Despite 'welcome to Medicare' benefit, one in eight enrollees delay first use of part B services for at least two years.

TitleDespite 'welcome to Medicare' benefit, one in eight enrollees delay first use of part B services for at least two years.
Publication TypeJournal Article
Year of Publication2012
AuthorsSloan, FA, Acquah, KF, Lee, PP, Sangvai, DG
JournalHealth Aff (Millwood)
Date Published2012 Jun
ISSN Number1544-5208
KeywordsAged, Female, Humans, Insurance Claim Review, Male, Medicare Part B, Time Factors, United States

Much research has focused on the possible overuse of health care services within Medicare, but there is also substantial evidence of underuse. In recent years, Congress has added a "welcome to Medicare" physician visit and a number of preventive services with no cost sharing to the Medicare benefit package to encourage early and appropriate use of services. We examined national longitudinal data on first claims for Part B services-the portion of Medicare that covers physician visits-to learn how people used these benefits. We found that 12 percent of people, or about one in eight, who enrolled in Medicare at age sixty-five waited more than two years before making their first use of care covered by Part B. In part, this delay reflected patterns of use before enrollment, in that people who sought preventive care before turning sixty-five continued to do so after enrolling in Medicare. Enrollees with Medigap coverage, higher household wealth, and a higher level of education typically received care under Part B sooner than others, whereas having greater tolerance for risk was more likely to lead enrollees to delay use of Part B services. Men had a lower probability of using Part B services early than women; blacks and members of other minority groups were less likely to use services early than whites. Although the "welcome to Medicare" checkup does not appear to have had a positive effect on use of services soon after enrollment, the percentage of beneficiaries receiving Part B services in the first two years after enrollment has steadily increased over time. Whether or not delays in receipt of care should be a considerable public policy concern may depend on what factors are leading specific categories of enrollees to delay care and how such delays affect health.

User Guide Notes

Endnote Keywords

Health care utilization/Public Health And Safety/Medicare/public policy

Endnote ID


Alternate JournalHealth Aff (Millwood)
Citation Key7727
PubMed ID22665838
PubMed Central IDPMC3508513
Grant ListR01 AG017473 / AG / NIA NIH HHS / United States
5R01AG017473-10 / AG / NIA NIH HHS / United States