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Briefing
How Well Insured Are Older Americans?
Using a combination of survey and administrative data, we calculate the portion of medical expenditures that retirees pay out of pocket. We find that retirees are mostly well insured against medical spending risk, with over 80 percent of their spending covered by Medicare, Medicaid or other insurers. We also find, however, that individuals with extremely high medical expenses pay a larger — not smaller — share out of pocket than those with more average expenses. Much of this difference is attributable to nursing home stays, which are typically uncovered by most insurers.
Working Paper
End-of-Life Medical Expenses
In this review, we document end-of-life medical spending: its level, composition, funding, and contribution to aggregate medical spending. We discuss how end-of-life expenses affect household behavior and economic evidence on the efficacy of medical spending at the end of life. Finally, we document recent trends in health and chronic disease at older ages and discuss what they might imply for end-of-life spending and medical spending in the aggregate.
Briefing
Lifetime Medical Spending of Retirees
Retirees face considerable medical expenses during their remaining lives. Model simulations suggest that although a large amount of that spending can be predicted ? based on attributes such as income, health, and marital status ? there remains significant dispersion. Households with heads who turned seventy in 1992 will incur $122,000 in medical spending on average, including out-of-pocket expenditures and Medicaid payments. But the top 5 percent of households will incur more than $300,000 in such spending. The level and dispersion of this spending diminish only slowly with age.
Journal Article
The Lifetime Medical Spending of Retirees
Using dynamic models of health, mortality, and out-of-pocket medical spending (both inclusive and net of Medicaid payments), we estimate the distribution of lifetime medical spending that retired US households face over the remainder of their lives. We find that households who turned 70 in 1992 will, on average, incur $122,000 in medical spending, including Medicaid payments, over their remaining lives. At the top tail, 5 percent of households will incur more than $300,000 and 1 percent of households will incur over $600,000 in medical spending inclusive of Medicaid. The level and the ...