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What Medicare doesn't pay for becomes hefty debt for millions of seniors

Kerry Hannon

8 min read

Connie Morton’s husband died last November. The cause: complications from Parkinson’s disease, which he had been living with for 18 years.

“During that time, there were multiple medical costs not covered by Medicare,” the Colonial Beach, Va., resident told Yahoo Finance. “We paid what we could. For the last nine years of his life, he could no longer work. I became his caretaker, and we survived on Social Security and some help from his kids.”

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A growing number of retirees, like Morton, are grappling with healthcare debt due to medical bills. Medicare, which provides health insurance coverage to more than 66 million people, covers the lion’s share of the cost of medical care, but not all.

On average, a 65-year-old who left the workforce last year may need $165,000 in savings to cover out-of-pocket healthcare expenses throughout retirement.

Earlier this year, Morton broke her ankle. “That also added up to significant hospital bills,” she said.

The combination of medical bills not covered by Medicare for the retired couple: roughly $90,000.

“I'm at a point now where I can't keep my house because the bills are much too high,” Morton said. “I'm trying to decide what I'm going to do.”

One in 10 people age 65 or older with healthcare debt owe $10,000 or more, according to a KFF study.

“That is a shocking number,” said Tricia Neuman, senior vice president of KFF. “Some of it is credit card debt, some of it is just debt owed to a healthcare provider or a hospital. Some of it is debt to other family members.”

Consider that half of all people on Medicare live on about $35,000 or less, Neuman added. “So a $10,000 bill, or $10,000 worth of medical debt, can really be unaffordable for people and have serious consequences.”

The bills that lead to the debt typically include routine healthcare services such as lab fees and diagnostic tests, dental care, and visits to the doctor, and long-term care services not covered by Medicare, according to KFF. Medicare often requires patients to pay out of pocket around 20% of their doctor bills.

“In-home care for people who are unable to take care of themselves and don't have family members that can drop everything to be there 24/7, is particularly big,” she added. “It's a variety of healthcare expenses that can pile up and lead to medical debt.”

One of the biggest culprits of credit card debt is out-of-pocket medical costs. The amount that people borrow increases dramatically with age. Half of adults 50 and older who report borrowing money to pay for healthcare in the past 12 months borrowed approximately $3,000 or more, according to a new West Health-Gallup healthcare survey. In contrast, the median amount was $750 for adults aged 30-49 and $300 for young adults aged 18-29.