44 % spent between 10 % and 24 %. Another 17 % said they or a family member had forgone needed care in the past year for financial reasons .
The Colyers in Pleasureville are among them . Both need new dentures and eyeglasses , but they can ’ t afford to pay thousands of dollars out-of-pocket , Connie said .
“ As the cost of living rises for basic necessities , it ’ s more difficult for lower-income and middle-income Medicare beneficiaries to afford the health care they need ,” said Gretchen Jacobson , vice president of the Medicare program at the Commonwealth Fund . Similarly , “ when healthcare costs rise , it ’ s more difficult to afford basic necessities .”
This is especially worrisome because older adults are more prone to illness and disability than younger adults , resulting in a greater need for care and higher expenses . In 2022 , seniors on Medicare spent $ 7,000 on medical services , compared with $ 4,900 for people without Medicare .
Not included in this figure is the cost of assisted living or long-term stays in nursing homes , which Medicare also doesn ’ t cover . According to Genworth ’ s latest survey , the median annual cost of a semiprivate room in a nursing home was $ 104,000 in 2023 , while assisted living came to $ 64,200 , and a year ’ s worth of services from home-health aides cost $ 75,500 .
Many older adults simply can ’ t afford to pay for these long-term care options or other major medical expenses out-of-pocket .
“ Seventeen million older adults have incomes below 200 % of the federal poverty level ,” said Tricia Neuman , executive director of the Program on Medicare Policy for KFF . ( That ’ s $ 30,120 for a singleperson household in 2024 ; $ 40,880 for a two-person household .) “ For people living on that income , the risk of a major expense is very scary .”
How to deal with unanticipated expenses in the future is a question that haunts Connie Colyer . Her monthly premiums for Medicare Parts B and D — and a Medigap supplemental policy come to nearly $ 468 , or 42 % of her $ 1,121 monthly income from Social Security .
With a home mortgage of $ 523 a month , and more than $ 150 in monthly copayments for her inhalers and her husband ’ s heart medications , “ we wouldn ’ t make it if my husband wasn ’ t still working ,” she said . ( James ’ monthly Social Security payment is $ 1,378 . His premiums are similar to Connie ’ s and his income fluctuates based on the weather . In the first five months of this year , it approached $ 10,000 , Connie said ).
The couple makes too much to qualify for programs that help older adults afford Medicare out-of-pocket costs . As many as 6 million people are eligible but not enrolled in these Medicare Savings Programs . Those with very low incomes may also qualify for dual coverage by Medicaid and Medicare or other types of assistance with household costs , such as food stamps .
Older adults can check their eligibility for these and other programs by contacting their local Area Agency on Agency , State Health Insurance Assistance Program , or benefits enrollment center . Enter your ZIP code at the Eldercare Locator and these and other organizations helping seniors locally will come up .
Persuading older adults to step forward and ask for help often isn ’ t easy . Angela Zeek , health and government benefits manager at Legal Aid of the Bluegrass in Kentucky , said many seniors in her area don ’ t want to be considered poor or unable to pay their bills , a blow to their pride .
“ What we try to say is , ‘ You ’ ve worked hard all your life , you ’ ve paid your taxes . You ’ ve given back to this government , so there ’ s nothing wrong with the government helping you out a bit .’”
Meanwhile , there ’ s little , if any , help available for seniors who aren ’ t poor but have modest financial resources . While the need for new dental , vision and long-term care benefits for older adults is widely acknowledged , “ the question is always how to pay for it ,” said Neuman of KFF .
This will become an even bigger issue in the coming years because of the burgeoning aging population .
There is some relief on the horizon , however . Assistance with Medicare drug costs is available through the 2022 Inflation Reduction Act , although many older adults don ’ t realize it yet . The act allows Medicare to negotiate the price of prescription drugs for the first time . This year , out-of-pocket costs for medications will be limited to a maximum $ 3,800 for most beneficiaries . Next year , a $ 2,000 cap on out-ofpocket drug costs will take effect .
“ We ’ re already seeing people who ’ ve had very high drug costs in the past save thousands of dollars this year ,” said Frederic Riccardi , president of the Medicare Rights Center . “ And next year , it ’ s going to get even better .”
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