Medicare beneficiaries spent a median of more than $3,100 of their own money on health expenses in 2007, the most recent comprehensive data, according to the AARP's Public Policy Institute. Four million beneficiaries, or 10 percent of the Medicare population, shelled out much more. Their out-of-pocket spending topped $7,800.
With health care costs outpacing income growth, study lead author Dr. David Grande, assistant professor of medicine at the University of Pennsylvania Perelman School of Medicine, wanted to know how families are coping financially.
"My sense is that we focus so much on whether people are covered or not, which is extremely important, we forget how important it is that the coverage is adequate," he said.
For the study, researchers interviewed 33 insured, chronically ill adults who were applying for financial assistance at a nonprofit foundation to help pay for their treatment costs. People were asked about illness-related financial challenges and their impact on housing, food, utilities, savings, borrowing and health expenses. The interviews were recorded, transcribed and coded for analysis.
Most of the study participants had Medicare, while the rest had employer coverage or temporary group coverage under COBRA. One had Medicaid.
About 85 percent of patients had annual incomes of $40,000 or less, and more than a third of those people lived on $20,000 or less.
Gaps in coverage, particularly Medicare's "doughnut hole" in prescription drug coverage, and benefit designs that make spending from month to month unpredictable, were among the key disruptions that study participants cited.
To pay medical bills, some people described compromises in housing and transportation. In one case, newer cars were voluntarily repossessed and replaced with a "junker."
Grande found patients' use of credit cards to cov
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