Changes in health for the uninsured after reaching age-eligibility for medicare
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BACKGROUND: Uninsured adults in late middle age are more likely to have a health decline than individuals with private insurance.
OBJECTIVE: To determine how health and the risk of future adverse health outcomes changes after the uninsured gain Medicare.
DESIGN: Prospective cohort study.
PARTICIPANTS: Participants (N=3.419) in the Health and Retirement Study who transitioned from private insurance or being uninsured to having Medicare coverage at the 1996, 1998, 2000, or 2002 interview.
MEASUREMENTS: We analyzed risk-adjusted changes in self-reported overall health and physical functioning during the transition period to Medicare (t −2 to t 0) and the following 2 years (t 0 to t 2).
RESULTS: Between the interview before age 65 (t −2) and the first interview after reaching age 65 (t 0), previously uninsured individuals were more likely than those who had private insurance to have a major decline in overall health (adjusted relative risk [ARR] 1.46; 95% confidence interval [CI] 1.03 to 2.04) and to develop a new physical difficulty affecting mobility (ARR 1.24; 95% CI 0.96 to 1.56) or agility (ARR 1.33; 95% CI 1.12 to 1.54). Rates of improvement were similar between the 2 groups. During the next 2 years (t 0 to t 2), adjusted rates of declines in overall health and physical functioning were similar for individuals who were uninsured and those who had private insurance before gaining Medicare.
CONCLUSIONS: Gaining Medicare does not lead to immediate health benefits for individuals who were uninsured before age 65. However, after 2 or more years of continuous coverage, the uninsured no longer have a higher risk of adverse health outcomes.
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- Changes in health for the uninsured after reaching age-eligibility for medicare
Journal of General Internal Medicine
Volume 21, Issue 11 , pp 1144-1149
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- medically uninsured
- health status
- Industry Sectors
- Author Affiliations
- 1. Division of General Internal Medicine, Department of Medicine Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- 2. Institute for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- 3. Department of Preventive Medicine and Epidemiology, Loyola University Chicago-Stritch School of Medicine, Chicago, IL, USA
- 4. Buehler Center on Aging, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- 5. Center for Health Care Research and Policy, Case Western Reserve University at MetroHealth Medical Center, Cleveland, OH, USA