How Much Is Enough? Out-of-Pocket Spending Among Medicare Beneficiaries: A Chartbook
| Table 1: Average and Percentile Estimates of Medicare Beneficiaries’ Total Out-of-Pocket Spending on Services and Premiums, by Demographics, 2010 | |||||||
| Beneficiaries | Out-of-pocket spending | ||||||
| Number | % of Total | Average | 25th percentile | Median | 75th percentile | 90th percentile | |
| TOTAL | 37,582,769 | 100% | $4,734 | $1,711 | $3,312 | $5,244 | $8,235 |
| Sex | |||||||
| Men | 16,874,786 | 45 | 4,363 | 1,581 | 3,012 | 4,933 | 7,660 |
| Women | 20,707,984 | 55 | 5,036 | 1,819 | 3,550 | 5,459 | 8,636 |
| Race/ethnicity | |||||||
| White | 29,646,586 | 79 | 5,179 | 2,026 | 3,642 | 5,528 | 8,683 |
| Black | 3,555,108 | 9 | 3,151 | 575 | 1,862 | 3,801 | 6,530 |
| Hispanic | 2,513,783 | 7 | 2,826 | 518 | 1,733 | 3,635 | 5,480 |
| Age | |||||||
| Under 65 | 6,410,667 | 17 | 3,007 | 437 | 1,826 | 3,898 | 6,463 |
| 65-74 | 16,125,438 | 43 | 4,020 | 1,753 | 3,179 | 4,955 | 7,427 |
| 75-84 | 9,991,714 | 27 | 5,245 | 2,274 | 3,868 | 5,687 | 8,536 |
| 85+ | 5,054,949 | 13 | 8,191 | 2,439 | 4,388 | 7,255 | 16,830 |
| Health status | |||||||
| Excellent | 5,712,735 | 15 | 4,058 | 1,857 | 3,188 | 4,889 | 6,897 |
| Very good | 10,386,666 | 28 | 4,114 | 1,903 | 3,402 | 4,974 | 7,400 |
| Good | 11,072,707 | 29 | 4,717 | 1,840 | 3,468 | 5,332 | 7,952 |
| Fair | 6,879,881 | 18 | 5,680 | 1,173 | 3,047 | 5,785 | 10,652 |
| Poor | 3,282,052 | 9 | 5,799 | 929 | 2,963 | 5,902 | 11,822 |
| Income | |||||||
| Under $10,000 | 4,576,593 | 12 | 2,817 | 186 | 870 | 3,416 | 6,771 |
| $10,000-20,000 | 9,318,874 | 25 | 4,467 | 1,050 | 2,581 | 4,705 | 7,441 |
| $20,000-30,000 | 6,240,589 | 17 | 5,406 | 2,246 | 3,723 | 5,524 | 8,513 |
| $30,000-40,000 | 4,957,866 | 13 | 5,273 | 2,275 | 3,799 | 5,368 | 8,922 |
| $40,000-50,000 | 3,269,558 | 9 | 4,762 | 2,310 | 3,722 | 5,496 | 7,805 |
| More than $50,000 | 9,219,289 | 25 | 5,199 | 2,384 | 3,934 | 5,807 | 8,768 |
| Type of residence | |||||||
| Community | 35,439,416 | 94 | 3,918 | 1,680 | 3,220 | 4,987 | 7,264 |
| Facility | 2,125,088 | 6 | 18,351 | 3,790 | 10,247 | 25,975 | 46,594 |
| Number of functional impairments | |||||||
| No ADLs/IADLs | 19,236,952 | 51 | 3,755 | 1,803 | 3,232 | 4,847 | 6,891 |
| Only IADLs | 5,238,023 | 14 | 4,338 | 1,495 | 3,205 | 5,100 | 7,446 |
| 1-2 ADLs | 7,760,135 | 21 | 4,432 | 1,618 | 3,342 | 5,393 | 8,171 |
| 3+ ADLs | 5,195,370 | 14 | 9,199 | 1,398 | 4,192 | 9,021 | 20,611 |
| Number of chronic conditions | |||||||
| None | 1,762,237 | 5 | 3,229 | 1,255 | 2,127 | 3,610 | 6,004 |
