Goodsurance
ES

Costs & IRMAA

KFF: Medicare Beneficiaries Spent an Average of 6,459 Dollars Out of Pocket on Health Care in 2023, Equal to 36 Percent of Average Social Security Income

A May 2026 KFF brief documents how Medicare's cost-sharing structure leaves many beneficiaries carrying health expenses that rival or exceed their incomes, particularly for long-term care the program does not cover.

By the Goodsurance editorial teamAugust 12, 2026

A KFF fact brief published May 27, 2026, finds that the average Medicare beneficiary spent 6,459 dollars out of pocket on health care premiums and cost-sharing in 2023, equal to 36 percent of the average Social Security benefit per person that year. The figures reflect a program that provides broad insurance coverage but leaves significant costs for enrollees to bear directly.

One in four Medicare beneficiaries, roughly 16.5 million people, had total income below 24,600 dollars in 2024. Nearly 23 percent of beneficiaries relied on Social Security for 90 percent or more of their income. As a result, health spending consumed 14 percent of a typical Medicare household budget, compared with 6 percent for non-Medicare households.

Medicare beneficiaries spent 36 percent of their average Social Security income on health care out of pocket in 2023, KFF finds.

Long-term care emerged as the sharpest unmet financial need. The median annual cost of a private nursing home room was 129,575 dollars in 2026, well above the median Medicare beneficiary income of 43,200 dollars. Round-the-clock home health aide services cost an estimated 305,760 dollars per year. Original Medicare covers neither long-term custodial nursing home care nor sustained home aide services.

Prescription drug costs compound the burden for beneficiaries without low-income subsidies, who averaged 872 dollars in Part D out-of-pocket expenses in 2023. Those in fair or poor health averaged 1,671 dollars. Dental services cost traditional Medicare enrollees a median 1,107 dollars annually, and hearing services cost a median 564 dollars, since Original Medicare generally excludes both.

One in five Medicare-age adults, 22 percent, reported carrying some form of medical or dental debt in 2022.

In plain words

KFF studied how much Medicare beneficiaries pay for health care themselves. In 2023, the average person with Medicare paid 6,459 dollars out of pocket. That is 36 cents of every dollar they received from Social Security. One in four Medicare enrollees had income below 24,600 dollars a year. Medicare does not cover nursing home stays for daily living help, which can cost 129,575 dollars a year or more. Home care around the clock costs even more. One in five Medicare-age adults had medical debt. Drug costs are also high for those who do not get extra help. Having Medicare does not mean health care is affordable for everyone.

Understand the basics first

Source: KFF
Read at the source →

More news

Other stories on what is moving in Medicare.

Costs & IRMAA

Medicare Will Pay 20 Percent Less for the Cheaper Service When a Doctor Bills Both a Visit and a Procedure on the Same Day Starting in 2027

A provision in the final 2027 physician pay rule, published today in the Federal Register, trims reimbursement when a physician furnishes an office visit and a minor procedure on the same date. CMS projects the change will prevent approximately 2.38 billion dollars in extra Medicare payments over the next 10 years.

November 9, 2026

Costs & IRMAA

Medicare Finalizes 2027 Outpatient Rule, Cutting Drug Costs for Patients at Hospital Clinics

CMS issued a final rule November 4 that sets a 2.3 percent hospital outpatient payment increase for 2027 and lowers what Medicare pays hospitals for 340B-acquired drugs, projecting average savings of about 900 dollars for beneficiaries who receive a qualifying drug at a hospital outpatient department.

November 5, 2026

Costs & IRMAA

Nearly All Medicare Stand-Alone Drug Plan Members Will Face a Deductible in 2027, With Averages Up Sharply

A KFF analysis of 2027 Part D plan designs finds average deductibles rising to 643 dollars for stand-alone plan enrollees and 489 dollars for Medicare Advantage drug plan members, while the share of enrollees subject to any deductible expanded in both plan types.

October 30, 2026

Costs & IRMAA

CMS Finalizes 2027 Medicare Dialysis Payment Rate at 297 Dollars and 52 Cents, With a Larger Add-On for Home Dialysis Training

A final rule issued October 28 sets the per-treatment base rate for kidney dialysis facilities and raises the payment designed to encourage training patients to do dialysis at home.

October 29, 2026

Costs & IRMAA

Medicare's Hospital Fund Is Projected to Fall Short of Full Payment Capacity by 2033, Trustees Report Finds

The 2026 Medicare Trustees Report projects the Part A Hospital Insurance fund will be partially depleted in 2033, at which point incoming revenues would cover only 89 percent of covered costs, absent new legislation.

October 26, 2026

Costs & IRMAA

KFF: Nearly Half of Traditional Medicare Beneficiaries Hold Medigap, as Average Monthly Premiums Reach 244 Dollars

A KFF analysis released two days before open enrollment finds 12.9 million people carry supplemental Medigap policies, that average premiums rose 7 percent in a single year, and that Plan G now covers nearly half of all policyholders.

October 15, 2026