Older Americans struggling with healthcare costs
Nearly one in four older adults in the U.S. spent at least $2,000 out of pocket on healthcare last year, survey shows.
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Although nearly all older Americans have Medicare coverage, they still pay more and are more likely to postpone or skip needed care because of costs than their counterparts in most other wealthy countries, according to new findings from the 2024 Commonwealth Fund International Health Policy Survey of Older Adults.
The findings demonstrate how high out-of-pocket costs – in both traditional fee-for-service Medicare and private Medicare Advantage plans – are making it difficult for many older Americans to afford care.
The Commonwealth Fund conducted the survey in 10 countries – Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland, the United Kingdom and the United States – to explore how financial factors affect older adults' healthcare decisions. The survey also examined differences between beneficiaries in traditional Medicare and those in a Medicare Advantage plan.
WHAT'S THE IMPACT?
One of the key pain points is that out-of-pocket costs are high. Nearly one in four older adults in the U.S. spent at least $2,000 out of pocket on healthcare last year. In contrast, less than 5% of older adults in France and the Netherlands spent that much. Switzerland was the only surveyed country in which older adults reported spending more.
Due to these high costs, older adults are delaying care, which can often worsen health conditions. Although less than 10% of older adults across countries reported skipping needed care or forgoing medical treatment because of costs, older Americans did so at the highest rate. One-third of older U.S. adults facing cost-related barriers reported being in fair or poor health.
People are also skipping dental care. One in five older adults in the U.S., Australia, and Canada skipped needed dental care because of costs. By comparison, 5% or fewer of older adults in the Netherlands and Germany went without dental care.
The researchers emphasized the need for continued improvements in Medicare to bring its coverage in line with other high-income countries, where cost-related barriers are much less common.
THE LARGER TREND
According to the Commonwealth Fund, policy changes from the Inflation Reduction Act may help make prescription drugs in particular more affordable for beneficiaries. These changes include limiting beneficiaries' Part D expenses for prescription drugs, negotiating drug prices, expanding subsidies for people with low incomes, and capping co-payments for insulin.
Some of these changes have already taken effect or will be implemented in 2025, while others, such as negotiating drug prices, are in the process of being implemented with beneficiaries experiencing potential benefits in the future.
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.
