The use of contraceptives among Medicare beneficiaries, particularly those of childbearing age with a permanent disability, greatly varies based on their enrollment in Medicare Advantage (MA) or traditional Medicare, according to a research study. The study, led by Jacqueline Ellison, a health policy and management specialist at the University of Pittsburgh School of Public Health, found a higher usage of contraceptives in MA enrollees compared to those in traditional Medicare.

The predicted probability of contraceptive use was notably higher in MA compared to traditional Medicare (20.0% vs 13.6%, respectively). Additionally, the probability of contraceptive usage nearly doubled amongst MA enrollees with a noncontraceptive clinical indication, compared to those without it.

The researchers highlighted the fact that Medicare does not mandate coverage of contraception for pregnancy prevention, which might lead to enrollees paying out of pocket or not using their preferred method of contraception. The researchers called for policy changes at a national level to offer all contraceptive methods without cost-sharing, to support the reproductive autonomy of people with disabilities.

The research used data from over 200,000 enrollees and was adjusted for covariates. The study included both traditional Medicare and MA enrollees. For traditional Medicare enrollees, the data from a random 20% sample of Medicare Parts A, B, and D claims were used. For those enrolled in MA, the Optum Clinformatics Data Mart database was used to gather data on inpatient, outpatient, and pharmacy claims.

Medicare is the primary health insurance for around 8 million people with disability-based eligibility, of which about 3.5 million are of reproductive age. This significant number of enrollees, coupled with traditional Medicare’s coverage limitations, makes the issue of contraceptive coverage even more essential.

The study showed that the rate of contraceptive use in the whole sample was 14.7%, with slightly higher use among MA enrollees compared to those with traditional Medicare. Oral contraceptives were the most commonly used method.