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Medicare Beneficiaries’ Out-of-Pocket Health Care Spending as a Share of Income Now and Projections for the Future

Table 1: Medicare Beneficiaries’ Average Per Capita Out-of-Pocket Health Care Spending and Average Per Capita Social Security Income, by Demographic Characteristics, 2013 and 2030
2013 2030
Average per capita out-of-pocket spending Average per capita Social Security income Spending as a share of income Average per capita out-of-pocket spending Average per capita Social Security income Spending as a share of income
All Medicare beneficiaries $5,503 $13,375 41% $7,877 $15,904 50%
Gender
   Female $5,864 $13,421 44% $8,394 $16,230 52%
   Male $5,072 $13,318 38% $7,261 $15,526 47%
Age
   Under 65 $3,647 $10,564 35% $5,220 $12,901 40%
   65 to 74 $4,767 $13,934 34% $6,824 $15,583 44%
   75 to 84 $5,745 $14,238 40% $8,223 $17,158 48%
   85 and over $10,208 $13,814 74% $14,612 $16,731 87%
Race/ethnicity
   White $6,147 $14,453 43% $8,799 $17,431 50%
   Black $3,573 $11,484 31% $5,115 $13,784 37%
   Hispanic $3,533 $8,937 40% $5,057 $10,801 47%
Marital status
   Married $5,389 $12,303 44% $7,715 $14,830 52%
   Divorced/separated $4,221 $14,027 30% $6,043 $16,619 36%
   Widowed $7,059 $16,056 44% $10,104 $19,030 53%
   Single (never married) $4,431 $12,307 36% $6,342 $15,116 42%
Education
   Less than high school $3,940 $10,285 38% $5,640 $10,149 56%
   High school graduate $5,432 $13,204 41% $7,776 $14,931 52%
   Some college $5,543 $14,262 39% $7,935 $17,016 47%
   College graduate $6,421 $15,439 42% $9,191 $18,743 49%
Gender by age
   Female under 65 $3,414 $10,250 33% $4,886 $12,855 38%
   Female 65 to 74 $4,847 $14,141 34% $6,938 $16,074 43%
   Female 75 to 84 $5,854 $14,106 41% $8,380 $17,434 48%
   Female 85 and over $11,438 $13,790 83% $16,373 $16,657 98%
   Male under 65 $3,847 $10,892 35% $5,507 $12,954 43%
   Male 65 to 74 $4,673 $13,701 34% $6,690 $15,052 44%
   Male 75 to 84 $5,607 $14,414 39% $8,026 $16,828 48%
   Male 85 and over $8,054 $13,859 58% $11,529 $16,841 68%
Health status
   Excellent/very good/good $5,246 $13,701 38% $7,510 $16,476 46%
   Fair/poor $6,128 $13,016 47% $8,772 $15,388 57%
Functional impairments
   No ADLs $4,673 $13,687 34% $6,689 $16,184 41%
   Any ADLs $6,946 $12,863 54% $9,943 $15,422 64%
Per capita total income
   $10,000 or less $3,563 $4,554 78% $5,101 $4,341 118%
   $10,001-$20,000 $4,458 $12,197 37% $6,382 $12,717 50%
   $20.001-$30,000 $5,836 $15,187 38% $8,354 $17,227 48%
   $30,001-$40,000 $6,146 $15,034 41% $8,797 $18,095 49%
   $40,001-$50,000 $6,451 $15,511 42% $9,235 $18,293 50%
   $50,001 or more $6,993 $16,710 42% $10,010 $19,901 50%
NOTE: Spending and income amounts in 2016 dollars. Includes Medicare Advantage enrollees, those enrolled in Part A or Part B only, and institutionalized and non-institutionalized beneficiaries. Total out-of-pocket health care spending includes spending on services and premiums for Medicare and private health insurance premiums. Per capita income for married couples is income for the couple divided by two.
SOURCE: Kaiser Family Foundation analysis based on CMs Medicare Current Beneficiary Survey and The Urban Institute’s DYNASIM3.
