In 2010, the Medicare program may covered 570,000 people ages 95 and older, including as many as 8,600 people ages 105 and older.
Xiaotong Niu, an analyst at the Congressional Budget Office (CBO), and two other analysts have published that data on extremely old Medicare beneficiaries in a new paper distributed by the CBO.
The analysts prepared the paper to look at why Medicare costs have been going up so much, and why costs seem to be going up more for older enrollees.
Medicare is not supposed to pay for true long-term care (LTC) services, but it does pay for home health care for people with acute health care needs. The program also pays for skilled facility care — nursing home care — for patients who are recovering from acute health care problems, and it pays for hospice care for patients who are believed to be near death.
When a patient is getting hospice care, Medicare will pay for nursing care, pain relief drugs, occupational therapy, social work services, dietary counseling, grief counseling, homemaker services and short inpatient stays, according to a Medicare fact sheet.
In one table, the CBO analysts compare traditional Medicare spending patterns for enrollees in four different age groups in 1999 with spending patterns for enrollees in those same age groups in 2005 and 2012. The big change was in the hospice services column: The cost of hospice services increased sharply, and the number of Medicare enrollees getting hospice services skyrocketed.
For Medicare enrollees ages 85 to 94, the percentage of Medicare spending going to hospice care jumped to 7.9 percent in 2012, from 2.3 percent in 1999. For enrollees ages 95 to 105, the percentage going to hospice care soared to about 19 percent, from 4.2 percent.
On the way to implying, indirectly, that the oldest enrollees’ Medicare bills may be climbing partly because hospice care has become a substitute for LTC services, the CBO analysts provide a glimpse of the very oldest old demographic group.
The analysts note, for example, that the Census Bureau counted only about 53,000 U.S. residents in 2010. Medicare had about 216,000 centenarians on its enrollee list that year.
Many of the centenarian enrollees may actually be dead, the analysts write.