This paper explores the financial and opportunity costs of adult morbidity and mortality for rural South African female pensioners in the era of HIV/AIDS. As mortality rates from HIV/AIDS and other causes escalate, older women are bearing the brunt of caregiving responsibilities for the sick and orphaned. They often use their state-funded non-contributory pensions to support kin during crises. Interviews conducted with 30 women aged 60-75 years in the Medical Research Council/University of the Witwatersrand Unit (Agincourt) study site in northeastern South Africa revealed that, to cover expenses incurred during crises, older women sometimes forgo spending money and time on their personal needs. They are thus negatively affected as individuals, while contributing positively to the household. Despite the additional household income from pensions, many of the study respondents still found it difficult to recover from the financial impact of these crises.