Table 2: Traditional Medicare Beneficiaries’ Out-of-Pocket Health Care Spending as a Share of Per Capita Total Income, at the Median and 90th Percentiles, by Demographic Characteristics,
2013 and 2030
Median out-of-pocket spending as a
share of total income
90th percentile of out-of-pocket spending as a
share of total income
2013 2030 2013 2030
Traditional Medicare beneficiaries 14% 17% 59% 74%
Gender
   Female 14% 17% 64% 79%
   Male 13% 16% 52% 64%
Age
   Under 65 12% 15% 57% 71%
   65 to 74 12% 14% 42% 51%
   75 to 84 16% 19% 56% 72%
   85 and over 22% 26% 142% 176%
Race/ethnicity
   White 14% 17% 59% 74%
   Black 12% 15% 57% 71%
   Hispanic 13% 16% 57% 74%
Marital status
   Married 15% 17% 52% 66%
   Divorced/separated 12% 14% 45% 55%
   Widowed 15% 18% 84% 102%
   Single (never married) 10% 12% 74% 92%
Education
   Less than high school 15% 19% 72% 93%
   High school graduate 15% 18% 64% 80%
   Some college 14% 17% 50% 64%
   College graduate 11% 13% 41% 49%
Gender by age
   Female under 65 11% 14% 45% 59%
   Female 65 to 74 13% 15% 43% 53%
   Female 75 to 85 16% 20% 63% 78%
   Female 85 and over 26% 31% 165% 204%
   Male under 65 12% 15% 68% 86%
   Male 65 to 74 11% 13% 42% 50%
   Male 75 to 85 15% 18% 51% 63%
   Male 85 and over 17% 20% 98% 123%
Health status
   Excellent/very good/good 13% 16% 47% 57%
   Fair/poor 16% 20% 92% 114%
Functional impairments
   No ADLs 12% 14% 41% 50%
   Any ADLs 18% 21% 99% 125%
Per capita total income
   $10,000 or less 26% 34% 206% 269%
   $10,001-$20,000 20% 25% 76% 95%
   $20.001-$30,000 18% 22% 47% 56%
   $30,001-$40,000 14% 17% 37% 44%
   $40,001-$50,000 11% 13% 28% 32%
   $50,001 or more 7% 8% 18% 20%
NOTE: Estimates based on spending and income amounts in 2016 dollars. Excludes Medicare Advantage enrollees and those enrolled in Part A or Part B only. Total out-of-pocket health care spending includes spending on services and premiums for Medicare and private health insurance premiums. Per capita income for married couples is income for the couple divided by two.
SOURCE: Kaiser Family Foundation analysis based on CMS Medicare Current Beneficiary Survey.
Table 3: Share of Traditional Medicare Beneficiaries Spending At Least 10 Percent and 20 Percent of Per Capita Total Income on Out-of-Pocket Health Care Spending, by Demographic Characteristics,
2013 and 2030
Share spending at least 10 percent of per capita total income on out-of-pocket health care spending Share spending at least 20 percent of per capita total income on out-of-pocket health care spending
2013 2030 2013 2030
Traditional Medicare beneficiaries 62% 70% 36% 42%
Gender
   Female 64% 71% 37% 43%
   Male 60% 68% 33% 40%
Age
   Under 65 56% 64% 30% 38%
   65 to 74 58% 66% 30% 36%
   75 to 84 67% 74% 39% 46%
   85 and over 74% 80% 53% 59%
Race/ethnicity
   White 64% 71% 37% 43%
   Black 55% 63% 30% 38%
   Hispanic 60% 67% 34% 42%
Marital status
   Married 66% 73% 37% 44%
   Divorced/separated 55% 64% 27% 36%
   Widowed 65% 71% 40% 46%
   Single (never married) 49% 57% 29% 34%
Education
   Less than high school 63% 71% 40% 47%
   High school graduate 67% 75% 39% 46%
   Some college 65% 71% 36% 43%
   College graduate 54% 61% 27% 32%
Gender by age
   Female under 65 54% 63% 28% 35%
   Female 65 to 74 61% 67% 30% 37%
   Female 75 to 85 68% 74% 42% 48%
   Female 85 and over 77% 82% 58% 63%
   Male under 65 57% 65% 32% 40%
   Male 65 to 74 56% 64% 29% 35%
   Male 75 to 85 66% 73% 36% 44%
   Male 85 and over 68% 75% 44% 50%
Health status
   Excellent/very good/good 61% 68% 36% 39%
   Fair/poor 67% 74% 43% 50%
Functional impairments
   No ADLs 58% 66% 29% 36%
   Any ADLs 69% 76% 45% 52%
Per capita total income
   $10,000 or less 66% 75% 53% 58%
   $10,001-$20,000 71% 78% 50% 57%
   $20.001-$30,000 80% 86% 46% 55%
   $30,001-$40,000 70% 76% 32% 38%
   $40,001-$50,000 57% 66% 18% 26%
   $50,001 or more 30% 38% 7% 10%
NOTE: Estimates based on spending and income amounts in 2016 dollars. Excludes Medicare Advantage enrollees and those enrolled in Part A or B only. Total out-of-pocket health care spending includes spending on services and premiums for Medicare and private health insurance premiums. Per capita income for married couples is income for the couple divided by two.
SOURCE: Kaiser Family Foundation analysis based on CMS Medicare Current Beneficiary Survey.
Methodology

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.