Dual Health Insurance Coverage Declining For Adults Age 65 and Over

Most adults age 65 and older qualify for Medicare coverage, the main reason coverage rates in that age group were 98.9% in 2022. A small percentage of them (9.2% in 2022) have additional types of public health insurance through the government besides just Medicare.

Some adults in that age group who are covered only by Medicare also choose to supplement it with private health plans. These plans offer additional medical benefits or a reduced cost for medical treatment.

The decline in private health coverage that occurred from 2017 to 2022 may affect the quality of medical care as well as access to providers for people in this age group.

Similar to overall coverage rates for adults age 65 and older, all age groups within this population experienced decreases in dual private and Medicare coverage and increases in rates of Medicare coverage alone from 2017 to 2022:

• Ages 65 to 69. Dual coverage decreased 8.0 percentage points and Medicare alone increased by 6.3 percentage points — the only older adults age group that did not experience higher rates of Medicare alone coverage than dual private and Medicare coverage.
• Ages 70 to 79. Dual coverage decreased 9.2 percentage points to 40.4% and Medicare alone increased 7.9 percentage points to 46.9%.
• Age 80 and older. Dual coverage decreased 7.9 percentage points to 37.8% and Medicare alone increased 7.6 percentage points to 50.8%.  

Because many people get private health insurance through an employer, adults age 65 and older who still work may find it easier to source affordable private coverage. However, the percentage of older adults with dual private and Medicare coverage decreased across all employment statuses from 2017 to 2022, while the rates of Medicare coverage alone increased:

• Older adults who worked full time. Dual coverage dropped 8.9 percentage points to 40.0% and Medicare alone increased 4.0 percentage points to 24.0%. These workers also saw an increase in private coverage alone from 25.2% to 29.0%, and full-time workers were the only group to have higher rates of private coverage alone than Medicare alone in 2022.
• Older adults who worked part time. Dual coverage decreased 6.3 percentage points to 52.0% but remained higher than Medicare alone, which increased 6.6 percentage points to 35.6%.
• Older adults age 65 and older who did not work. Dual coverage declined 8.4 percentage points to 37.8% and Medicare alone increased 7.7 percentage points to 49.2% — the only employment status group to have lower dual coverage rates than Medicare only rates in 2022. In 2017, dual coverage rates were 4.7 percentage points higher than those with Medicare alone. In 2022, the share with Medicare alone was 11.4 percentage points higher than the share with dual coverage. 

More information on confidentiality protection, sampling error, nonsampling error and definitions is available in the technical documentation. All comparative statements in this article have undergone statistical testing and, unless otherwise noted, all comparisons are statistically significant at the 10% significance level.