Medicare is the federal program that gives well being protection to over 66 million individuals ages 65 and older and youthful individuals with long-term disabilities. Greater than half of all individuals with Medicare are ladies, together with greater than 31 million ages 65 and older and about 4 million underneath age 65 with long-term disabilities. Medicare performs a key position in supporting the well being and well-being of girls, overlaying a broad vary of providers important to ladies’s well being, together with preventive, reproductive, main, and specialty care, and prescribed drugs.
This transient presents 10 key details about ladies with Medicare, based mostly on knowledge from varied sources (see strategies for added info). (A separate KFF transient, Protection of Sexual and Reproductive Well being Providers in Medicare, describes Medicare protection of providers for ladies of reproductive age.) The language used right here makes an attempt to be as inclusive as doable, however the evaluation attracts on survey knowledge that makes use of particular gender labels for feminine and male for the information 12 months used for this evaluation, not inclusive of gender non-binary, transgender and different gender expansive identities. As well as, because of pattern measurement and knowledge assortment limitations, evaluation is unavailable by race and ethnicity for Asian adults, American Indian and Alaska Native adults, and Native Hawaiian and Pacific Islander adults.
1. Extra Than Half of All Individuals with Medicare Are Girls, a Proportion That Rises with Age
In 2021, greater than half (55%) of all Medicare beneficiaries had been ladies and 45% had been males (Determine 1). Of the greater than 35 million ladies with Medicare, about 4 million are underneath age 65 with long-term disabilities (11%) and 4.3 million are ages 85 and older (12%). Since ladies stay longer than males, on common (having 19.7 years of life expectancy at age 65 vs. 17 for males in 2021), ladies characterize a bigger share of older age cohorts. For instance, almost two-thirds (63%) of Medicare beneficiaries ages 85 and older are ladies.
2. Amongst Girls with Medicare, Beneficiaries Below Age 65 with Disabilities Are Extra Prone to be Black and Hispanic Than Girls in Older Age Teams
Reflecting the demographics of older residents of the U.S., White persons are the most important racial/ethnic group amongst individuals with Medicare, each women and men, whereas Black and Hispanic individuals collectively characterize roughly 2 in 10 beneficiaries. Amongst ladies with Medicare, Black and Hispanic ladies characterize bigger shares of these underneath age 65 – who qualify for Medicare because of having a long-term incapacity – than of girls ages 65 and older (Determine 2). Individuals on Medicare who’re underneath age 65 with disabilities report worse entry to care, extra value issues, and decrease satisfaction.
3. Girls with Medicare Are Extra Prone to Reside Alone or in a Facility Than Males; the Identical is True for Girls Ages 85 and Older In comparison with Youthful Girls
Amongst Medicare beneficiaries, ladies are extra seemingly than males to stay alone, which can pose challenges as they get older and are at higher probability of needing long-term care providers and helps (LTSS). Multiple-third of all ladies with Medicare (36%) stay alone, rising to greater than half (53%) of all ladies ages 85 and older (Determine 3). Girls ages 85 and older are additionally significantly extra seemingly than ladies ages 65 to 84 to stay in facility (11% vs. 1%), together with nursing properties, assisted residing amenities, and different long-term care amenities. Medicare presents solely time-limited protection for expert nursing facility providers (as much as 100 days) and doesn’t sometimes cowl long-term care providers and helps wanted by people who find themselves unable to take care of themselves locally. (Medicaid is the first payer of LTSS within the U.S., overlaying 20% of girls with Medicare in 2021, as described beneath.)
4. Girls Are Extra Probably Than Males to Be Enrolled in Medicare Benefit, and Amongst Girls, Medicare Benefit Enrollment Charges Are Larger for Twin-Eligible People and Girls Who Are Black or Hispanic
Medicare beneficiaries can select to get their Medicare advantages by the standard Medicare program or a non-public Medicare Benefit plan. Many Medicare beneficiaries even have some sort of further protection, which may help with Medicare cost-sharing necessities and, in some cases, offers advantages not in any other case lined by Medicare. This consists of Medicaid, the federal-state medical insurance program for individuals with low-incomes and modest property.
In 2021, 49% of girls lined by Medicare had been enrolled in Medicare Benefit plans, a considerably greater share than males (46%) (Determine 4). (The share of all eligible Medicare beneficiaries enrolled in Medicare Benefit has elevated since then and now exceeds 50% of all eligible beneficiaries.) Bigger shares of Black and Hispanic ladies with Medicare had been enrolled in Medicare Benefit in 2021 than White ladies (68%, 63%, and 44%, respectively).
