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. |
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| 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 |
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| Median out-of-pocket spending as a share of total income |
90th percentile of out-of-pocket spending as a share of total income |
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| 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. |
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| 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 |
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| 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. |
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