Unlike older adults in other high-income countries, those in the United States face significant financial barriers to getting health care, despite Medicare’s universal coverage. These barriers may affect use of health services as well as health outcomes.

One-fifth of older Americans spent more than $5,000 out of pocket on health care in the past year. Only a small share of older adults in most of the other surveyed countries had such high out-of-pocket health costs. Similarly, a higher share of older Americans reported forgoing health care because of costs. Rates of skipping dental care because of costs were similar for older adults in nations that do not offer coverage of such services, including the U.S.

Older Americans pay more for health care and are more likely to not get care for cost-related reasons than people in other high-income countries. Affordability and out of pocket expesnse with Medicare Advantage  remains a concern and should continue to be a focus of research and policy.

Despite the financial protections Medicare offers to seniors, the program leaves many older adults exposed to high health care costs. Medicare has significant cost-sharing requirements, including deductibles and, for people in the traditional program, coinsurance with no limit on out-of-pocket spending. Services that many older adults and people with disabilities often need, including long-term care, vision, hearing, and dental services, are not covered under traditional Medicare.

Health Care Postponed or Skipped Because of Costs

If out-of-pocket costs for health care services are not affordable, some older adults will postpone nonurgent care or forgo it entirely. Not receiving timely care can worsen health conditions, delay diagnoses, lead to poorer health outcomes, and increase overall health care spending.⁴

Overall, relatively few people across the countries postponed or skipped care because of costs. Compared to older adults in other high-income countries, a larger share of those surveyed in the United States — about one in 12 — postponed or did not seek a consultation about their medical problem or get a recommended medical test, treatment, or follow-up examination (Exhibit 2). In countries like Germany, the Netherlands, Norway, and Sweden, no more than 2 percent of older adults said they skipped medical services because of the cost. While high out-of-pocket costs are more common in Switzerland than the U.S., and as common in Australia, U.S. adults age 65 and older were more likely to skip or postpone needed care.

We can help cover the gap (20%) that Medicare Advanatge does not with our Senior Plan with Impact Health..