Medicare Blog

how baby boomers will affect medicare costs

by Roy Brekke Published 2 years ago Updated 1 year ago
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That one year drop in average age is significant for Medicare costs. An influx of Baby Boomers enrolling in Medicare is playing a role in slowing down an increase in costs for Medicare Part A, which funds hospital stays, skilled nurse facilities, hospice and parts of home health care.

Aging comfortably as a baby boomer is a major concern. By 2020, retiring baby boomers are expected to more than double Medicare and Medicaid costs. As a result, some pundits anticipate that the Trust Fund will be bankrupt by 2033. Meanwhile, taxes will cover only 48 percent of the associated health care costs.

Full Answer

How will baby boomers affect Medicare?

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Do Baby Boomers need life insurance?

The Insurance Information Institute recommends that baby boomers consider buying or extending life insurance, which can fulfill financial obligations after your death and provide financial aid to your survivors like spouses, children or even parents. Consider whole or universal life insurance, which include savings components.

Are baby boomers healthier than prior generations?

When comparing today's older adults to those a century ago, the results favor baby boomers. Thanks to vaccines and antibiotics, baby boomers are less likely to suffer from infectious diseases and acute illness. Chronic diseases (heart disease, diabetes and arthritis, for example) develop 10 to 25 years later in life [source: Kolata ].

Why are baby boomers really delaying retirement?

Whether it’s out of need or desire, baby boomers are changing the face of retirement by delaying it- as long as possible in many cases. Here are the main reasons why. Common Reasons Older Adults Delay Retirement. Debt & Savings. It’s obvious that for many boomers, the when, how, and where factors of retirement are determined by money. The Great Recession caused some boomers to put thoughts of retiring on the back burner.

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When did Medicare spend growth slow?

Across all Medicare age groups, even the oldest beneficiaries, annual Medicare per-beneficiary spending growth was low from 2007 to 2015. If the Medicare age distribution had not changed during this time, the Medicare program would have still experienced lower spending growth. The Slowdown in Medicare Spending Growth for Baby Boomers ...

What age group did Medicare increase?

Even though there was a large increase in Medicare beneficiaries ages 65 to 74 when the baby boomers began entering Medicare, this age shift does not explain why Medicare spending per beneficiary has grown so little in recent years. Across all Medicare age groups, even the oldest beneficiaries, annual Medicare per-beneficiary spending growth was ...

How much did Medicare spend on beneficiaries in 2015?

Among beneficiaries age 90 and older, spending per beneficiary increased by 10.0 percent from $12,948 in 2007 to $14,244 in 2015. Almost all age groups among traditional beneficiaries younger than age 65 had increases in Medicare spending levels from 2007 to 2015.

What age group did the spending rate decline in 2009?

The timing of when spending growth rates began to decline varied by age group. Unlike older beneficiaries, those ages 65 to 79 had modest increases in 2009 spending growth. In contrast, 2009 marked the first year of declining spending growth for beneficiaries 80 and older during this time period.

What is the downside of Medicare?

Although Medicare offers exceptional benefits, the big downside to Medicare plans is that they only cover 80% of medical expenses. That leaves a retiree owing the remaining 20% themselves without an out-of-pocket spending limit to protect them.

What are the challenges of Medicare?

The challenges that retirees face when they are Medicare-eligible also include being inundated with marketing information through the mail, over the phone and through the various forms of television and social media. It can make what should be an exciting time for the retiree stressful.

What are the three most common standardized plans used to supplement Medicare?

The three most popular standardized plans used to supplement Medicare are Plans F, G and N. Since Medicare does not cover prescriptions, an individual would need a stand-alone plan referred to as Part D. There is a separate monthly premium for a Medigap Supplement or a Part D plan.

What is Medicare Advantage?

More retirees today are selecting an alternative plan to traditional Medicare, called Medicare Advantage, thinking they are supplementing their Medicare card. This is in large part due to not fully understanding the Medicare process and its options.

What is traditional Medicare?

