We need to expand Medicare so that it covers all essential medical costs. Today, people with Medicare typically spend $4,000 a year out-of-pocket on health care costs. While the Medicare premiums and cost-sharing are their biggest expense, according to a May 2017 Commonwealth Fund issue brief, long-term care, prescription drugs and dental care, which Medicare do not cover, take a big toll on their pocketbooks. As a result, people with limited incomes and people with costly health care needs. often are forced to go without critical uncovered care, which tends to be unaffordable.
- For the general Medicare population, long-term care represents more than a quarter (28 percent) of out-of-pocket spending and prescription drugs represent another quarter (25 percent) of their spending. Dental care represents 11 percent. Seven out of 10 older people will eventually need long-term care services and supports.
- For people with Medicare living in the community, not in a nursing home, long-term care represents 8 percent of total out-of-pocket health care spending. Prescription drug costs represent a third (33 percent) of out-of-pocket costs. Dental care represents 14 percent.
- People with several chronic diseases or severe cognitive or physical conditions typically spend more than three times more out of pocket than people in good health, $5,519 vs. $1,549.
The Commonwealth Fund issue brief does not take into consideration the hundreds of billions of dollars in Medicaid cuts in President Trump’s and the GOP’s proposed budgets. More than 11 million people with Medicare depend on Medicaid to help pay for premiums and health care services that Medicare does not cover. If these cuts are enacted, out-of-pocket costs will rise dramatically for these “dual-eligibles” and many of them will likely have no choice but to go without necessary care.

Here’s more from Just Care:
- Health care needs can lead to enormously high out-of-pocket costs for people with Medicare
- Medicare premiums and cost-sharing in 2017
- Medicare for all controls spiraling health care costs
- ACA repeal would mean higher costs for people with Medicare as would AHCA enactment
- Six tips for keeping your drug costs down if you have Medicare
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