Near-Elderly Adults, Ages 55-64: Health Insurance Coverage, Cost and Access

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Technical Appendix

Definitions for Tables 1, 2, 4, and 5 and Figure 1

Individual Health Insurance

Individual health insurance was defined as private health insurance that was obtained from sources other than an employer or union, including coverage from some other group, such as an association, as well as from non-group sources, such as an insurance company or HMO (health maintenance organization) and coverage identified as being obtained by self-employed individuals with no employees.

Employment-related health insurance

Employment-related coverage was defined as including health insurance obtained through an employer or union. It also includes coverage through someone outside of the household or coverage whose source was unknown, since both sources are likely to be employment related.

Other Public Insurance

Individuals were classified as having other public insurance if they reported insurance from other public hospital/medical coverage that was not Medicaid and if they reported TRICARE (Armed Forces related) coverage.

Appendix Tables

General statistics that serve as the basis for Figures 5-10 in the body of the text are shown in Tables A1, A2, and A3.

Table A1. Percentage of adults in families with out-of-pocket spending on health care and health insurance premiums exceeding 10% of after-tax income, by insurance and age, 2005

Age	Variable Label	Private Group		Private Nongroup		Public		Uninsured
Age	Variable Label	Mean	Standard Error	Mean	Standard Error	Mean	Standard Error	Mean	Standard Error
Total	After-tax family income	59,343	667	52,499	2,166	17,331	462	26,790	866
	OOP spending on care	1,394^*	30	2,071	234	1,226	204	1,016^*	71
	OOP premiums	2,041^*	47	4,549^*	223	227^*	20	160	16
	Total OOP burden	3,435^*	59	6,620^*	335	1,453^*	205	1,176^*	75
	% in families w/ high burdens	18.7^*	0.6	52.6^*	2.9	25.0^*	1.3	15.2^*	0.9
25-34	After-tax family income	50,841^*	1,065	42,092	4,040	17,928	748	22,922	933
	OOP spending on care	798^*	33	1,052^*	185	336^*	48	499^*	43
	OOP premiums	1,505^*	54	2,239^*	240	90^*	15	115	25
	Total OOP burden	2,304^*	67	3,291^*	371	427^*	53	614^*	51
	% in families w/ high burdens	12.2^*	0.9	34.2^*	6.2	11.3^*	1.7	10.6^*	1.3
35-44	After-tax family income	63,160^*	1,140	55,895	3,995	17,948	1,053	29,045	1,428
	OOP spending on care	1,248^*	50	1,310^*	182	1,728	805	1,007^*	112
	OOP premiums	2,164	90	3,707^*	390	133^*	28	158	37
	Total OOP burden	3,412^*	100	5,017^*	477	1,861	805	1,165^*	119
	% in families w/ high burdens	16.4^*	0.9	40.8^*	6.7	18.9^*	2.7	13.5^*	1.7
45-54	After-tax family income	63,151^*	929	58,924	4,532	16,615	791	30,814^*	1,724
	OOP spending on care	1,654^*	51	3,147	762	1,137^*	125	1,320	164
	OOP premiums	2,101^*	75	5,682	474	277^*	47	198	33
	Total OOP burden	3,756^*	100	8,830	946	1,414^*	142	1,518	174
	% in families w/ high burdens	19.4^*	1.1	60.8	5.4	28.5^*	2.7	17.0^*	1.8
55-64	After-tax family income	58,396	1,253	51,905	3,454	16,761	1,071	25,674	1,597
	OOP spending on care	1,894	79	2,432	236	1,776	191	1,743	283
	OOP premiums	2,381	95	5,975	510	437	61	210	41
	Total OOP burden	4,275	126	8,406	568	2,214	213	1,953	286
	% in families w/ high burdens	28.0	1.3	69.0	4.0	43.9	2.8	25.4	2.6

Source: 2006 Medical Expenditure Panel Survey—Household Component
Notes: * indicates estimates that are significantly different from those in the 55-64 year old category (p<0.05). " OOP" refers to out-of-pocket and " high burdens" refers to out-of-pocket costs for medical care and premiums that exceed 10% of the family's after-tax income. The family is defined as a " Health Insurance Eligibility Unit," which generally refers to an individual and a spouse and children, if present. Each person is assigned the income and costs of the unit. Individuals were classified into one health insurance category based on the type of coverage for which they had the most number of months in 2005. Uninsured individuals were uninsured throughout 2005. Premium amounts were prorated for the number of months of coverage

Table A2. Percent of adults with no medical visits and average visits, by health insurance status, condition, and health status: 2003-2006

