July 1, 2000
Cathy Schoen, Karen Davis, Elisabeth Simantov and Lisa Duchon
Counting on Medicare: Perspectives and Concerns of Americans Ages 50 to 70, Cathy Schoen, Elisabeth Simantov, Lisa Duchon, and Karen Davis, The Commonwealth Fund, July 2000
Americans ages 50 to 70those nearing the age of Medicare eligibility and those who recently enrolled in the programplace high value on Medicare. At the same time, many people in this age group are struggling to pay for prescription drugs, which Medicare doesn't cover. Medicare's benefit package was designed when the program was established in 1965 and hasn't changed significantly since then, despite the fact that drugs play an increasingly crucial role in modern medicine and in people's ability to live longer, healthier, and more productive lives. Counting on Medicare: Perspectives and Concerns of Americans Ages 50 to 70
reveals that adults not yet eligible for Medicare are eager to join the program. Two-thirds of adults 50 or older but not yet eligible for Medicare say they would be interested in participating early, before age 65. And when respondents were asked who they would trust most to insure people their age, Medicare received the highest rating, outranking employer-sponsored coverage or direct purchase of insurance. Sixty-eight percent of Medicare beneficiaries ages 65 to 70 say it was ""very important"" for them to become covered by Medicare.
But the absence of comprehensive prescription drug coverage is a major concern among the 50 million people ages 50 to 70. Although eight of 10 adults in this age group have a health condition requiring regular use of prescription drugs, only half (54%) report having a drug benefit. Whether they are currently in Medicare or nearing eligibility, respondents lacking a drug benefiteven if they have other insurancereport high levels of out-of-pocket spending, difficulties affording doctors' recommendations for care, and struggles paying medical bills. One of 10 (9%) adults ages 50 to 64 and nearly one of six (16%) ages 65 to 70 report that they typically spend more than $100 per month out-of-pocket for prescription medications. Not surprisingly, men and women ages 50 to 70 endorse the idea of adding prescription drug coverage to the basic Medicare package: eight of 10 either strongly favor (62%) or somewhat favor (20%) such a proposal.
One explanation for the trust many people ages 50 to 64 place in Medicare may be their high uninsurance rates and instability of coverage combined with an increased risk for chronic, acute, or disabling health conditions. About 5.6 million of the 39 million men and women in this age group are uninsured, and those who are tend to go without needed medical care and remain uninsured for long stretches of time. One of five 50-to-64-year-olds reports a time without coverage since turning 50, including 15 percent who were uninsured during 1999.Facts and Figures
- Medicare beneficiaries ages 65 to 70 are more likely than adults ages 50 to 64 to be very confident in their ability to obtain quality medical care when needed and to be satisfied with the quality of that care.
- Otherwise-insured adults ages 50 to 70 lacking a drug benefit are three times as likely as those with drug coverage to have let a prescription go unfilled because of the cost.
- The majority (53%) of adults 50 to 64 who were uninsured in the past year say they have been without health insurance for three years or more. Nearly seven of 10 who were uninsured for a time during 1999 have been without coverage for a year or more.