Medicare beneficiaries who were older spent a greater portion of their self-reported income (including Social Security and other sources) on out-of-pocket costs. Original Medicare enrollees age 85 and older spent 16 percent of income on these costs, beneficiaries ages 65 to 74 spent only 12 percent, and this number was even lower (7 percent) for beneficiaries under 65. (It should be noted that while Medicare beneficiaries under 65 spend a lower percentage of income on medical care, they also have lower incomes overall, with the average Social Security Disability benefit being $1,236 in 2019.)
There are also differences based on gender. Female Medicare beneficiaries spent a slightly higher average portion of self-reported income on health coverage and out-of-pocket costs than their male counterparts (spending $5,748 versus $5,104 spent by men), although this was not the case for those under age 65 who are enrolled in Medicare because of disability. The overall higher spending as a percentage of income reflects longer life expectancies for women, and the associated higher long-term care facility costs (more than 70 percent of nursing home residents are women).
And unsurprisingly, those in poorer health have higher out-of-pocket spending because they need more medical treatment during the year. In 2016, Medicare enrollees who reported being in poor health spent $6,384 in premiums and out-of-pocket health costs, while those who reported being in excellent or good health had average costs of $4,715.