Condition/Health Status	Insured Full Year		Insured Part Year		Uninsured Full Year		Insured Full Year		Insured Part Year		Uninsured Full Year
Condition/Health Status	% No visits	SE	% No visits	SE	% No visits	SE	Avg # visits	SE	Avg # visits	SE	Avg # visits	SE
	Ages 25-54
All persons	22.24^{^}	0.32	31.78^*^{^}	0.78	53.90^*^{^}	0.79	8.08^{^}	0.12	6.48^*^{^}	0.23	5.33^*^{^}	0.17
Depression	5.49^{^}	0.46	11.22^*^{^}	1.41	27.45^*	2.33	14.80^{^}	0.46	10.98^*^{^}	0.84	9.46^*	0.88
Diabetes	6.29^{^}	0.68	6.07	1.55	19.19^*^{^}	2.84	13.45	0.72	9.70^*	0.90	6.49^*	0.63
Heart disease	3.60^{^}	0.55	6.99	1.98	16.62^*	2.88	14.04	0.62	9.54^*	0.87	7.87^*	0.99
Hypertension	6.68^{^}	0.49	9.97^*	1.36	15.85^*	1.61	11.13^{^}	0.37	9.15	1.23	6.03^*	0.46
Any chronic condition	8.81^{^}	0.28	14.00^*^{^}	0.82	27.71^*^{^}	1.06	9.91^{^}	0.16	7.87^*^{^}	0.34	6.75^*	0.28
Trauma	7.39^{^}	0.46	13.65^*^{^}	1.34	23.85^*	1.43	11.51^{^}	0.30	8.22^*^{^}	0.43	7.12^*	0.48
No chronic condition	39.32	0.52	48.72^*	1.10	67.93^*	0.86	4.59	0.10	4.26	0.20	3.61^*	0.20
Health: exc./vg/good	23.72^{^}	0.33	34.79^*^{^}	0.85	57.15^*^{^}	0.86	7.01^{^}	0.11	5.65^*^{^}	0.24	4.51^*^{^}	0.16
Health: fair/poor	7.96^{^}	0.57	13.18^*	1.36	32.72^*^{^}	1.51	16.68	0.51	10.35^*	0.62	8.74^*	0.63
SF-12 physical health ≤40	5.09^{^}	0.43	10.79^*	1.44	24.64^*	1.72	18.45	0.54	11.65^*	0.62	10.33^*	0.65
SF-12 physical health >40	22.15^{^}	0.34	32.44^*^{^}	0.89	55.17^*^{^}	0.88	6.86^{^}	0.10	5.68^*^{^}	0.26	4.40^*	0.18
SF-12 mental health ≤40	11.06^{^}	0.50	17.87	1.59	38.81	1.70	13.23^{^}	0.39	9.31^*^{^}	0.45	7.96^*	0.62
SF-12 mental health >40	21.79^{^}	0.36	32.52^{^}	0.92	54.40^{^}	0.90	7.45^{^}	0.12	5.87^*^{^}	0.29	4.76^*^{^}	0.17
	Ages 55-64
All persons	11.65	0.44	19.26^*	1.58	37.59^*	1.68	10.93	0.23	8.84^*	0.55	6.51^*	0.42
Depression	3.19	0.55	3.95	1.80	22.30^*	4.25	17.94	1.06	16.31	2.28	9.03^*	1.02
Diabetes	2.67	0.44	8.17^*	2.47	7.78^*	2.34	14.67	0.63	9.83^*	1.01	8.38^*	0.79
Heart disease	1.63	0.33	2.87	1.78	11.10^*	2.97	15.58	0.63	11.64^*	1.27	9.99^*	1.09
Hypertension	3.94	0.34	7.98^*	1.69	13.77^*	2.05	12.30	0.32	9.27^*	0.75	7.21^*	0.54
Any chronic condition	4.84	0.29	8.24^*	1.11	18.82^*	1.60	11.90	0.26	9.69^*	0.63	7.05^*	0.47
Trauma	4.53	0.66	6.16	2.06	23.18^*	3.52	16.51	0.64	15.61	2.09	8.50^*	1.08
No chronic condition	38.89	1.35	52.27^*	4.22	66.19^*	2.25	4.90	0.28	3.99	0.58	4.54	0.88
Health: exc./vg/good	13.09	0.50	22.38^*	1.98	41.47^*	1.85	9.32	0.22	7.85^*	0.63	5.66^*	0.45
Health: fair/poor	4.48	0.57	9.66^*	2.36	24.88^*	2.78	18.17	0.75	11.46^*	1.46	8.69^*	0.84
SF-12 physical health ≤40	3.35	0.49	6.90	2.07	23.93	2.78	18.70	0.76	12.64	1.27	9.58	0.95
SF-12 physical health >40	11.97	0.52	21.81	2.27	39.96	2.15	8.81	0.21	7.20	0.60	5.04	0.40
SF-12 mental health ≤40	7.28	1.00	14.11	3.44	31.77	3.38	17.48	1.11	12.58	1.36	8.05	1.00
SF-12 mental health >40	10.35	0.45	17.89	1.84	36.31	1.91	10.37	0.22	8.19	0.65	6.15	0.47

Source: Pooled Data from the 2003-2006 Medical Expenditure Panel Survey—Household Component
* indicates the estimate is statistically different than the estimate for the full-year insured at the 5% level.
^ indicates that the estimates for ages 25-54 are statistically different from the estimates for ages 55-64 at the 5% level. SE is standard error.

