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The Gerontologist 44:85-94 (2004)
© 2004 The Gerontological Society of America

Are Healthier Older Adults Choosing Managed Care?

Gail A. Jensen, PhD1, and Michael A. Morrisey, PhD2

Correspondence: Address correspondence to Gail A. Jensen, PhD, Institute for Gerontology and Department of Economics, Wayne State University, 87 E. Ferry Street, Detroit, MI 48202. E-mail: gail.jensen{at}

Purpose: We attempt to determine whether older workers and early retirees avoid managed care plans and to explore whether health plan choices are linked to the health status of workers or their spouses. Design and Methods: We use the responses of those born between 1931 and 1941 to the 1994 and 1998 waves of the Health and Retirement Survey. We analyze current workers and early retirees separately, using cross-tabular and multinomial logit techniques. Results: Among older adults with active worker coverage, 60% were enrolled in either a health maintenance organization or preferred provider organization in 1998; 42% of early retirees were enrolled in these plans. Those with a choice of plans were even more likely to be in managed care. When demographic characteristics, time, and differences in the benefits and cost of the various plans offered by an employer are controlled for, health status (measured in a variety of ways) has little bearing on an older worker's choice of health plan. Implications: These findings suggest that older workers choose plans much as younger workers do. Employers are likely to continue to offer managed care as their workers age. The lack of unidirectional findings on health status bodes well for the long-term practicality of managed care under Medicare. Many workers are choosing an insurance type early in their tenure and remaining with that type of plan as they age.

Key Words: Health insurance • Retiree benefits • HMOs

All GSA journals Journals of Gerontology Series A: Biological Sciences and Medical Sciences Journals of Gerontology Series B: Psychological Sciences and Social Sciences
Copyright © 2004 by The Gerontological Society of America.