Out-of-pocket medical expenses amongst elderly social security recipients

Out-of-pocket medical expenses are significantly higher for elderly women than men of the same age; they also increase with age significantly more rapidly for women.  In some respects, these are surprising findings.  At any given age, women have much lower mortality than men and correspondingly much higher remaining life expectancy.   Why, then, are the out-of-pocket medical expenses higher for women?   One hypothesis, which we intend to explore and test, is that there are differences in living arrangements for elderly men and women.  Because men face higher mortality rates, and because wives tend to be younger than their husbands, elderly women are much more likely to be widowed and live alone than elderly men.  For instance, fully 56 percent of men over the age of 85 are married, whereas only 17 percent of women over the age of 85 are married.  A striking majority of 85+ women are widows.  If two people live together, they benefit from risk pooling in the sense that episodes of illness will not be simultaneous for couples.   The spouse who is not ill can act as caregiver for the other spouse, substituting for paid medical care. The classic living arrangements include living together with a spouse or living alone, but we will also try to study the many other ways that elderly people live.  For instance, many elderly may have roommates, or children living at home or nearby.  Using data from the Health and Retirement Study, we will explore the impact of changes in marital status (e.g., becoming widowed) and living arrangements on the out-of-pocket medical expenses of the elderly.  Our findings will have policy implications for the adequacy of Social Security widow benefits.