OBJECTIVES: Abdominal aortic aneurysm (AAA) is typically asymptomatic, but over time may lead to a rupture of the aorta, with a high fatality rate.  The Screening AAA Very Efficiently (SAAAVE) Act of 2007 adds a new preventative service as part of the Welcome to Medicare visit (WTM), a free one-time AAA screening for men with smoking history, and men and women with a family history of AAA.  This study aimed to estimate utilization of the new benefit and its impact on AAA diagnostics and treatment. METHODS: We analyzed Medicare claims data (2005-2009) to estimate Welcome to Medicare examination utilization (CPT codes G0344 and G0402) among new enrollees, and use of the new AAA screening benefit (CPT code G0389).  We also examined utilization of AAA-related diagnostics and treatment from 2005 to 2009, i.e., two years prior to and following the 2007 adoption of the new benefit. RESULTS: Medicare data revealed very low uptake of AAA screening among newly enrolled Medicare beneficiaries, with rates of less than 1% each year, and under 1% among those eligible for the screening benefit.  The number of newly enrolled beneficiaries newly diagnosed with AAA ranged from 6,660 to 9,260 per year, increasing over time.  AAA-related use of abdominal ultrasound has decreased from 13 per 100 AAA patients in 2005 to 10 per 100 AAA patients in 2009.  Overall AAA repair procedure rates have remained constant at 7 per 100 AAA patients, with endovascular repair use increasing and open repair use decreasing. CONCLUSIONS: Medicare data showed that the Welcome to Medicare (WTM) visit for new enrollees and the AAA screening benefit established by the 2007 SAAAVE Act have been underutilized, and have not affected diagnostic and repair procedure rates for AAA.  The need for screening remains, given that AAA incidence is not declining in Medicare beneficiaries.