Traditional Medicare is what retirees have paid into their entire lives through their payroll taxes known as FICA. FICA is comprised of the following taxes: 6.2% Social Security tax; 1.45% Medicare tax. The Medicare tax the baby boomer generation paid into was designed so that Medicare would be their last insurance plan.

Is Medicare a primary insurance?

A Medigap plan retains Medicare as the primary insurance. I often tell retirees to think of Medicare as the body and the Medigap as the arm attached to it. The Medigap plan is accepted everywhere Medicare is accepted and is portable if someone moves or is traveling.

Is Medicare Advantage a supplement?

Having personally talked to thousands of eligible Medicare beneficiaries that have Medicare Advantage plans, most think the Medicare Advantage plan is their supplement to Medicare. Many are surprised to learn that the Medicare Advantage plan is not a supplement to Medicare, but instead an alternative plan designed to privatize ...

How many people are born in the baby boom generation?

Individuals born between the years 1946 and 1964 are categorized as baby boomers, according to The U.S. Census Bureau. Approximately 75 million Americans make up the baby boom generation, and every year for the next 20 years roughly 3 million baby boomers will reach retirement age. 2 These facts will drastically change society, ...

Why is it more expensive to treat chronic illnesses?

It’s more expensive for hospitals to treat patients with chronic conditions because those individuals are more vulnerable to other illnesses.

How many geriatricians will be needed by 2030?

According to a study conducted by the Alliance for Aging Research, 33,000 geriatricians will be needed by 2030, and currently there are only 8,800 practitioners that are certified. 1.

How many seniors will be in the US by 2030?

According to the American Medical Student Association, the population of individuals over the age of 65 will increase by 73 percent between 2010 and 2030, meaning one in five Americans will be a senior citizen.

Do boomers need special care?

Boomers will need specialized care. The overall health of the boomer generation was compared with that of their parents in a research study published in JAMA Internal Medicine.

How much does Medicare cost in 2018?

In 2018, the overall cost of Medicare per enrollee was $13,339 per year, about $30 less than it was in 2009, adjusting for inflation. That’s even as benefits across Medicare totaled $713.4 billion, $144.4 billion more than in 2009.

How many outpatient visits did Medicare Part B have in 2008?

In 2008, the average Medicare Part B enrollee had 7.33 outpatient visits during the year. In 2017, that average rose to 8.5 visits, a 16% increase.

When did Medicare reauthorization change?

In 2015, the Medicare Access and CHIP Reauthorization Act was enacted, changing how physicians are paid under Medicare. Under the program, physicians have choices, based on qualifications, to get paid by Medicare via a merit-based payment system or an incentive-based payment system.

When was the Hospital Readmissions Reduction Program enacted?

A 2018 report from the Medicare Payment Advisory Commission, the independent federal body that advises Congress on health care costs, explored the impact of the Hospital Readmissions Reduction Program (HRRP), which was enacted in 2010 giving hospitals financial incentives to cut readmission rates.

Is Medicare going up?

In response to an aging population , Medicare costs are going up. Benefits totaled $713 billion in 2018, 25% higher than in 2009, and Medicare spending accounts for a fifth of all healthcare spending as of the latest year of data. However, while program costs are increasing, there is an interesting counter-trend – the per person cost ...

Is the average age of Medicare beneficiaries getting younger?

The average Medicare beneficiary is getting younger. The average age fell from 76 to 75 between 2007 and 2017. Enrollment in all types of Medicare increased 29% during that period from 44.4 million to 58.5 million. That one year drop in average age is significant for Medicare costs.

How much does Medicare Advantage cost?

In some cases, Medicare Advantage plans have a separate premium that a member pays in addition to the standard Part B premium. According to the Centers for Disease Control and Prevention, Medicare Advantage premiums were an average of $28.00 per month in 2019, and nearly half of enrollees had no additional premium.

How much does Medicare cover out of pocket?

Some plans may, for example, have an out-of-pocket maximum of $6,700. Once a member has reached that limit, their plan will cover 100% of eligible expenses. Original Medicare doesn’t have an out-of-pocket maximum limit.

