OBJECTIVES: To examine the economic burden and health care utilizations of rheumatoid arthritis (RA) patients in the U.S. Medicare population.  METHODS: The study sample was extracted from the national Medicare claims data from 2008 to 2010. All patients diagnosed with RA were identified using International Classification of Disease, 9^th Revision, Clinical Modification (ICD-9-CM) diagnosis code 714.0x. The initial RA diagnosis date was designated as the index date. Comorbid conditions during the 12-month pre-index (baseline) period, and treatment patterns within 60 days post-index date were examined. Health care utilization and costs were assessed for each Medicare research identifiable file (RIF) for the 12-month post-index (follow-up) period. Inflation was adjusted to 2010 U.S. dollars.  RESULTS: Out of the 21,910 identified patients, 74.5% were male and 81.1% White. RA patients had a mean age of 76.8 years, and were more likely to reside in the Southern U.S. region (37.7%). The baseline Charlson Comorbidity Index score was 2.27. The most commonly diagnosed comorbid conditions included diabetes (34.1%), chronic obstructive pulmonary disease (29.3%) and tumor (28.2%). Hydrocodone bitartrate/acetaminophen (14.7%), levothyroxine sodium (11.7%) and furosemide (10.7%) were the most often prescribed medications for RA patients.  Health care utilizations were examined including proportion of patients with Medicare carrier visits (99.0%), Durable Medical Equipment (DME, 47.0%), Home Health Agency (HHA, 25.5%) use, outpatient visits (79.5%) and inpatient hospital (36.1%), Skilled Nursing Facility (SNF, 12.7%) and hospice admissions (4.4%) and prescription drug (part D event) claims (59.3%). RA patients incurred significant Medicare carrier ($5,919), DME ($640), HHA ($1,814), outpatient ($13,916), inpatient ($7,977), SNF ($2,389), hospice ($457), prescription drug ($2,299) and total costs ($35,412).  CONCLUSIONS: RA patients were associated with more Medicare Carrier service use and outpatient visits, in addition to frequent comorbid condition diagnoses, which resulted in higher health care expenditures.