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This issue brief merged beneficiary-level Medicare and Medicaid data from 2021 to document sources of coverage for dual-eligible individuals nationwide and by state.
This brief examines current Medicaid eligibility policies and enrollment patterns using data from KFF’s 2024 50-state survey of states’ eligibility and enrollment policies for seniors and people with disabilities, and 2021 Medicare and Medicaid claims data from the Centers for Medicare and Medicaid Services (CMS).
This brief presents facts about Medigap, including the characteristics of Medicare beneficiaries with a Medigap policy, variation in Medigap enrollment by state, and Medigap premiums.
This issue brief analyzes federal and state guaranteed issue rules and how they impact beneficiaries’ access to Medigap, including the implications for Medicare beneficiaries with pre-existing conditions and those under age 65 with long-term disabilities. This brief also explores a recently finalized rule: Nondiscrimination in Health Programs and Activities regarding Section 1557 of the Affordable Care Act that may have implications for the Medigap market.
On October 8, 2024, Vice President Harris has proposed to expand Medicare to provide home care to help families who are struggling with the costs of long-term care. If enacted, this would be the first major expansion of Medicare since the Medicare Modernization Act of 2003 that added a prescription drug benefit to the program.
This policy watch examines monthly premiums for Medicare Part D stand-alone drug plans in 2025, as changes to the Part D benefit are being implemented in 2025, including a new $2,000 cap on out-of-pocket drug spending.
Nearly half (47%) of metropolitan areas across the country had only one or two hospitals or health systems providing general inpatient hospital care in 2022, a new KFF analysis finds.The analysis examines the extent of competition among hospitals amid a wave of hospital consolidation that has drawn the attention of state and federal regulators. About one in five (19%) metropolitan statistical areas have only one hospital or health system providing hospital care, and more than…
This brief examines the share of Medicare beneficiaries who reviewed their coverage and compared plans during the open enrollment period for 2022 (that takes place in the Fall of 2021), and who made use of Medicare’s official information resources, as well as variations by demographic groups. Overall, nearly 7 in 10 Medicare beneficiaries did not compare their own source of Medicare coverage with other Medicare options offered in their area.
Changes to the Medicare Part D benefit in the Inflation Reduction Act will mean lower out-of-pocket costs for Part D enrollees but higher costs for Part D plans overall, leading to concerns about possible premium increases. These FAQs provide context for understanding Part D premiums in 2025 and changes in recent years, and describe actions the Centers for Medicare & Medicaid Services (CMS) is taking to mitigate potential premium increases.
Health care debt is a widespread problem in the United States. Medicare offers coverage for a range of health care services, including hospitalizations, physician visits, prescription drugs, and post-acute care, but Medicare beneficiaries generally pay out-of-pocket for their monthly premiums and deductibles, cost-sharing for Medicare-covered services, and the cost of services not covered by Medicare. This data note examines findings from the KFF Health Care Debt Survey to assess the prevalence, sources and consequences of…
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