Medicare provides a vital foundation for the health and wellness of Americans who are 65 or older or have significant disabilities. The program currently covers a portion of health care costs for over 47 million individuals throughout the United States.

Although Medicare has been a trusted health organization for almost half a decade. It covers 60% of the hospitalization, almost 80% of the doctor’s bill, and other precautionary services. However, now its beneficiaries are facing higher costs for the benefits it offers.

In recent years several factors, including an economic downturn and policies by lawmakers, have caused the costs of services and care to shift even further to the beneficiary. Many deficit reduction proposals include changes to Medicare cost-sharing.

A huge population of US relies on the Medicare. And in the coming years, more people will be under Medicare coverage. However, this benefit does not include all the medical facilities.

For example, cosmetic surgery, dental and vision care, hearing aid, long term care, care delivered outside of USA, Acupuncture and other alternative care. So the beneficiaries end up paying half of their income for the benefits excluded from Medicare.

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Effect of Higher Out-of-Pocket Expenses:

The threat of taking even more from their income endangers not just the financial stability, but the health of these vulnerable beneficiaries. Though some policy makers contend that requiring Medicare beneficiaries to pay more out-of-pocket for their health care makes them better health care consumers and reduces “unnecessary” care, studies conducted over the past decade show that increased cost-sharing in fact often has serious adverse effects on beneficiaries.

• Increased cost-sharing has been shown to have a direct negative effect on beneficiary utilisation of necessary services, appropriate drug use, and health outcomes.
• Increased cost-sharing and out-of-pocket expenses disproportionately affect women and minorities, who may for go critical prevention screenings and skimp on medications due to high costs.
• In a recent poll, 86% of those over the age of 65 as well as 89% of those aged 18-64 opposed requiring seniors to pay a larger share of Medicare costs out of pocket.

Supplemental Coverage:                                                       

• Supplemental coverage can help shield patients from some out-of-pocket expenses if they can afford the added premium payments.  But many on limited incomes cannot.  The report notes that annual premiums for supplemental coverage average $2,000 but can be “much higher.” Out-of-pocket spending for patients without supplemental coverage is about $7,000 per year, more than twice the Medicare average.
• Seniors with multiple chronic conditions also face a significant out-of-pocket cost burden.  About one-third of patients with three or more chronic conditions paid 20 percent of their income for premiums and medical care. And for chronic disease patients who also qualify as low income, the proportion is even higher; 42 percent spent one-fifth of their income on out-of-pocket medical care.

“Medicare faces substantial challenges as the overall cost of health care continues to rise and as the population gets older. The Affordable Care Act started to address these changes through payment and delivery system reforms, and through an increased focus on eliminating fraud, waste and abuse. However, proposals to further shift the burden of costs for health care to beneficiaries who are already reeling from the economic downturn and other rising costs are short-sighted, risk the health and wellness of Medicare beneficiaries, and place a further financial burden on them and their families”.