More Than Half of Seriously Ill Medicare Recipients Struggle to Pay Medical Bills

According to a study published in Health Affairs, 53% of seriously ill Medicare enrollees struggle to pay their medical bills, particularly for prescription drugs.

In addition to expensive therapies, hospital bills, and ambulance rides, emergency room visits contribute to substantial out-of-pocket costs for the sickest beneficiaries. More than one third of seriously ill Medicare recipients said they used all or most of their savings to pay medical bills, 27% had bills in collections, and 23% struggled to pay for basic needs like housing, utilities, and groceries. Half of these patients also reported psychological distress related to medical bills, and one quarter said these costs were a major burden on their families.

“Seriously ill” was defined in the study as having a condition (often heart disease, cancer, or diabetes) that required two or more hospitalizations and visits to three or more doctors over the past three years.

Another study by the Kaiser Family Foundation estimated that in 2016, Medicare beneficiaries spent an average of $5,400 out of pocket on health care, including premiums, medical services, and long-term care.

While Democrats and Republicans disagree on legislation to lower prescription drug costs, both parties support an annual out-of-pocket maximum on drug costs for senior citizens on Medicare.

Sources: AP News, November 4, 2019; Kaiser Family Foundation, “How Much Do Medicare Beneficiaries Spend Out of Pocket on Health Care?”; Kyle MA, Blendon RJ, Benson JM, et al. Financial hardships of Medicare beneficiaries with serious illness. Health Aff. 2019;38:1801-6.