(HealthDay News) – Out-of-pocket health care expenditures can put a significant financial burden on elderly Medicare beneficiaries in their last five years of life, according to a study published online Sept 4 in the Journal of General Internal Medicine.

Amy S. Kelley, MD, MSHS, of the Mount Sinai School of Medicine in New York City, and colleagues conducted a retrospective cohort study involving 3,209 decedents from the nationally representative Health and Retirement Study to examine the out-of-pocket health care expenditures for Medicare beneficiaries in their last five years of life.

In the five years prior to death, the researchers found that the average out-of-pocket expenditure was $38,688 for individuals (median, $22,885; 90th percentile, $89,106) and $51,030 for couples with one spouse surviving (median, $39,759; 90th percentile, $94,823). The average spending varied based on the cause of death, from $31,069 for gastrointestinal disease to $66,155 for Alzheimer’s disease. These out-of-pocket expenditures exceeded baseline total household assets for 25% of participants, and 43% of participants surpassed their non-housing assets. Ten percent of couples with one surviving spouse exceeded their total baseline assets, while 24% exceeded their non-housing assets.

“Despite Medicare coverage, elderly households face considerable financial risk from out-of-pocket health care expenses at the end of life,” the authors write. “Disease-related differences in this risk complicate efforts to anticipate or plan for health-related expenditures in the last five years of life.”

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