COLA boost for Social Security in 2024 still leaves seniors bleeding. Here's why.

Social Security checks will increase next year, but for retired staffing company executive Lou Scrivani, 76, the bump won't even be enough to cover increases in his health care costs, much less the inflated prices of everything else over the past year.

Starting in January, more than 66 million beneficiaries of the program will receive a cost-of-living adjustment (COLA) of 3.2%, averaging out to more than $50 extra each month. 

COLA is meant to help Americans keep up with inflation so they can maintain their standard of living year to year. But the hikes are falling short, many seniors say. The cost of items older adults spend most of their money on consistently outpaces COLA, according to The Senior Citizens League, a nonprofit advocate for older adults. The biggest expense is health care.

Even with COLA “we will not net enough to keep up with current inflation,” said Scrivani, who lives in Delaware.

Show me the math 

This is how Scrivani does the math for himself and his wife: 

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Total monthly COLA increase for both: about $135.

LESS:

• Medicare Part B monthly increase: about $10 x 2 = $20 
• Drug plan increase: $25.70 x 2 = $51.40
• Medicare supplement increase: $10 total 

That means from the $135 monthly COLA increase, the Scrivanis keep about $53.60. The deductible on their drug rose $60, however.

“So goodbye $53 increase,” Scrivani said. “With current inflation rates, that puts us in negative territory overall.”

And that example only accounts for higher health care costs. When you factor in pricier housing, food, gas, and utilities, the bleeding gets worse, and older adults have to hope their savings can cover the differences, experts and seniors say. 

But that doesn't always happen.

Poverty has increased among Americans age 65 and older for three years in a row to 14.1% in 2022 from 10.7% in 2021, according to the latest Census Bureau data.  

"We have a problem, a lot of people are feeling it," said Kris Whipple, partner and financial advisor at Kristopher Curtis Financial in Nashville, Tenn. "So I jump to what can be done? What can I do? Plan accordingly."

Do Americans have enough savings to cover extra costs every year? 

Unlikely. 

The Senior Citizens League said more than one-quarter of the 1,055 adults it surveyed in the first three months of the year said they had depleted a retirement account over the past 12 months. That was up from 20% in the second half of last year. 

And a record 45% said they carried credit card debt for more than 90 days even as interest rates soared, the League said. 

“Worry that retirement income won’t be enough to cover the cost of essentials in the coming months is a top concern,” Mary Johnson, Social Security and Medicare policy analyst at The Senior Citizens League, said in a statement last month. 

Will health care costs get cheaper? 

Many cost-saving measures from the Inflation Reduction Act won’t come soon.  

Only the $35 monthly out-of-pocket insulin cap and free recommended adult vaccines for Medicare Part D participants took effect this year. 

Price negotiations with pharmaceutical companies on 10 drugs started this year, but "most savings, if any, will not be seen by anyone, on any drugs, until about 2026,” Scrivani said.

Starting January 1, out-of-pocket spending of $8,000 (including certain payments made by other people or entities on your behalf) will automatically get you “catastrophic coverage” so you won’t have to pay a copayment or coinsurance for drugs covered under Part D for the rest of the calendar year. 

A cap on annual prescription drug out-of-pocket cost sharing of $2,000 also isn’t expected until 2025. 

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What do seniors do to stretch their health care dollars? 

Drug costs are so high that many seniors will order from Canadian pharmacies to pay a fraction of U.S. prices.  

Scrivani takes Xarelto to prevent strokes. With his insurance and copay, it costs $550 for a 30-day supply. Using GoodRx, a free online price comparison platform for prescription drugs, he would pay between $528 and $567, depending on the pharmacy, or nearly $7,000 out of pocket each year.  

Those prices prompted him to do extensive research to find cheaper drugs. The Canadian government and the U.S. Food and Drug Administration have tips on how to find online or overseas pharmacies, and some people consult the People’s Pharmacy for consumer drug information or check the Canadian International Pharmacy Association’s list of vetted pharmacies. 

Scrivani said he significantly lowered his costs using a Canadian pharmacy. His drug is shipped from Turkey, and he will get a 3-month supply this year for $119, or $49 monthly compared to $550 a month from the U.S. pharmaceutical company licensed to sell the drug.    

“That is the state of healthcare for seniors in this country,” he said.

In extreme cases, Whipple said some people will even move to Texas, California or Arizona so they can easily cross the border to Mexico to buy supplies. While he understands why people would do this, he and other financial experts say a better way is to work on your financial plan earlier in life.

Morgan D. Hill, chief executive of wealth management firm Hill & Hill Financial, said. “You have to plan a third of your income for medical costs.” 

What resources can seniors tap now to help them, overall? 

If you're already in the thick of old age, here are some ways to find help:

• Use BenefitsCheckUp.org to find local assistance programs for everything from food, medicine to utilities, or call the free helpline at 1-800-794-6559, Monday through Friday, 8 a.m. to 7 p.m. ET. 
• For Medicare and Medicaid help, check State Health Insurance Assistance Programs or call 1-877-839-2675. 
• Visit or call your local social services office if you don’t have a computer and Internet access. Doing so a few months ago helped Bick Adams, 69, of Saltville, Virginia, find $23 per month from the Supplemental Nutrition Assistance Program (SNAP). “That’s like milk and bread and maybe, a dozen eggs,” he said.  

Adams, whose wife Cheryl, 64, has cancer, also discovered they were eligible for Limited Medicaid, which he hopes will help pay some of the bills this month.

Applying over the phone takes a long time, but “we’re lucky. Of course, I can’t go to a ball game, and I could use a hearing aid, but we've got heat and food, and we are thankful. We’re just old people taking care of each other.” 

Medora Lee is a money, markets, and personal finance reporter at USA TODAY. You can reach her at [email protected] and subscribe to our free Daily Money newsletter for personal finance tips and business news every Monday through Friday.