In 2021, 20% of girls with Medicare had been additionally enrolled in Medicaid. Girls underneath 65 had been enrolled in Medicaid at over thrice the speed of girls ages 65 and older (59% vs. 16%); Black (47%) and Hispanic (48%) ladies with Medicare had been additionally considerably extra prone to have Medicaid than White ladies (13%). Having supplemental Medicaid protection provides ladies monetary help in paying their Medicare deductibles and price sharing, whether or not they obtain their Medicare protection by conventional Medicare or a Medicare Benefit plan. As well as, they qualify for protection of long-term providers and helps underneath Medicaid than can present assist for care in a facility or community-based at residence supportive care to help with a variety of well being and purposeful wants.
5. Per Capita Earnings Is Decrease for Girls with Medicare Than Males, Declines with Age, and Is Considerably Decrease for Black and Hispanic Girls Than White Girls
Total, ladies with Medicare have decrease per capita incomes than males. That is largely because of the truth that common Social Safety earnings and pension advantages are decrease for ladies than males, primarily as a result of ladies usually have lower-paying jobs than males throughout their working years and since many labored part-time or left the workforce for intervals of time to lift households or take care of getting old relations. For instance, the common annual Social Safety profit was considerably decrease for ladies than males ages 65 and older in 2021 – $14,204 and $18,101, respectively.
KFF evaluation reveals that in 2023, half of all ladies with Medicare had per capita earnings of $33,750 or much less, which is about $5,000 decrease than median per capita earnings for males with Medicare ($38,950) (Determine 5). Amongst these ages 65 and older, median earnings declines with age, from $38,150 for ladies ages 65 to 74 to $25,850 for ladies 85 and older. Median earnings can also be considerably decrease for Black and Hispanic ladies in comparison with White ladies; half of all Black ladies with Medicare had per capita incomes of $25,500 or much less, and half of all Hispanic ladies with Medicare had per capita incomes of $18,750 or much less in 2023, in comparison with median per capita earnings of $38,250 for White ladies.
6. Per Capita Financial savings Are Decrease for Girls Than Males, and Black and Hispanic Girls with Medicare Have Considerably Decrease Financial savings Than White Girls
As with earnings, financial savings are additionally a lot decrease for ladies with Medicare in comparison with males, with half of all ladies having per capita financial savings of $90,850 or much less in comparison with $120,450 for males (Determine 6). Amongst ladies with Medicare, each the youngest and the oldest age cohorts have considerably decrease per capita financial savings than ladies ages 65 to 74 ($131,100, in comparison with $40,900 for these underneath age 65 and $31,850 for these ages 85 and older).
Median per capita financial savings are a lot decrease for Black and Hispanic ladies than White ladies with Medicare. Half of all Black ladies have $19,300 or much less in financial savings, which is 7 occasions decrease than that of White ladies in 2023. Half of all Hispanic ladies have financial savings of $16,350 or much less, which is almost 9 occasions decrease than that of White ladies. Variations in earnings and financial savings amongst Black and Hispanic ladies in comparison with White males and White ladies mirror the cumulative affect of variations in schooling, job alternatives, entry to retirement advantages and inherited wealth. Girls total are additionally barely extra prone to haven’t any financial savings or to be in debt in comparison with males (11% vs. 9%).
7. Extra Than Half of Girls with Medicare Below Age 65 and Ages 85 and Older Have a Practical Impairment; These Girls Expertise Larger Charges of Cognitive Impairment and Truthful/Poor Well being Standing In comparison with Girls of Different Ages
Reflecting the truth that for individuals underneath age 65, eligibility for Medicare is predicated on having a long-term incapacity, ladies with Medicare underneath age 65 expertise significantly greater charges of purposeful and cognitive impairment and poorer well being standing than their older counterparts on Medicare. Half of these underneath age 65 have a cognitive impairment, over thrice the speed of girls ages 65 and older (14%) (Determine 7). Girls underneath age 65 are additionally extra prone to have a purposeful impairment (56%) than ladies ages 65 and older (26%). Girls underneath age 65 report honest or poor well being (52%) at over thrice the speed of girls ages 65 and older (16%) and usually tend to have 5 or extra persistent circumstances (24%) in comparison with older ladies (17%).
