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One in 10 on Medicare delays care, struggles with medical debt, study finds


Nearly one in 10 people using Medicare delay care due to costs or struggle with medical bills, according to a new study. Photo by TBIT/Pixabay


Dec. 10 (UPI) -- Nearly one in 10 people on Medicare experiences debt because of medical expenses despite receiving health coverage under the federal program, an analysis published Friday by JAMA Health Forum found.

About 8% of Medicare beneficiaries have ongoing medical debt, have been contacted by a collection agency or both, the data showed

Enrollees age 65 and older with annual incomes between $15,000 and $25,000 were three times more likely to report problems paying medical bills than those with incomes above $50,000.

In addition, older adults with four to 10 chronic health conditions covered under the program were more than twice as likely to have problems paying medical bills as those with no or one chronic condition, according to the researchers.

"Financial accessibility of care within Medicare is very uneven over the population [and the program] has substantial cost-sharing requirements for patients, and it's all pretty complex," study co-author Jeanne M. Madden told UPI in an email.

"With all these complex moving parts, it is not terribly surprising that there is a lot of inequality there, despite good intentions," said Madden, an associate professor of pharmacy and health systems sciences at Northeastern University in Boston.

Established in 1965, Medicare is a national health insurance program that primarily serves people age 65 and older, as well as certain adults with disabilities, according to the Center for Medicare and Medicaid Services, which oversees it.

The program provides coverage for about 60 million people nationally, including 52 million seniors and 8 million younger adults, the agency estimates.

Although it covers most health expenses for eligible, legal residents of the United States, enrollees are still responsible for significant out of pocket costs, including co-pays and the costs of uncovered services, such as dental, hearing and vision care.

For this study, Madden and her colleagues analyzed data from more than 13,000 respondents to a nationwide survey of Medicare beneficiaries conducted in 2017.

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Nearly 11,000 of the respondents were 65 years and older, while the rest were younger adults, the researchers said.

Just over 30% of the older respondents had annual incomes below $25,000, while about two-thirds of the younger respondents earned below that threshold.

About 8% of older respondents reported delaying medical care because of cost, while one in four younger respondents said that they did so.

And just over 7% of older enrollees said they had problems paying medical bills, compared with 30% among younger respondents, the researchers said.

Of all respondents, 11% reported having problems paying medical bills.

"The study shows that unaffordability is really concentrated among people who have very low incomes or who have poor health and high health care needs [as] the former don't have enough money to pay, and the latter have great needs that overwhelm their ability to pay," Madden said.

"Getting more assistance to those at the low-income end and [implementing] a cap on out-of-pocket spending for beneficiaries would address the people with major healthcare needs," she said.