Medicare is a critical lifeline for older adults who need health care as they age. But a new study shows that over the next two decades, out-of-pocket medical costs for older adults are likely to rise significantly, even with access to Medicare.

By 2035, a typical senior will spend one out of every seven dollars of retirement income on medical care, a 40 percent increase from 2012. The study, by Laura Hatfield, Thomas McGuire, and Michael Chernew of the Harvard Medical School and my Urban Institute colleague Melissa Favreault, projected that out-of-pocket cost increases will hit poor and near-poor households hardest. It was published in the journal Health Services Research (paywall).

Keep in mind that the authors were looking at the cost of medical care only. More than two-thirds of older adults will have some long-term care needs before they die. And other research by Melissa shows that half will require a significant level of assistance over their lives. Those who do need this high level of care will pay an average of $140,000 out of pocket, on top of the medical costs this study projects.