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Next time President Obama vacations in Hawaii– his usual Christmas destination –he might want to tell seniors there about how provides free annual wellness visits for people enrolled in Medicare.

So far, just 1 percent of Medicare beneficiaries who live there, or 890 people, have used this year, the lowest percent of any state, according to figures released Monday by the Centers for Medicare & Medicaid Services.

In contrast, about 8 percent of seniors in Rhode Island have taken advantage of wellness visits in the first five months of 2012, the most of any state. Nationally, about 3.6 percent of beneficiaries, or 1.1 million seniors, have used the visits since January. The wellness visit is not a physical exam. Instead, it’s a time for the doctor to draw up an individual health plan for the patient, including setting up a schedule to get certain screenings and updating a patient’s family and medical history.

There is also wide variation in how seniors in different states use other new preventive services covered by Medicare as a result of the health law. For example, half of Florida seniors this year have used a free benefit that waives the cost of services such as mammograms and colorectal cancer screenings, the highest of any state. Nationally, 43 percent of Medicare beneficiaries, or about 14 million people, have taken advantage of the free care this year.  For all of 2011, about 32 million people in Medicare received one or more preventive benefits free of charge.

In an interview with KHN at the White House Monday, Jonathan Blum, a Medicare deputy administrator, said he can’t explain the state variations, but suggested rates might vary based on each state’s “physician culture” and use of Medicare managed care plans.

Blum he said he is pleased more seniors are becoming aware of the additional Medicare benefits under the law, but noted there is still more work to be done.

“Most seniors don’t know what’s in the law,” said Jim Firman, CEO of the , a nonprofit advocacy group, at a White House event Monday highlighting benefits to seniors in the health law. Of the new wellness visit benefit, he said: “This is a really good benefit, but you have to use it to maximize the opportunity.”