Medicare Beneficiaries With AIDS

Understanding the role Medicare plays in the service system for people with acquired immunodeficiency syndrome (AIDS) has become increasingly important. With the advent of new life-prolonging therapies, more people disabled by AIDS will survive long enough to quality for Medicare.

In the late 1990s, we examined the population of people with AIDS or HIV who received Medicare-covered care between 1991 and 1996, by applying our AIDS case-finding algorithm, developed in a previous project, to Medicare claims data. Over that six-year period, we identified more than 74,000 beneficiaries with AIDS, almost 30,000 of whom were living at the end of 1996. This suggests that about 12 percent of people living with AIDS at the end of 1996 were covered by Medicare.

We examined their characteristics, patterns of enrollment, service use, and expenditures focusing on variation over time and among beneficiaries in different states. Medicare expenditures for these beneficiaries averaged more than $2,300 per month of enrollment and totaled more than $813 million in 1996. Medicare expenditures for the nearly 24,000 beneficiaries with HIV were about one-quarter those for the AIDS group. The first powerful antiretroviral drugs were only just beginning to be used when this study ended.

The study was funded by the U.S. Department of Health and Human Services, Health Care Financing Administration. Click here for the executive summary from the report, "Profile of Medicare Beneficiaries with AIDS: Application of an AIDS Case-Finding Algorithm, Final Report."

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