| 1-2 | 11,491,433 | 31 | 4,251 | 1,526 | 2,959 | 4,706 | 7,414 |
| 3-4 | 14,635,202 | 39 | 4,852 | 1,899 | 3,530 | 5,288 | 8,259 |
| 5+ | 9,693,897 | 26 | 5,401 | 1,839 | 3,751 | 6,040 | 9,397 |
| NOTE:Analysis excludes beneficiaries enrolled in Medicare Advantage plans. Functional impairments include limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs).The count of chronic conditions includes heart condition, high blood pressure, diabetes, arthritis, osteoporosis/broken hip, pulmonary disease, stroke, Alzheimer’s, Parkinson’s, skin cancer, other cancer, mental disorder, and incontinence. SOURCE: Kaiser Family Foundation analysis of the Medicare Current Beneficiary Survey 2010 Cost & Use file. |
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| Table 2: Medicare Beneficiaries’ Average Total Out-of-Pocket Spending on Services and Premiums, by Demographics, 2000 and 2010 | ||||||||||
| 2000 | 2010 | |||||||||
| Beneficiaries | Out-of-pocket spending | Beneficiaries | Out-of-pocket spending | |||||||
| Number | % of Total | Premiums | Services | Total | Number | % of Total | Premiums | Services | Total | |
| TOTAL | 33,594,228 | 100% | $1,132 | $2,161 | $3,293 | 37,582,769 | 100% | $1,989 | $2,744 | $4,734 |
| Sex | ||||||||||
| Men | 14,690,408 | 44 | 1,081 | 1,778 | 2,859 | 16,874,786 | 45 | 1,879 | 2,485 | 4,363 |
| Women | 18,903,820 | 56 | 1,172 | 2,458 | 3,630 | 20,707,984 | 55 | 2,080 | 2,956 | 5,036 |
| Race/ethnicity | ||||||||||
| White | 27,055,448 | 81 | 1,255 | 2,333 | 3,588 | 29,646,586 | 79 | 2,196 | 2,983 | 5,179 |
| Black | 3,024,231 | 9 | 564 | 1,611 | 2,175 | 3,555,108 | 9 | 1,135 | 2,016 | 3,151 |
| Hispanic | 2,220,219 | 7 | 646 | 1,328 | 1,974 | 2,513,783 | 7 | 1,199 | 1,627 | 2,826 |
| Age | ||||||||||
| Under 65 | 5,058,221 | 15 | 449 | 1,759 | 2,208 | 6,410,667 | 17 | 948 | 2,059 | 3,007 |
| 65-74 | 14,137,492 | 42 | 1,185 | 1,403 | 2,588 | 16,125,438 | 43 | 2,093 | 1,926 | 4,020 |
| 75-84 | 10,316,096 | 31 | 1,385 | 2,175 | 3,560 | 9,991,714 | 27 | 2,369 | 2,876 | 5,245 |
| 85+ | 4,082,419 | 12 | 1,155 | 5,249 | 6,405 | 5,054,949 | 13 | 2,229 | 5,962 | 8,191 |
| Health status | ||||||||||
| Excellent | 4,289,314 | 13 | 1,375 | 1,084 | 2,460 | 5,712,735 | 15 | 2,283 | 1,774 | 4,058 |
| Very good | 7,945,551 | 24 | 1,329 | 1,390 | 2,719 | 10,386,666 | 28 | 2,268 | 1,846 | 4,114 |
| Good | 10,538,972 | 31 | 1,185 | 2,049 | 3,234 | 11,072,707 | 29 | 2,078 | 2,638 | 4,717 |
| Fair | 7,188,604 | 21 | 894 | 3,180 | 4,074 | 6,879,881 | 18 | 1,521 | 4,159 | 5,680 |
