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Most older Medicare recipients are concerned over future healthcare costs

Half are worried that a major health situation in their household could lead to bankruptcy or debt.

Jeff Lagasse, Associate Editor

Elderly Americans are worried about their ability to afford healthcare, with 58% of those aged 65 or older showing concern about their ability to afford future healthcare costs in a new poll from

Half are worried that a major health situation in their household could lead to bankruptcy or debt, while 32% said they would use retirement savings to treat a severe illness such as COVID-19. More than three in 10 reported a surprise medical bill in the last two years.

The survey polled 1,125 Medicare recipients aged 65 or older from October 5-8.

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The findings have implications for providers seeking to maintain care quality during the pandemic, a particularly troubling proposition given that many patients of all age groups are electing to forgo even routine care in the midst of the pandemic.

Asked to identify their highest healthcare expenses, the most oft-cited answers were health insurance (33%), dentist bills (19%) and prescription drugs (16%), followed by inpatient hospital bills (9%), long-term care (5%), outpatient hospital bills (4%) and doctor bills (4%).

Medical bankruptcy and debt concerns also weigh on Medicare beneficiaries, with 50% saying they were either somewhat or very concerned that a major health situation in their household could lead to bankruptcy or debt.

More than one in 10 (13%) reported carrying medical debt. Of those who reported medical debts, (39%) said the amount was over $1,000.

A majority would turn to savings or their credit cards to pay for treatment of a severe illness such as the coronavirus. Just under one-third of respondents said they would use retirement savings to pay for treatment, and 21% of them would use non-retirement savings. Nearly a quarter said they would use a credit card to pay for a severe illness.

Borrowing money from a financial institution such as a bank was an option for 4% of respondents, while only 2% would use a health savings account. If faced with a severe illness, 2% each said they would borrow money from family or crowdfund online.

Nearly a third reported receiving a surprise medical bill in the last two years, since October 2018. Among those who received surprise medical bills, nearly three out of five said the total amount exceeded $500.


About one-quarter of Medicare beneficiaries experienced difficulty settling a healthcare-related bill within the last year, and for 59% of them prescription drugs topped the list of costs. Health insurance out-of-pocket costs (36%) and health insurance monthly premiums (28%) weren't too far behind. They were followed by hospital/surgical bills (18%), doctor visits (12%), scans or screenings (11%), long-term treatments (5%) and other expenses (9%).

Meanwhile, 44% asked for the generic version of a brand-name drug in order to save on prescription drug costs, while 37% said they purchased a larger supply so their co-pays would be less frequent.

One in seven shopped around at pharmacies or with apps, while more than one in 10 took less than the prescribed dosage. One in 10 asked for a larger dosage and used a pill-splitter to cut pills. Another 8% skipped a medically necessary prescription, while 5% bought medications from abroad.


Empowering Medicare to directly negotiate drug prices, accelerating the adoption of value-based care, using philanthropy as a catalyst for reform and expanding senior-specific models of care are among recommendations for reducing healthcare costs published in a February special report and supplement to the Winter 2019-2020 edition of Generations, the journal of the American Society of Aging.

It called for allowing Medicare to directly negotiate drug prices with manufacturers, which is currently prohibited by law. Authors wrote that it "would be a game-changing lever that could force prescription drug manufacturers to bring down prices and lower costs for older Americans." They also said it's essential to quickly move from unfettered fee-for-service to value-based payment models, and that more transparency on price and quality is needed so consumers and other purchasers can make more informed decisions about care.

A November 2019 HealthPocket survey found that 85% of U.S. adults think that healthcare costs in general are too high. Underscoring that point, 51% of those surveyed have avoided medical care due to lack of ability to pay.

Medicare open enrollment began on October 15.

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