Median Annual Out-of-Pocket Health Care Costs for People Aged 70 or Older: $2,012

One of the biggest concerns of the American public is not having enough money to pay for health expenses in old age. Only 14 percent of workers and 26 percent of retirees feel "very confident" they will have enough money to pay for medical care throughout retirement, according to the 2018 Employee Benefit Research Institute's Retirement Confidence Survey.

How much do older Americans pay out-of-pocket for medical care in their final decades of life? That question has an answer: a median of $2,012 per year in addition to the cost of health insurance, according to Sudipto Banerjee of the Employee Benefit Research Institute. He estimated the out-of-pocket medical costs of people from age 70 until death, using longitudinal data from the Health and Retirement Study. The estimate is in 2015 dollars and adjusted for medical inflation.

A couple thousand dollars a year doesn't sound too bad. Many retirees can pay for those expenses out of current income rather than dipping into savings. But, here's the catch—some older Americans will pay much more. Those with the bad luck to end up in the 95th percentile of medical expenses, for example, must cough up $19,103 per year out-of-pocket. It's hard to pay bills like that without tapping into savings or running out of money altogether.

Long-term care costs are driving up out-of-pocket medical expenses for the unfortunate few. To cover those costs, retirees must drain savings accounts, and many ultimately become dependent on Medicaid—the health insurance program for the poor. By the end of life, 33 percent of retirees in the HRS study were dependent on Medicaid to cover their health care costs, up from only 11 percent who were on Medicaid at age 70.

No one knows whether they will need long-term care, but the numbers are not encouraging. Banerjee's study shows that 38 percent of men and 51 percent of women aged 70 will receive nursing home care at some point before they die.

With the threat of long-term care costs looming, many retirees are hesitant to spend their savings. (See the Demo Memo post about another Banerjee study showing this to be the case.) "This raises a question about whether, if such risks could be insured more efficiently, retirees would be able to spend their retirement assets more freely and whether this might improve their personal welfare and/or have positive macroeconomic effects as well," Banerjee concludes.

Source: Employee Benefit Research Institute, Cumulative Out-of-Pocket Health Care Expenses After the Age of 70