Senior citizens' primary health care concern revolves around cost inaccessibility.
The financial burdens of healthcare and living expenses are a significant worry for many seniors.
Connie Colyer, a 68-year-old retired forklift operator, voiced her concerns regarding the escalating costs of healthcare and living essentials, especially considering her lung disease and her husband James's potentially dangerous heart condition. James, a 70-year-old dump truck driver, shares similar anxieties.
Approximately 50 million seniors share this apprehension about affording healthcare due to its rising costs and the expense of necessities like housing and food.
A recent poll by the University of Michigan's National Poll on Healthy Aging revealed that concerns about healthcare costs were the top three issues for seniors, including the cost of general medical care, long-term care, and prescription drugs. More than half of the 3,300 respondents expressed "very concern" about these matters.
Cost-related issues occupied five of the top ten "very concerned" issues, with people mentioning the cost of health insurance, Medicare, and dental care. Less concerning were issues like social isolation, obesity, and age discrimination.
In a political year, John Ayanian, director of the University of Michigan's Institute for Healthcare Policy and Innovation, emphasized that the poll's findings send a clear message to candidates about the importance of addressing healthcare costs.
Older adults, particularly those living on fixed incomes, are indeed justified in their worries. Around 1 in 10 seniors struggle with incomes below the federal poverty level, while nearly a quarter rely solely on Social Security payments. Inflation has eased since its peak in 2022, but prices haven't decreased, putting stress on seniors' budgets.
Conventional Medicare doesn't cover several necessary services like dental care, vision care, or home assistance, although private Medicare Advantage plans provide limited coverage for these. However, these benefits often have limitations. This situation contributes to financial strain for many seniors dealing with healthcare costs.
According to the Commonwealth Fund's 2023 Health Care Affordability Survey, nearly a third of people aged 65 or older faced difficulties paying for healthcare expenses, including Medicare premiums, medications, and medical service costs. One in seven older adults reported spending a quarter or more of their monthly budget on healthcare, with 44% spending between 10-24%. 17% acknowledged forgoing necessary care due to financial reasons.
The Colyers in Pleasureville are among these individuals facing financial challenges. Both require new dentures and eyeglasses, but the high costs make it impossible for them to pay out-of-pocket.
Gretchen Jacobson, Vice President of the Medicare Program at the Commonwealth Fund, highlighted that rising healthcare costs make it difficult for lower and middle-income Medicare beneficiaries to afford necessary care, while emphasizing that when healthcare costs increase, it's more challenging to cover basic necessities.
This concern is especially concerning given that older adults are more susceptible to illness and disability, requiring more care and increasing expenses. In 2022, seniors on Medicare spent $7,000 on medical services, compared to $4,900 for those without Medicare.
The cost of long-term care options like assisted living, nursing home stays, or home-health aides' services is not included in this figure and is often unaffordable for many older adults. 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 week's worth of services from home-health aides averaged $75,500.
Planning for future unanticipated expenses is a persistent worry for Connie Colyer. Her combined monthly Medicare Parts B and D, Medigap supplemental policy premiums amount to nearly $468, or 42% of her $1,121 monthly Social Security income. With a home mortgage of $523 a month and more than $150 in monthly copayments for her inhalers and her husband's heart medications, their survival depends on James continuing to work.
High-earning seniors miss out on programs offering aid for Medicare out-of-pocket expenses, with around 6 million individuals eligible but unenrolled in these Medicare Cost Reduction Programs. People with minimal income may also qualify for concurrent coverage by Medicaid and Medicare or other forms of assistance with household expenses, such as food stamps.
Seniors can determine their eligibility for these and other programs by reaching out to their local Area Services Agency, State Health Insurance Guidance Program, or enrollment center for benefits. Simply input your ZIP code in the Senior Services Finder to uncover these and other organizations providing assistance to seniors locally.
Encouraging seniors to request assistance is not always straightforward. Angela Zeek, manager of health and government benefits at Legal Aid of the Bluegrass in Kentucky, stated many seniors in her area feel embarrassed about being perceived as impoverished or incapable of paying their bills, a matter of pride. “What we advise is, ‘You’ve spent your whole life working, you’ve paid your taxes. It’s okay for the government to help you a bit.’”
Unfortunately, there is scant support for seniors with decent, but not extravagant, financial resources. Although the demand for fresh dental, eye care, and long-term care benefits for older adults is recognized, funding issues persist. As noted by Neuman of KFF, "The issue is always how to fund it."
This concern will escalate as the growing senior population continues to expand.
Nevertheless, there's some optimism: Assistance with Medicare drug costs is accessible through the 2022 Price Reduction Act, although numerous older adults remain oblivious to the benefits. This legislation grants Medicare the ability to negotiate medication costs for the first time. This year, drug expenditures are capped at a maximum $3,800 for many beneficiaries. As of next year, a $2,000 limit on out-of-pocket drug costs will be implemented.
"We've already noticed individuals who previously faced high drug costs sparing thousands of dollars this year," said Frederic Riccardi, Medicare Rights Center's president. "And next year, it's going to improve."
