What concerns older people most in relation to healthcare?
The costs of services and therapies and their ability to pay.
“We're always worried about it because of our age and because everything is getting more expensive,” said Connie Colyer, 68, of Pleasureville, Kentucky. She is a retired forklift driver who suffers from lung disease and hypertension. Her husband, James, 70, drives a dump truck and has a potentially dangerous irregular heart rhythm.
Tens of hundreds of thousands of seniors face similar concerns about their ability to afford health care, because it is expensive and the prices of housing, food and other necessities proceed to rise.
A brand new wave of research underscores the magnitude of those fears. When the University of Michigan National survey on healthy ageing When we surveyed people ages 50 and older on 26 health-related issues, their three biggest concerns were about costs: health care usually, long-term care and prescribed drugs. More than half of the three,300 respondents in February and March said they were “very concerned” about these issues.
In fact, five of the highest 10 issues rated as very concerning were cost-related. In addition to the highest three, respondents cited the fee of medical health insurance and Medicare (52%) and the fee of dental care (45%). Financial fraud and scams got here in fourth (53% were very concerned). Far less concerning were issues that receive considerable attention, including social isolation, obesity and ageism.
In an election yr, “our poll sends a very clear message that older people are concerned about the cost of health care and expect candidates to discuss what they have done or plan to do to contain those costs,” said John Ayanian, director of the Institute for Healthcare Policy and Innovation on the University of Michigan.
Older people have every reason to fret. One in ten seniors (about 6 million people) has an income below the federal poverty line. About one in 4 relies solely on welfare, which averages $1,913 per person per thirty days.
Even though inflation has moderated since its peak in 2022, prices haven’t fallen, putting a strain on seniors on fixed incomes.
At the identical time, traditional Medicare insurance doesn’t cover several services that hundreds of thousands of older adults need, similar to dental care, vision care or home care assistance from a caregiver. Private Medicare Advantage plans do provide some coverage for these services, but the advantages are sometimes limited.
All this contributes to creating healthcare increasingly difficult for older people to afford. Recently published research results A study from the Commonwealth Fund's 2023 Health Care Affordability Survey found that almost a 3rd of individuals over 65 have difficulty paying health care costs, including Medicare premiums, medications and costs related to using medical services.
One in seven older adults reported spending 1 / 4 or more of their average monthly budget on health care; 44% spent between 10% and 24%. 17% said they or a member of the family had foregone vital care up to now yr resulting from financial constraints.
The Colyers in Pleasureville are amongst them. Both need latest dentures and glasses but can't afford to pay 1000’s of dollars out of pocket, Connie said.
“When the cost of living for basic needs increases, it becomes harder for low- and middle-income Medicare beneficiaries to afford the health care they need,” said Gretchen Jacobson, vice chairman of the Medicare program on the Commonwealth Fund. And “when health care costs increase, it becomes harder to afford basic needs.”
This is very concerning because older adults are more vulnerable to illness and disability than younger adults, resulting in greater care needs and better costs. In 2022, seniors with Medicare spent $7,000 on medical services, in comparison with $4,900 for people without Medicare.
That figure doesn’t include the fee of assisted living or long-term nursing home stays, that are also not covered by Medicare. According to Genworth's most up-to-date survey, the typical annual cost of a semi-private room in a nursing home in 2023 was $104,000, while assisted living cost $64,200 and weekly home health aide services cost a mean of $75,500.
Many older people simply cannot afford to pay for this long-term care or other major medical expenses out of their very own pocket.
“Seventeen million older adults have incomes below 200 percent of the federal poverty level,” said Tricia Neuman, executive director of KFF's Medicare program. (That's $30,120 for a one-person household in 2024 and $40,880 for a two-person household.) “For people living on that income, the risk of a major expense is very scary.”
How she’s going to handle unexpected expenses in the long run is a matter that’s troubling Connie Colyer. Her monthly premiums for Medicare Parts B and D and a Medigap supplemental insurance plan total nearly $468, or 42% of her monthly Social Security income of $1,121.
With a $523-a-month mortgage and over $150 in monthly copayments for her inhalers and her husband's heart medication, “we wouldn't make it if my husband wasn't still working,” she told me. (James' monthly Social Security payments are $1,378. His premiums are much like Connie's, and his income fluctuates with the weather. In the primary five months of this yr, it approached $10,000, Connie told me.)
The couple earns an excessive amount of to qualify for programs that help older adults pay Medicare costs out of pocket. As many as 6 million persons are eligible but not enrolled in these programs. Medicare savings programs. Very low-income individuals might also be eligible for dual coverage through Medicaid and Medicare or other types of assistance with household expenses, similar to food stamps.
Older adults can check their eligibility for these and other programs by contacting their local Agency to Agency Area, State Health Insurance Assistance Programor Benefits Registration CenterEnter your postcode Elderly care finder and these and other organizations that help local seniors are mentioned.
Convincing older people to return forward and ask for help is usually difficult. Angela Zeek, health and advantages manager at Legal Aid of the Bluegrass in Kentucky, said many seniors in her area don't need to be seen as poor or unable to pay their bills, which is a blow to their pride. “We try to tell them, 'You've worked hard all your life, you've paid your taxes. You've given back to the state, so there's nothing wrong with the state giving you a little help.'”
And the sad truth is that there’s little to no help for seniors who aren’t poor but have modest financial means. While it’s well known that latest dental, vision and long-term care advantages for the elderly are needed, “the question is always how to fund them,” says KFF's Neuman.
Due to the increasing ageing of the population, this problem will grow to be much more severe in the approaching years.
However, there’s some relief on the horizon: support for Medicare drug costs is offered through the Inflation Reduction Act 2022although many older adults don't yet realize it. The law allows Medicare to barter prescription drug prices for the primary time. This yr, out-of-pocket drug costs will probably be capped at a maximum of $3,800 for many beneficiaries. Next yr, a $2,000 cap on drug out-of-pocket costs will go into effect.
“We're already seeing people who have historically had very high drug costs saving thousands of dollars this year,” said Frederic Riccardi, president of the Medicare Rights Center. “And next year will be even better.”
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