Residents of long-term care facilities who have traditional Medicare coverage spent an average of $22,384 out of pocket for healthcare in 2016, the latest data available, according to a new analysis of Centers for Medicare & Medicaid Services data by the Kaiser Family Foundation.
In the study, “long-term care facility” was defined to include assisted living, personal care facilities and retirement homes, lead researcher Juliette Cubanski Ph.D., associate director for the foundation’s Program on Medicare Policy, told McKnight’s Senior Living. Researchers used data from CMS’ Medicare Current Beneficiary Survey. “Skilled nursing facility” was a separate category.
Eighty-eight percent of the out-of-pocket healthcare costs for long-term care residents, or $19,632, went toward the cost of long-term care services, the authors said.
Long-term care facility residents who did not have Medicaid spent an average of $41,782 out of pocket to cover their healthcare costs, according to the analysis. Out-of-pocket spending on long-term care facility services also was higher among traditional Medicare beneficiaries with certain types of chronic conditions — in particular, Alzheimer’s disease or other dementia ($27,308) and Parkinson’s disease ($28,165), the researchers found.
Regardless of where they lived, traditional Medicare beneficiaries aged 85 or more years had the highest median out-of-pocket healthcare expenses, spending 16% of their incomes to cover those costs.
Those 85+ spent an average of $10,307 annually out of pocket on healthcare costs, an amount that included $8,101 on services and $2,206 on premiums.
The total is more than twice as much out of pocket as beneficiaries aged 65 to 74 (they paid an average of $5,021) and compares with a median of $5,829 for those aged 75 to 84, mainly due to significantly higher spending on long-term care facility services among beneficiaries in the oldest age group, the authors said.