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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).

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.

Age Group

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



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Disability Status

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



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Ethnicity

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



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Income Level

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



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Medicare Coverage

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



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Metropolitan Status

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



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National Summary

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



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Number of Chronic Conditions

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



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Race

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



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Region

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



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Sex

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



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