Differences in Out-of-Pocket Health Care Expenses of Older Single and Couple Households

This paper examines in detail the differences in out-of-pocket health care spending between couple and single older households. The data for this paper come from the Health and Retirement Study (HRS), a study of a nationally representative sample of U.S. households with individuals over age 50. Throughout the paper participants are classified into three different age groups: ages 65-74 (Age Group I), ages 75-84 (Age Group II), and ages 85 and above (Age Group III). All the numbers reported are for a two-year period between 2010 and 2012. This paper also includes total recurring and total non-recurring expenses for the households studied. It should be noted that health insurance premiums and spending on over-the-counter drugs are not included in this study. The average per-person out-of-pocket spending for households ages 65 and above during a two-year period on doctor visits, dentist visits, and prescription drugs (referred to collectively as recurring health care services) is roughly 2,500 for both single and couple households. This amount does not change with age. There are large differences in non-recurring health care spending (which includes overnight hospital stays, outpatient surgery, home health care, nursing home stays, and other services) between older singles and older couples, and these differences increase with age. For Age Group I, the average total non-recurring expenses were 2,790 for singles and 2,024 for couples, a difference of 766. For Age Group II, the average total non-recurring expenses went up to 5,502 and 3,930 for singles and couples, respectively, a difference of 1,572. For the oldest age group (those 85 and above), the difference went up to 4,825 ( 13,355 for singles and 8,530 for couples). Some of the largest differences in non-recurring health care spending between older singles and older couples are in home health care and nursing home expenses. This suggests that couples benefit from their spouses or partners acting as their caregivers.