Options to Make Medicare More Affordable For Beneficiaries Amid the COVID-19 Pandemic and Beyond

Report
  1. The lower bound estimate in both ranges is based on the number of beneficiaries with income below 150% FPL based on KFF analysis of the Centers for Medicare & Medicaid Services (CMS) Medicare Current Beneficiary Survey, 2017; the upper bound estimate is based on the number of beneficiaries with income below 150% FPL based on KFF analysis of Urban Institute DYNASIM4 microsimulation model, 2017.

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  2. Unpublished estimates of KFF analysis of Urban Institute DYNASIM4 microsimulation model, 2017. Asset data in the DYNASIM4 model corresponded to $12,140 for individuals and $24,250 for couples in 2017, so these estimates slightly overstate the number of people with assets above the allowable limit in 2017 ($12,320 for individuals, $24,600 for couples).

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  3. KFF analysis of the CMS Medicare Current Beneficiary Survey, 2017; differences are statistically significant.

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  4. KFF analysis of the CMS Medicare Current Beneficiary Survey, 2017; differences are statistically significant.

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  5. The savings estimates for the $5,000 and $6,700 limits are similar because of the shape of the out of pocket and Medicaid spend distributions, particularly the portion between the two limits of $5,000 and $6,700. While individuals with eligible spending above $6,700 would have their spending reduced by an additional $1,700 under the lower limit, this additional reduction is roughly offset by individuals with spending between the two limits, who have modest reductions in spending under the lower threshold but are not affected at all by the policy at the higher limit.

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  6. Medigap policies vary widely, both across policy types and across insurers. Estimates vary, but the average monthly premium was about $150 in 2019. See https://www.ehealthinsurance.com/medicare/supplement-all/how-much-medicare-supplement-plans-cost, https://www.markfarrah.com/mfa-briefs/continued-year-over-year-growth-for-medicare-supplement-plans/

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  7. Full Medicaid benefits generally include services not covered by Medicare, such as inpatient hospital and nursing facility services when Medicare limits on covered days are reached. States may also choose to cover additional benefits, including durable medical equipment, personal care and other home- and community-based services (HCBS), dental care, vision, and hearing services.

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  8. Another 8.9 million received full Medicaid benefits in addition to financial assistance through the Medicare Savings Programs. KFF analysis of the CMS Chronic Conditions Data Warehouse Medicare data from a 20% sample of beneficiaries, 2017.

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  9. There is one other category of Medicare Savings Programs: Qualified Disabled and Working Individuals (QDWI); these are individuals who have lost free Medicare Part A benefits because of their return to work but are eligible to purchase Medicare Part A. Through the Medicare Savings Programs, QDWIs receive assistance with their Medicare Part A premiums only. Enrollment in QDWI represents about 325 individuals.

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  10. We do not include estimates for savings on Part A premiums because about 99% of beneficiaries do not have to pay a Part A premium.

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  11. This estimate may overstate the number of beneficiaries who could be helped by this expansion since some beneficiaries live in states that have higher income and/or asset limits and are currently eligible but not enrolled in the program. KFF analysis of Urban Institute DYNASIM4 microsimulation model and 2017 Medicare Current Beneficiary Survey.

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  12. Ibid.

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  13. KFF analysis of the CMS Chronic Conditions Data Warehouse Medicare data from a 20% sample of beneficiaries, 2017.

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