How do Pre-Medicare Adults Aged 55-64 Interact with the Health Care System?

Tracking healthcare use and spending patterns of older adults with employer-sponsored insurance (ESI) as they approach Medicare eligibility helps anticipate future needs of the healthcare system. Adults aged 55–64 with ESI use more health care services and have higher per-person spending than any other adult age group. Higher spending on services for people ages 55-64 is consistent across types of care. Adults aged 55-64 spend the most on outpatient services (including general labs and administered drugs), whereas other age groups spend a larger proportion on professional services.  

Higher spending is driven in part by high utilization of services. Adults aged 55–64 with ESI use more health care services and have higher per-person spending than any other adult age group. In 2022, 88% of women and 83% of men in this age group had at least one health care service, leading all other age bands. These trends reflect increasing health care use and spending by Americans as they age, placing greater financial and logistical burdens on individuals and families.

In this image, you can see the data shows a higher spending on all health care services amongst adults 55-64 is consistent across all types of care.