Health care debt can force older Americans to make tough decisions

More than 4 in 10 U.S. adults have some form of medical debt, and older Americans may be especially vulnerable to the financial stress it can cause.

“The Medicare program, which provides health insurance coverage to 66 million people, most of whom are older adults ages 65 or older, helps to cover the cost of medical care for those who qualify, yet health care cost-related problems among Medicare-age adults are not uncommon and leave many exposed to debt, with potentially serious and long-lasting health and financial consequences,” according to a new report from KFF.

Among the key findings in the report:

• Among Medicare-age adults with health care debt, large shares say some of the bills that caused their debt were due to routine health care services such as lab fees and diagnostic tests (49%), dental care (48%) and visits to the doctor (41%).
• One in three attribute a portion of their debt to emergency care, and 1 in 4 to prescription drugs. Dental care is one of the leading causes of health care debt among Medicare-age adults, likely because traditional Medicare does not offer coverage for dental-care services.
• Nearly 3 in 10 say their household has been contacted by a collection agency in the past five years as a result of medical or dental bills, while one in four say health care debt has negatively affected their credit score.
• Three in five Medicare-age adults with health care debt say they or another member of their household have delayed, skipped or sought alternatives to needed health care or prescription medications because of costs in the past year.
• Roughly 1 in 10 reports having medical or dental bills that they are paying off over time directly to a provider (12%); put on a credit card and are paying off over time (11%); are past due or unable to be paid (8%); or have debts owed to a bank, collection agency or other lender as a result of loans used to pay off medical or dental bills (7%). A smaller share reports debts owed to family and friends for money borrowed to pay off medical or dental bills (3%).

Read more: To protect workers from medical debt, help fill their coverage holes

“Medicare beneficiaries generally pay out-of-pocket for their monthly premiums and deductibles, cost-sharing for Medicare-covered services and the cost of services not covered by Medicare, such as dental, vision and hearing care and long-term services and supports,” the report said. “Medicare households also spend more on health care than other households and devote a larger share of their household budgets to medical costs and premiums. Health costs are a particular challenge for the millions of Medicare beneficiaries with limited income and savings to absorb unexpected health or other expenses.”