Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Drug Expenses

This measure reports the percentage of Medicare beneficiaries with high medical expenses for prescription drugs that are not covered by their health insurance coverage.  High out-of-pocket cost is defined as exceeding a threshold percentage of income (i.e. 10%, 15%, and 20% of income).

Data Source: Medical Expenditure Panel Survey (MEPS)

Metrics Calculation

Percentage of Medicare beneficiaries with out-of-pocket medical costs (not covered by the government or a third party) exceeding particular threshold of reported income. The numerator is out-of-pocket prescribed medicines expenses. The denominator is total individual income. The result is then allocated to one of the following categories: Exceeding 10% of Income; Exceeding 15% of Income; Exceeding 20% of Income.

Additional Information

Inclusion Criteria: Individual reported to be enrolled in Medicare some time during the reference year, civilian non-institutional population.

Exclusion Criteria: Excluded from this measure are people in the military and the institutional population. Also excluded are people who did not report being enrolled in Medicare.

 

This measure is calculated by AHRQ from the MEPS.

{dataset.metadata.custom_fields.ASPE.Chart Title}

Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Drug Expenses

Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses among those with Medicare Coverage

Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses by Medicare Coverage

18 Medicare Coverage

In order to define coverage types, disability is defined as follows: Individuals were identified as having a disability if any of the following conditions existed: One or more Activities of Daily Living impairments, blindness, or deafness.

{dataset.metadata.custom_fields.ASPE.Chart Title}

Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses by Ethnicity

[ Measure 18 : Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses | Ethnicity

For more information on how ethnicity was defined, please see the Glossary under Help.

{dataset.metadata.custom_fields.ASPE.Chart Title}

Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses by Race

] Measure 18 : Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses | Race

For more information on how race was defined, please see the Glossary under Help.

{dataset.metadata.custom_fields.ASPE.Chart Title}

Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses by Age Group

Measure 18 : Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses | Age Group

Data are not available for 19-25 year-old Medicare beneficiaries because of sample size limitations.

{dataset.metadata.custom_fields.ASPE.Chart Title}

Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses by Number of Chronic Conditions

Measure 18 : Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses | Chronic Condition

For more information on how chronic conditions were defined, please see the Glossary under Help.

{dataset.metadata.custom_fields.ASPE.Chart Title}

Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses by Income Level

Measure 18 : Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses | Income Level

Poverty is defined by Census Bureau poverty thresholds. For more information on the definition of poverty, please see the Glossary under Help.

{dataset.metadata.custom_fields.ASPE.Chart Title}

Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses by Metropolitan Status

Measure 18 : Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses | Metropolitan Status

For more information on how metropolitan status was defined, please see the Glossary under Help.

{dataset.metadata.custom_fields.ASPE.Chart Title}

Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses by Region

Measure 18 : Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses | Region

For more information on how regions are defined, please see the Glossary under Help.

{dataset.metadata.custom_fields.ASPE.Chart Title}

Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses by Sex

Measure 18 : Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses | Sex

{dataset.metadata.custom_fields.ASPE.Chart Title}

Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Expenses by Disability Status

Measure18 By Disability Status

Individuals were identified as having a disability if any of the following conditions existed: One or more Activities of Daily Living impairments, blindness, or deafness.