Measures of total well being, cognitive, and purposeful standing additionally mirror the poorer well being standing of girls within the oldest age cohort relative to different older ladies. Greater than half of girls ages 85 and older have a purposeful impairment (54%), almost double the speed amongst ladies ages 65 to 84 (23%). Practically one-third of girls ages 85 and older have a cognitive impairment (30%) in comparison with 11% of girls ages 65 to 84. Girls ages 85 and older are additionally considerably extra seemingly than ladies ages 65 to 84 to be in honest or poor well being (20% vs. 16%) and have 5 or extra persistent circumstances (24% vs. 16%).
A considerably greater share of girls than males have a purposeful impairment together with limitations in actions of day by day residing (30% of girls vs. 25% of males) and have 5 or extra persistent well being circumstances (18% vs. 15%) (Appendix Desk 1). Related shares of ladies and men have a cognitive impairment (18% vs. 16%), and report being in honest or poor well being (20% for each teams).
8. Black and Hispanic Girls with Medicare Report Poorer Well being Standing and Have Larger Charges of Cognitive and Practical Impairments Than White Girls
Black and Hispanic ladies with Medicare are considerably extra seemingly than White ladies with Medicare to fare worse alongside sure measures of well being standing. For instance, almost 4 in ten (38%) Black and Hispanic ladies have a purposeful impairment in comparison with lower than three in ten (27%) White ladies; 26% of Hispanic ladies and 21% of Black ladies have a cognitive in comparison with 16% of White ladies (Determine 8). Moreover, 36% of Hispanic ladies and 27% of Black ladies report being in honest or poor well being in comparison with 18% of White ladies.
9. Amongst Girls with Medicare, Coronary heart Illness, Alzheimer’s/Dementia, and Incontinence Are Extra Widespread Amongst These Ages 85 and Older; Despair, Lung Illness, and Diabetes Are Extra Widespread Amongst These Below Age 65
Well being circumstances of girls enrolled in Medicare differ by age cohort (Determine 9, Appendix Desk 1). Girls ages 85 and older are considerably extra seemingly than ladies ages 65 to 84 to have coronary heart illness (41% vs. 25%), Alzheimer’s/dementia (17% vs. 3%), and urinary incontinence (53% vs. 34%). Girls underneath 65 are considerably extra seemingly than ladies 65 and older to have melancholy (63% vs. 27%), diabetes (37% vs. 29%) and pulmonary illness (33% vs. 19%).
Girls with Medicare total expertise greater charges of sure well being circumstances in comparison with males; for instance, urinary incontinence (37% vs. 18%), melancholy (31% vs. 21%), osteoporosis (29% vs. 7%), and pulmonary illness (20% vs. 16%) (Appendix Desk 1). Conversely, a bigger share of males than ladies with Medicare had coronary heart illness (35% vs. 26%) and diabetes (33% vs. 30%).
10. A Related Share of Girls and Males with Medicare Report Well being Care Price Issues; Amongst Girls, They Are Most Generally Reported by These Who Are Low-Earnings, Below Age 65, or in Truthful or Poor Well being
Gaps in advantages, cost-sharing necessities, and premiums for Medicare and supplemental protection can result in cost-related challenges for some individuals with Medicare, together with bother getting care because of value or cash, delay in care because of value, or issues paying medical payments. In 2021, an analogous share of ladies and men with Medicare (12% vs 10%, respectively) reported that they confronted at the very least a number of of those cost-related issues (Determine 10; knowledge for males not proven). A better share of girls underneath age 65 (29%), Black (19%) and Hispanic (13%) ladies, ladies in honest or poor well being (24%), and ladies with incomes beneath $20,000 (20%) reported experiencing extra cost-related challenges than their counterparts.
Strategies |
This evaluation is predicated on knowledge from the Facilities for Medicare & Medicaid Providers 2021 Medicare Present Beneficiary Survey (MCBS) (the latest 12 months out there), a nationally consultant survey of Medicare beneficiaries. Sources of protection are decided based mostly on the supply of protection held for probably the most months of Medicare enrollment in 2021. For extra info, see strategies within the following transient: A Snapshot of Sources of Protection Amongst Medicare Beneficiaries.
The evaluation on cost-related issues excludes beneficiaries in institutional settings for the reason that evaluation was based mostly on questions requested of neighborhood residents solely. “Price-related issues” was outlined based mostly on optimistic responses to any of the next 4 questions:
Earnings and asset ranges in 2023 are based mostly on the City Institute’s Dynamic Simulation of Earnings Mannequin (DYNASIM4). DYNASIM4 is a dynamic microsimulation mannequin that initiatives the inhabitants and analyzes the long-term distributional penalties of retirement and getting old points. See Earnings and Belongings for Medicare Beneficiaries in 2023 for extra info on strategies. |