Key Takeaways

  • The Elder Index is a tool that defines how much seniors need to afford basic living expenses.

  • Millions of older adults struggle to make ends meet, according to the Elder Index.

  • Use these tools to share Elder Index data on the state of senior economic insecurity in your state with policymakers, media, and program developers.

What is the true cost of growing older in America?

Knowing the answer to that question, and what resources are needed to prepare for the future, is a challenge faced by researchers, advocates, policymakers, social service providers, and individuals and families alike. 

The Elder Index™  offers a tool to increase this understanding. The  Elder Index present local expenses, savings requirements, and what incomes are needed to achieve economic security by family type, and at the city, county, and state levels.

What is the Elder Index?

The Elder Index was developed by the Gerontology Institute at the University of Massachusetts Boston with Wider Opportunities for Women (WOW), and is currently maintained through a partnership between the Gerontology Institute and NCOA. The Elder Index is a measure of the income that older adults need to meet their basic needs and age in place with dignity. The Elder Index is specific to household size, location, housing, and health status. It includes the cost of:

  • Housing
  • Health care
  • Transportation
  • Food
  • Miscellaneous essentials

Anyone can use the database to find out how much is needed to be economically secure, by location and family type; compare expenses across locations and family types; download national, state, county and city index data; and access additional information on elder economic security. Use the Index.

The Elder Index vs. Medicaid eligibility

The COVID-19 pandemic has further highlighted the critical importance of programs like Medicaid, even while exposing how frayed our social safety net has become. Medicaid eligibility is based on the federal poverty level (FPL), which is based on the cost of a 1960 subsistence food budget adjusted only for inflation. Also, the FPL criteria:

  • Do not typically account for age-related needs of older adults
  • Do not account for geographic differences in the cost of living
  • Ignore how expenditure patterns have changed over time

Medicaid eligibility criteria are widely recognized as being far too low and as excluding many people who not be "poor enough"  to qualify for the program under current standards but have significant financial distress.

In contrast, the Elder Index, which was developed in 2006 and has ongoing updates and releases, summarizes how much it actually costs to live in the community.

The Elder Index is built around everyday expenses encountered by older adults and measures the income older adults require to meet their daily living expenses while staying independent in their own homes. it takes into account household size, geographic location, mortgage status, and health status when determining costs of living. It measures the income older adults need to meet their basic needs and age in place with dignity.

Our infographic shows the difference in the characteristics of the populations that would be eligible for public assistance based on the current Medicaid standard compared to those who would be eligible based on using an Elder Index standard.

How to use the Elder Index in your state

The Elder Index can be a powerful tool for state and local advocates and aging service providers. This guide was designed to provide:

  • An introduction to the Elder Index and the associated Elder Economic Insecurity Rates (EEIRs) and an explanation of how they are best presented to specific audiences
  • Suggestions for how caseworkers and advocates can use the tools to communicate seniors’ needs and apply them directly in their daily work
  • Ideas on how to talk about the tools and integrate economic security messaging into an organization’s work, or even its mission.

Our customizable economic security advocacy fact sheet template is designed to be fill-able, so that professionals can share the landscape of elder economic insecurity in their state with policymakers, media, and program developers.


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To learn more about using the Elder Index, watch our archived webinar below.