Your Medicare Patients Are Struggling

Psychiatric TimesVol 40, Issue 11

About 1 in 6 of Medicare patients report trouble paying Medicare bills and debt.

Rix Pix_AdobeStock

Rix Pix_AdobeStock

A new report from the Commonwealth Fund looked at the financial struggles of Medicare patients 65 years and older, and the results show that many still struggle with costs and coverage.1

Researchers surveyed 1604 adults (65 years and older) who were on Medicare, and the findings illustrate that although many have government-sponsored health care, they can often struggle with obtaining and paying for care. Following are some of the key findings.

  • Medicare patients are often in poverty. More than 1 in 3 participants reported incomes below 200% of the federal poverty level ($27,180 for an individual and $36,620 for a couple).
  • Many Medicare patients are underinsured. About 1 in 5 (19%) respondents reported high health care costs in the past year that make them underinsured. Underinsured rates were highest (33%) for those with low incomes (< 200% of federal poverty level).
  • Many cannot afford their premiums. Almost a quarter (23%) of respondents reported struggling to afford premium costs associated with their health insurance. For those with lowest incomes, almost half (48%) on traditional Medicare plans struggled with premium costs.
  • Older adults on Medicare often delayed or skipped care. About 8% of participants skipped recommended tests, treatments, or follow-up visits due to cost. Similarly, about 6% did not seek care for a medical problem, and 6% likewise avoided necessary specialist visits. The study results also noted 14% did not fill prescriptions. Dental care was most affected; more than one-fourth (27%) of respondents said they delayed or avoided dental care. Overall, approximately 1 in 4 respondents reported at least 1 cost-related health care access issue.
  • Medical bills and debt are troubling for patients. About 1 in 6 (18%) reported trouble paying Medicare bills and debt. This included being contacted by a collection agency, needing payment plans, or changing their way of life to pay bills.
  • The study results also indicated 28% used all their savings to pay for medical bills, and 33% took on additional credit card debt to pay bills. Likely as a result, 28% also noted they had lower credit rankings.
  • Individuals cannot afford non-medical necessities. Among those reporting medical bill or medical debt problems, about 1 in 6 said they had been unable to pay for necessities like food, heat, or rent.



1. Leonard F, Jacobson G, Collins SR, et al. Medicare’s affordability problem: a look at the cost burdens faced by older enrollees. The Commonwealth Fund. September 19, 2023. Accessed October 4, 2023.

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