How old do you have to be to qualify for Medicare Advantage?

To be eligible for Medicare Advantage, baby boomers must be at least 65 years old or eligible for Original Medicare due to an injury or disability. They must be a U.S. citizen or a legal resident for at least five years in a row, and they must either qualify for or be enrolled in Original Medicare. They must also live within the service area of the Medicare Advantage plan that they choose.

What is Medicare Advantage?

In many ways, Medicare Advantage plans are similar to private or group healthcare plans that baby boomers had during their working years. They are run by private health insurance companies and provide comprehensive coverage for inpatient and outpatient medical care to protect members from burdensome medical bills.

Do Medicare Advantage plans have to accept preexisting conditions?

Because Medicare Advantage plan providers are required to accept any Medicare-eligible enrollee regardless of health status or preexisting conditions, they control costs through the way they structure their copays and deductibles. As enrollees age and their health needs change, their monthly premiums and other out-of-pocket expenses are likely to increase significantly.

Does Medicare Advantage have a preferred provider network?

Unlike Original Medicare, Medicare Advantage plans have preferred provider networks. If a member goes to a healthcare provider outside of this network, they will likely have a much higher out-of-pocket copay or coinsurance amount. This may be a consideration for seniors who travel often.

Do seniors have to have separate health insurance?

Seniors who have separate health insurance plans for vision, dental, prescription, long-term care and medical care not only have multiple plans to juggle, but also have various copays, premiums and deductibles to track. Comprehensive Medicare Advantage plans provide streamlined coverage, making it simpler for members to pay monthly premiums, file claims, remember copays and deductibles and track total out-of-pocket spending.

How much will the baby boomers pay for health care in 2020?

Retiring baby boomers will more than double Medicare and Medicaid costs by 2020. Retired 65-year-old couples can expect to pay $275,000 in out-of-pocket expenses for health care, excluding long-term nursing care and rehabilitation — but only have a 50 percent chance of covering these costs. On the bright side, exorbitant health spending by baby ...

How much chance of covering health care costs?

But by some estimates, they only have a 50 percent chance of covering these costs. According to a report by AARP, "the U.S. stands out for the high cost of health care and its failure to generate better health outcomes.".

What is the Medicare limit for 2035?

According to the Congressional Budget Office, by 2035 spending for Medicare alone will reach 8 percent of gross domestic product; as of 2080, that figure may be 15 percent.

What are the structural changes in the health care industry?

As health care continues to take up a larger part of the overall economy, structural changes — such as the push toward paying for value, greater emphasis on care management and increased cost sharing with consumers — are taking a stronger hold, pulling back against rapid health-care spending growth. Retiring baby boomers will more ...

How many Americans are personally responsible for retirement?

Americans are unique in that a vast majority feel personally responsible for retirement preparation — a survey by Transamerica found that 91 percent felt very or somewhat personally responsible for post-retirement income sufficiency, versus 73 percent of workers globally.

How much money do I need to retire with 40,000?

According to some industry calculations, a person with a $40,000 annual income needs $1.5 million to comfortably retire (the higher your income, the more millions you need in order to maintain your lifestyle).

Does baby boomer spending drive innovation?

If there is an upside, it's that exorbitant health spending by baby boomers has driven innovation in health care. Not all innovation leads to lowered costs, though; in fact, sometimes the opposite can occur. As new innovations, drugs and processes are created, demand for these services rise, increasing spending by an order of magnitude.

When did Medicare start?

When Medicare first launched in 1966, Americans on average were younger, lived shorter lives and had less access to expensive advanced medical care. Today, the program is hugely popular, offering much wider benefits—and is heading into a crisis.

Do people pay into Medicare when they are young?

A common assumption is that people “pay into” Medicare when they’re young and then withdraw their benefits later, but that’s not how the system really works: Since the beginning, Medicare has been funded by working-age people paying taxes to support older beneficiaries.

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