Meet a baby boomer who will never retire because she has terminal cancer and can’t afford to live off $1,800 in monthly Social Security

Mary, not pictured, doesn’t think she’ll ever be able to retire.

Mary, 68, originally thought she’d be able to retire as early as 2023 — but no later than 2025. Then came the diagnosis: She had pancreatic cancer.

She said it came completely out of left field; she thought she was healthy and very active. Before her diagnosis, everyone, including her doctors and her insurance agent, said she’d most likely live longer than her mother, who died at age 94. But that’s no longer the case; pancreatic cancer has a “grim prognosis,” she said.

“At that point, I thought, well, retirement is off the table because I need my income,” said Mary, who lives in the Midwest and whose last name and profession are known to B-17 but are being withheld over privacy concerns.

She realized she had to keep working to afford the costs of her treatment, such as traveling out of state to see specialists. She decided to start drawing Social Security earlier than she anticipated to supplement her income. What she found, though, was that her benefits were reduced because, in a prior job, her employer paid into a pension and not into Social Security — even though Mary cashed out that pension.

“It was traumatic enough to deal with the cancer and the cancer diagnosis,” she said. “And then to realize that I had no one to fall back on — I have no other income to fall back on.”

Now, Mary is subsisting on her salary, Social Security, and a robust insurance plan through her workplace. If she retired, she’d have to switch to a Medicare insurance option. While the current iteration of the plan seems to potentially cover her treatments, she’d be out of luck if it ever changed — or came up against billing issues.

Many Americans are heading into what they expected to be their retirement years still working or just scraping by. Older Americans are also increasingly dealing with medical debt and financial instability in their later years. It’s yet another example of a new reality facing America’s would-be retirees: working until they can’t anymore.

“I used to say this all the time as a joke, I’m going to have to work until the day I die because I can’t possibly ever afford to retire,” Mary said. “And now it looks like I will be working until the day I die because I cannot afford to lose my job and my health insurance, as much as I would like to retire.”

Older Americans are racking up medical debt

Mary still feels fortunate — her ability to work from home and have insurance gives her peace of mind. She finally got a “windfall” salary increase in the past few years, which has gone toward paying debt.

“I know there are so many people in my shoes who don’t have what I have,” she said.

Indeed, a report from the Consumer Financial Protection Bureau found that as of 2020, adults 65 and older had $53.8 billion in unpaid medical bills — a 20% increase from 2019. On average, older adults had $13,800 in unpaid medical bills, even as they were going to the doctor less. That came as many still had what the report called “comprehensive medical insurance”; older Americans on Medicare and Medicaid were actually more likely to report having unpaid bills. And Americans like Mary, who were still paying off debts like mortgages, were also more likely to report having unpaid medical bills.

Even with Mary’s “incredible” health insurance, it took a little while to get everything straightened out with her coverage. She wasn’t sure how much the treatment would cost, so she started to tap into Social Security — but, because of her prior pension, her check was reduced by about $230 a month. She said that while it might not sound like a lot of money, it had made a difference. Her check is currently about $1,800.

“My retirement plan right now is keep going until they tell me I have six months or less left to live,” she said. “And at that point, that’s when I’ll retire because it won’t matter anymore what health-insurance plan I’m on. I’ll be on hospice; Medicare covers that. I won’t have to worry about bills.”

Making difficult choices

While Mary is terrified of losing her job — and the insurance that comes with it — she still stresses that she’s lucky to have both of those.

“I think of the people who are losing their homes or taking out second mortgages, unable to keep working, unable maybe even to keep their insurance,” she said. She said she thought all the time about how there must be a better way for the country to fund healthcare so people don’t have to end up making difficult choices.

One of her medications costs $3,000 a month; her health insurance brings that copay down to about $30 a month, and she knows some people have to pay $500 for that same drug. Mary said she needed that medication to be able to digest food.

“This has been eye-opening,” she said. “I don’t know that I could have ever understood the kinds of really difficult decisions seniors have to make in situations like this until I was confronted with it myself.”

And for Mary, that means anticipating that she won’t be able to retire. She said she had a “wonderful” support system and had accepted her disease.

“It’s the hand I’ve been dealt. It is what it is,” she said, adding: “I have plenty of well-intentioned friends and family who keep saying to me: ‘Well, why didn’t you just retire? You might not have that much time left’ — which I don’t — ‘and wouldn’t you like to just enjoy it?'”

She always has the same response: “I can’t afford to; I literally cannot afford to give up my paycheck or my health insurance until I’m forced to.”