The effect of Medicare Part D on health care utilization for non-elderly Medicare recipients with disabilities

Richard E. Nelson, Ph.D., Stephen L. Nelson, J.D., Ph.D., Benedikt Huttner, M.D., M.S., Adi Gundlapalli, M.D., Ph.D.

Published Online: September 20, 2013
Disability and Health Journal,  January 2014 Volume 7, Issue 1, Pages 64–69


The effect of Medicare Part D prescription drug coverage on non-elderly beneficiaries, most of whom have disabilities, has not been fully explored.


The objective of this study was to estimate the impact of Medicare Part D on expenditures and utilization of prescription drugs, hospitalizations, physician office visits and emergency department visits in non-elderly Medicare beneficiaries with disabilities.


Using Medical Expenditure Panel Survey (MEPS) data from 2005 to 2006, we assembled a cohort of non-elderly Medicare beneficiaries and controls using propensity score matching. We used zero-inflated negative binomial regressions and generalized linear models to examine the effect of Medicare Part D on health care utilization and expenditures, respectively. We controlled for demographic characteristics, census region of residence, and self-reported health status.


We were able to match 299 Medicare non-recipients to 299 Medicare recipients. The mean (SD) age was 49.8 (10.7) years for the Medicare non-recipients and 49.9 (10.0) years for Medicare recipients. While the introduction of Medicare Part D was not associated with a significant change in the number of prescriptions consumed by this group of individuals, there was a significant decrease in out-of-pocket prescription drug expenses as well as expenses paid for by Medicaid and private insurance.


Our study is the first to examine the impact of Medicare Part D on non-elderly Medicare beneficiaries. We find that the introduction of Medicare Part D did not lead to changes in prescription drug consumption, only in the method of payment.