Costs by Payer

We separately estimate the costs of eye disorders and vision loss from the perspective of three payers; government, private insurance, and individuals, which includes patients and their families. Individuals incur 52% of the total economic burden ($71.6 billion), largely due to productivity and informal care losses, which together constitute 36% of the total economic burden. Government pays approximately 34% of total costs ($47.4 billion), most of this total consisting of direct medical costs and long-term care. Private insurers pay $20.8 billion in direct medical costs and $1.3 billion for long-term care, totaling about 16% of the total burden. Government pays more for direct medical costs than private insurance, largely due to the Medicare-aged population 65 and older. Among those aged 65 and older, government accounts for nearly half of the total burden due to an increase in medical and long-term care expenditures by government for Medicare and Medicaid beneficiaries in this age group.

Figure 4. Costs by payer by age group (in $ billions)

Payer Category Age 0-17 Age 18-39 Age 40-64 Age 65+ All ages
Government* 1.76 1.49 5.58 38.6 47.44
Insurance 1.88 4.08 9.33 6.86 22.15
Patient 1.83 15.99 16.79 37.05 71.66
Comprehensive 5.47 21.39 31.41 80.72 138.99

*Government total includes transfer payment/tax loss costs of $2.254 billion that are not included in Comprehensive