans offer some coverage for these services, their benefits may be limited.
Other current trends appear to point to a “health care affordability squeeze” for older adults.
Recently published research from the New York-based Commonwealth Fund, and its 2023 Health Care Affordability Survey, found nearly a third of people 65 or older report difficulty paying for health care expenses. They included premiums for Medicare, medications, and expenses associated with receiving medical services.
One in 7 older adults report spending a quarter or more of their average monthly budget on health care; 44% spent between 10% and 24%. Seventeen percent said they or a family member had forgone needed care in the past year for financial reasons.
“As the cost of living rises for basic necessities, it’s more difficult for lower-income and middle-income Medicare beneficiaries to afford the health care they need,” says Gretchen Jacobson, vice president of the Medicare program at the Commonwealth Fund. Similarly, “when health care costs rise, it’s more difficult to afford basic necessities.”
Greater need for care means higher expense
Because older adults are more prone to illness and disability than younger adults, it can result in a greater need for care and higher expenses. In 2022, seniors on Medicare spent $7,000 on medical services, compared with $4,900 for people without Medicare.
Not included in the figure is the cost of assisted living, or long-term stays in nursing homes, which Medicare also doesn’t cover. According to a latest Genworth survey, the median annual cost of a semiprivate room in a nursing home was $104,000 in 2023, while assisted living came to $64,200, and a year’s worth of services from home-health aides cost $75,500.
Many older adults simply can’t afford to pay out-of-pocket for long-term care options or other major medical expenses.
“Seventeen million older adults have incomes below 200% of the federal poverty level,” according to Tricia Neuman, executive director of the Program on Medicare Policy for the Kaiser Family Foundation. “For people living on that income – $30,120 for a single-person household in 2024; $40,880 for a two-person household – “the risk of a major expense is very scary,” she adds.
Above photo by Igor Vetushko on Deposit Photos, used under license
Are you eligible for benefit programs?
As many as 6 million people are eligible, but not enrolled, to qualify for Medicare Savings Programs that help older adults afford Medicare out-of-pocket costs. Those with very low incomes may also qualify for dual coverage by Medicaid and Medicare or other types of assistance with household costs, such as food stamps.
Older adults can check their eligibility for these and other programs by contacting their local area agency on aging, state Health Insurance Assistance Program, or benefits enrollment center. Enter your ZIP code at the Eldercare Locator, and these and other organizations helping seniors locally will come up.
Persuading older adults to step forward and ask for help often isn’t easy. One health and government benefits manager suggests many seniors don’t want to be considered poor or unable to pay their bills, a blow to their pride. To that, the manager replies: “What we try to say is, ‘You’ve worked hard all your life, you’ve paid your taxes. You’ve given back to this government so there’s nothing wrong with the government helping you out a bit.’”
Kaiser Family Foundation’s Tricia Neuman also observes that little, if any, help is available for seniors who aren’t poor but have modest financial resources. The need for new dental, vision, and long-term care benefits for older adults is widely acknowledged, she says and adds, “the question is always how to pay for it.”
Relief on the horizon
This could become an even bigger issue in the coming years as the aging population grows. There is some relief on the horizon, however.
Assistance with Medicare drug costs is available through the 2022 Inflation Reduction Act, although many older adults don’t realize it yet. The act allows Medicare to negotiate the price of prescription drugs for the first time. This year, out-of-pocket costs for medications will be limited to a maximum $3,800 for most beneficiaries. Next year, a $2,000 cap on out-of-pocket drug costs will take effect.
“We’re already seeing people who’ve had very high drug costs in the past save thousands of dollars this year,” says Frederic Riccardi, president of the Medicare Rights Center in New York. “And next year, it’s going to get even better.”
Top photo by Alla Serebrina on Deposit Photos, used by Travels With The Post under license
KFF Health News is a national newsroom that produces in-depth journalism about health issues. It is one of the core operating programs at Kaiser Family Foundation (KFF), an independent source of health policy research, polling, and journalism.
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