Filling the need for trusted information on national health issues
Filling the need for trusted information on national health issues
Nov 04, 2019
The average person with traditional Medicare coverage paid $5,460 out of their own pocket for health care in 2016, according to a new KFF analysis and interactive tool.
This $5,460 includes about $1,000 in out-of-pocket spending for long-term care facility services, averaged across all traditional Medicare beneficiaries. Such services are used by only 5 percent of beneficiaries in traditional Medicare. For the 95 percent of beneficiaries living in the community, average out-of-pocket spending on health care was $4,519 in 2016. But some groups of beneficiaries spent substantially more than others.
According to the analysis – based on the most current public data — beneficiaries who were likely to spend more out of pocket include women, people in older age groups, those who had been hospitalized, people in poorer self-reported health, and those with multiple chronic conditions.
The analysis comes at a time when some policymakers and presidential candidates are discussing proposals to expand coverage through programs modeled in some respects on Medicare, and improve financial protections and lower out-of-pocket costs for people currently covered by Medicare. Current Medicare-for-all proposals would largely eliminate premiums and out-of-pocket costs, including for those now covered by Medicare.
The analysis includes three interactive graphics that allow users to explore out-of-pocket spending data for different subgroups of Medicare beneficiaries, such as age, gender, and income, to see:
The analysis is based on the most current year of out-of-pocket spending data available from the Medicare Current Beneficiary Survey, a nationally representative survey of Medicare beneficiaries. It does not include spending by beneficiaries in Medicare Advantage plans, due to a lack of publicly available data for beneficiaries enrolled in the private Medicare plans.