| Poor | 3,534,777 | 11 | 720 | 3,309 | 4,029 | 3,282,052 | 9 | 1,295 | 4,505 | 5,799 |
| Income | ||||||||||
| Under $10,000 | 8,177,862 | 24 | 516 | 2,081 | 2,597 | 4,576,593 | 12 | 643 | 2,174 | 2,817 |
| $10,000-20,000 | 9,451,333 | 28 | 1,165 | 2,366 | 3,531 | 9,318,874 | 25 | 1,505 | 2,962 | 4,467 |
| $20,000-30,000 | 5,918,629 | 18 | 1,343 | 2,020 | 3,363 | 6,240,589 | 17 | 2,347 | 3,060 | 5,406 |
| $30,000-40,000 | 3,672,472 | 11 | 1,403 | 2,002 | 3,406 | 4,957,866 | 13 | 2,452 | 2,821 | 5,273 |
| $40,000-50,000 | 2,121,199 | 6 | 1,421 | 2,671 | 4,091 | 3,269,558 | 9 | 2,410 | 2,352 | 4,762 |
| More than $50,000 | 4,252,733 | 13 | 1,571 | 1,938 | 3,510 | 9,219,289 | 25 | 2,507 | 2,692 | 5,199 |
| Type of residence | ||||||||||
| Community | 31,394,889 | 93 | 1,187 | 1,345 | 2,532 | 35,439,416 | 94 | 2,060 | 1,858 | 3,918 |
| Facility | 2,199,339 | 7 | 353 | 13,806 | 14,159 | 2,125,088 | 6 | 816 | 17,534 | 18,351 |
| Number of functional impairments | ||||||||||
| No ADLs/IADLs | 16,647,765 | 50 | 1,274 | 1,135 | 2,409 | 19,236,952 | 51 | 2,227 | 1,528 | 3,755 |
| Only IADLs | 5,201,027 | 15 | 1,107 | 1,541 | 2,649 | 5,238,023 | 14 | 1,824 | 2,513 | 4,338 |
| 1-2 ADLs | 6,628,009 | 20 | 1,053 | 2,319 | 3,372 | 7,760,135 | 21 | 1,868 | 2,564 | 4,432 |
| 3+ ADLs | 5,062,063 | 15 | 796 | 5,857 | 6,653 | 5,195,370 | 14 | 1,461 | 7,737 | 9,199 |
| Number of chronic conditions | ||||||||||
| None | 2,425,586 | 7 | 1,076 | 1,093 | 2,169 | 1,762,237 | 5 | 1,876 | 1,353 | 3,229 |
| 1-2 | 12,615,489 | 38 | 1,122 | 1,935 | 3,056 | 11,491,433 | 31 | 1,926 | 2,325 | 4,251 |
| 3-4 | 12,461,312 | 37 | 1,149 | 2,336 | 3,485 | 14,635,202 | 39 | 2,081 | 2,771 | 4,852 |
| 5+ | 6,091,841 | 18 | 1,140 | 2,697 | 3,837 | 9,693,897 | 26 | 1,947 | 3,454 | 5,401 |
| NOTE:Analysis excludes beneficiaries enrolled in Medicare Advantage plans. Premiums includes Medicare Parts A, B, and D and other types of health insurance beneficiaries may have (Medigap, employer-sponsored insurance, and other public and private sources). Functional impairments include limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs).The count of chronic conditions includes heart condition, high blood pressure, diabetes, arthritis, osteoporosis/broken hip, pulmonary disease, stroke, Alzheimer’s, Parkinson’s, skin cancer, other cancer, mental disorder, and incontinence. SOURCE: Kaiser Family Foundation analysis of the Medicare Current Beneficiary Survey 2000 and 2010 Cost & Use files. |
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