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Take-up of Medicare Part D: Results From the Health and Retirement Study

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  • Helen Levy
  • David R. Weir

Abstract

We analyze data from the Health and Retirement Study on senior citizens' take-up of Medicare Part D. Take-up among those without drug coverage in 2004 was high; about fifty to sixty percent of this group have Part D coverage in 2006. Only seven percent of senior citizens lack drug coverage in 2006 compared with 24 percent in 2004. We find little circumstantial evidence that Part D crowded out private coverage in the short run, since the persistence of employer coverage was only slightly lower in 2004 -- 2006 than it was in 2002 -- 2004. We find that demand for prescription drugs is the most important determinant of the decision to enroll in Part D among those with no prior coverage. Many of those who remained without coverage in 2006 reported that they do not use prescribed medicines, and the majority had relatively low out-of-pocket spending. Thus, for the most part, Medicare beneficiaries seem to have been able to make economically rational decisions about Part D enrollment despite the complexity of the program. We also find that Part D erased socioeconomic gradients in drug coverage among the elderly.
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Suggested Citation

  • Helen Levy & David R. Weir, 2010. "Take-up of Medicare Part D: Results From the Health and Retirement Study," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 65(4), pages 492-501.
  • Handle: RePEc:oup:geronb:v:65b:y:2010:i:4:p:492-501
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    File URL: http://hdl.handle.net/10.1093/geronb/gbp107
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    Cited by:

    1. Carey, Colleen, 2021. "Sharing the burden of subsidization: Evidence on pass-through from a subsidy revision in Medicare Part D," Journal of Public Economics, Elsevier, vol. 198(C).
    2. Gary V. Engelhardt & Jonathan Gruber, 2010. "Medicare Part D and the Financial Protection of the Elderly," NBER Working Papers 16155, National Bureau of Economic Research, Inc.
    3. Jonathan Gruber & Helen Levy, 2009. "The Evolution of Medical Spending Risk," Journal of Economic Perspectives, American Economic Association, vol. 23(4), pages 25-48, Fall.
    4. Heiss, Florian & Leive, Adam & McFadden, Daniel & Winter, Joachim, 2013. "Plan selection in Medicare Part D: Evidence from administrative data," Journal of Health Economics, Elsevier, vol. 32(6), pages 1325-1344.
    5. Vetter, Stefan & Heiss, Florian & McFadden, Daniel & Winter, Joachim, 2013. "Risk attitudes and Medicare Part D enrollment decisions," Economics Letters, Elsevier, vol. 119(2), pages 128-132.
    6. Helen Levy, 2020. "The Risk of High Out-of-Pocket Health Spending among Older Americans," Working Papers wp409, University of Michigan, Michigan Retirement Research Center.
    7. Padmaja Ayyagari & Daifeng He, 2017. "The Role of Medical Expenditure Risk in Portfolio Allocation Decisions," Health Economics, John Wiley & Sons, Ltd., vol. 26(11), pages 1447-1458, November.
    8. William Encinosa, 2009. "Value-based insurance design in medicare," Applied Health Economics and Health Policy, Springer, vol. 7(3), pages 149-154, September.
    9. Alpert, Abby, 2016. "The anticipatory effects of Medicare Part D on drug utilization," Journal of Health Economics, Elsevier, vol. 49(C), pages 28-45.
    10. Pinka Chatterji & Chun-Yu Ho & Tao Jin & Yichuan Wang, 2024. "Does Consolidation in Insurer Markets affect Insurance Enrollment and Drug Expenditures? Evidence from Medicare Part D," NBER Working Papers 32267, National Bureau of Economic Research, Inc.
    11. Moulton, Stephanie & Rhodes, Alec & Haurin, Donald & Loibl, Cäzilia, 2022. "Managing the onset of a new disease in older age: Housing wealth, mortgage borrowing, and medication adherence," Social Science & Medicine, Elsevier, vol. 314(C).
    12. Keane, Michael & Ketcham, Jonathan & Kuminoff, Nicolai & Neal, Timothy, 2021. "Evaluating consumers’ choices of Medicare Part D plans: A study in behavioral welfare economics," Journal of Econometrics, Elsevier, vol. 222(1), pages 107-140.
    13. Pak, Tae-Young & Kim, GwanSeon, 2017. "The impact of Medicare Part D on cognitive functioning at older ages," Social Science & Medicine, Elsevier, vol. 193(C), pages 118-126.
    14. Thomas C. Buchmueller & Kyle Grazier & Richard A. Hirth & Edward N. Okeke, 2013. "The Price Sensitivity Of Medicare Beneficiaries: A Regression Discontinuity Approach," Health Economics, John Wiley & Sons, Ltd., vol. 22(1), pages 35-51, January.
    15. Robert Kaestner & Cuping Schiman & G. Caleb Alexander, 2019. "Effects of Prescription Drug Insurance on Hospitalization and Mortality: Evidence from Medicare Part D," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 86(3), pages 595-628, September.
    16. Elham Mahmoudi & Helen G. Levy, 2016. "How Did Medicare Part D Affect Racial and Ethnic Disparities in Drug Coverage?," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 71(3), pages 581-589.
    17. Gary V. Engelhardt & Jonathan Gruber, 2009. "Medicare Part D and the Financial Protection of the Elderly," Working Papers, Center for Retirement Research at Boston College wp2009-24, Center for Retirement Research, revised Oct 2009.
    18. Dan Shane; & Pravin Trivedi;, 2012. "What Drives Differences in Health Care Demand? The Role of Health Insurance and Selection Bias," Health, Econometrics and Data Group (HEDG) Working Papers 12/09, HEDG, c/o Department of Economics, University of York.
    19. Florian Heiss & Daniel McFadden & Joachim Winter, 2009. "Regulation of private health insurance markets: Lessons from enrollment, plan type choice, and adverse selection in Medicare Part D," NBER Working Papers 15392, National Bureau of Economic Research, Inc.
    20. Padmaja Ayyagari & Dan M. Shane & George L. Wehby, 2017. "The Impact of Medicare Part D on Emergency Department Visits," Health Economics, John Wiley & Sons, Ltd., vol. 26(4), pages 536-544, April.
    21. Padmaja Ayyagari, 2016. "Prescription drug coverage and chronic pain," International Journal of Health Economics and Management, Springer, vol. 16(2), pages 189-200, June.
    22. Robert Kaestner & Nasreen Khan, 2010. "Medicare Part D and its Effect on the Use of Prescription Drugs, Use of Other Health Care Services and Health of the Elderly," NBER Working Papers 16011, National Bureau of Economic Research, Inc.
    23. Ayyagari, Padmaja & Shane, Dan M., 2015. "Does prescription drug coverage improve mental health? Evidence from Medicare Part D," Journal of Health Economics, Elsevier, vol. 41(C), pages 46-58.

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    More about this item

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs

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