Table A3. Percent of adults reporting a delay in medical care/prescription drugs, by health insurance status, condition, and health status: 2003-2006

Condition/Health Status	Insured Full Year		Insured Part Year		Uninsured Full Year		Insured Full Year		Insured Part Year		Uninsured Full Year
Condition/Health Status	% MD delay	SE	% MD delay	SE	% MD delay	SE	% RX delay	SE	% RX delay	SE	% RX delay	SE
	Ages 25-54
All persons	4.41^{^}	0.18	12.01^*	0.63	12.76^*	0.62	3.46^{^}	0.14	8.01^{^}	0.50	7.80^*	0.51
Depression	10.96	0.69	25.82^*	2.21	30.71^*	2.56	10.87	0.55	22.28	1.83	24.33^*^{^}	1.98
Diabetes	8.15	0.84	27.76^*	4.15	21.92^*	3.41	9.82	1.00	25.49	3.20	21.02^*^{^}	3.28
Heart disease	9.71	0.95	21.63^*	3.29	29.03^*	3.65	7.85	0.91	23.67	3.30	21.54^*^{^}	3.25
Hypertension	6.35	0.49	19.93^*^{^}	2.04	22.99^*	2.09	7.01	0.54	19.39^{^}	2.11	20.78^*^{^}	2.21
Any chronic condition	6.42	0.28	18.78^*	1.02	22.36^*^{^}	1.18	5.61	0.22	14.66	0.90	16.46^*^{^}	1.00
Trauma	7.88	0.48	15.75^*	1.46	22.75^*	1.60	5.78	0.37	11.03	1.25	12.96^*	1.30
No chronic condition	1.85	0.14	5.57^*^{^}	0.55	7.62^*	0.47	0.72	0.10	1.66	0.25	3.16^*	0.33
Health: exc./vg/good	3.50^{^}	0.17	9.28^*	0.58	10.11^*	0.57	2.59	0.13	5.43^{^}	0.39	5.58^*	0.47
Health: fair/poor	13.17^{^}	0.74	28.92^*	1.92	30.04^*	1.66	11.86	0.64	23.97	1.97	22.27^*	1.49
SF-12 physical health ≤40	14.08^{^}	0.77	30.51^*	2.21	33.93^*	2.28	12.71	0.77	25.66^*	2.34	23.84^*	1.66
SF-12 physical health >40	3.60	0.17	10.01^*	0.69	10.74^*	0.59	2.70^{^}	0.14	5.85^*	0.47	6.05^*	0.54
SF-12 mental health ≤40	11.12	0.69	24.17^*	1.57	29.45^*	1.88	9.38	0.57	19.24^*	1.49	21.72^*	1.65
SF-12 mental health >40	3.71^{^}	0.17	9.83^*	0.72	10.04^*	0.55	2.89^{^}	0.14	5.75^*^{^}	0.53	5.22^*^{^}	0.43
	Ages 55-64
All persons	5.27	0.30	12.67^*	1.33	13.94^*	1.04	4.94	0.30	11.30	1.24	9.00^*	0.84
Depression	10.10	1.09	27.78^*	5.04	25.42^*	3.60	10.25	1.05	19.63	4.03	16.01	3.17
Diabetes	7.42	0.82	17.67^*	3.72	16.79^*	3.03	8.36	0.90	20.30	3.82	12.16	2.29
Heart disease	8.38	0.85	18.17^*	4.23	22.12^*	4.00	9.56	0.94	18.78	4.26	11.00	2.97
Hypertension	5.33	0.43	12.98^*	2.10	17.85^*	2.12	6.64	0.54	12.39	1.91	13.45^*	1.76
Any chronic condition	5.95	0.35	16.09^*	1.73	17.96^*	1.45	6.04	0.37	14.28	1.56	12.81^*	1.24
Trauma	8.76	0.78	20.60^*	4.51	21.96^*	2.93	7.04	0.79	12.32	3.05	13.31^*	2.43
No chronic condition	2.56	0.45	2.42	1.10	7.81^*	1.19	0.54	0.16	2.39	1.13	3.20^*	0.69
Health: exc./vg/good	4.34	0.30	9.46^*	1.29	10.06^*	1.02	3.54	0.27	8.75	1.38	6.66^*	0.90
Health: fair/poor	9.87	0.90	22.55^*	3.08	26.63^*	2.48	11.92	0.88	19.17	2.62	16.67^*	1.84
SF-12 physical health ≤40	11.39	0.90	25.31	3.38	27.24	2.79	11.20	0.85	20.77	2.87	19.43	2.28
SF-12 physical health >40	3.67	0.29	7.94	1.44	9.21	1.04	3.58	0.31	7.54	1.46	5.69	0.79
SF-12 mental health ≤40	10.20	1.06	26.38	4.24	27.67	3.00	10.93	1.12	17.36	3.41	18.85	2.70
SF-12 mental health >40	4.79	0.31	10.09	1.57	11.28	1.12	4.56	0.33	10.26	1.47	7.46	0.87

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Current as of May 2009

Internet Citation:

Near-Elderly Adults, Ages 55-64: Health Insurance Coverage, Cost and Access. Agency for Health Care Policy and Research, Rockville, MD. http://www.ahrq.gov/data/meps/mepsneareld/