Date of Conferral

2022

Degree

Ph.D.

School

Public Policy and Administration

Advisor

Richard DeParis

Abstract

The rising cost of Medicare is a growing concern for recipients. Beneficiaries are often forced to implement a host of strategies to meet rising out-of-pocket expenses. This qualitative study was conducted to address a research gap in methods used by senior citizens to manage rising Medicare coverage costs. Garmezy’s resilience theory was used to contextualize the rising costs of Medicare premiums and copays and strategies used to manage healthcare needs. The purposive sample of 12 socioeconomically diverse respondents included eight women and four men ranging in age between 65 and 77, for an average age of 70.2 years. Participants completed a semi structured interview that consisted of close-ended and open-ended questions that were thematically analyzed using the modified van Kaam method popularized by Moustakas. While most respondents reported being satisfied with their Medicare coverage, nearly half (41.7%) reported difficulty financing the rising costs of premiums and copays, and half used a strategy to meet those costs, including forgoing other bills, limiting care to free clinics, receiving free nutritional benefits, and simply avoiding clinical visits to meet rising costs. Nearly all (91. 6%) felt that dental and eye care should be covered and that elders should not be forced to work after retirement to meet the portion of Medicare not currently covered by the government. This study confirmed the difficulty of meeting rising Medicare costs and may lead to positive social change by increasing awareness and informing policy makers about the need to reform Medicare cost-sharing policies to assure healthcare access for this highly vulnerable population.

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