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  • The Obama Administration’s 2010 Call Letter for Medicare Advantage and Prescription Drug Plans: Implications for Beneficiaries

    Issue Brief

    On March 30, 2009, the Centers for Medicare & Medicaid Services issued the 2010 “call letter,” which functions as a request for proposals to private health insurers and organizations that want to sponsor Medicare Advantage Plans or Medicare Prescription Drug Plans. This issue brief reviews the call letter — the first issued by the Obama Administration — and examines the implications for beneficiaries of some of the proposed changes, including its emphasis on accountability of health plan sponsors, promoting…

  • Revisiting ‘Skin in the Game’ Among Medicare Beneficiaries: An Updated Analysis of the Increasing Financial Burden of Health Care Spending From 1997 to 2005

    Issue Brief

    This issue brief presents an analysis of the financial burden of out-of-pocket health care spending for Medicare beneficiaries between 1997 and 2005. The analysis shows median out-of-pocket spending as a share of Medicare beneficiaries' income increased between 1997 and 2005, from 11.9 percent to 16.1 percent. For some beneficiaries, the spending burden was even greater, with 25 percent of people on Medicare spending nearly one-third or more of their income on health care.

  • Medicare Part D 2009 Data Spotlight: Premiums

    Report

    This Medicare Part D data spotlight analyzes the premiums charged by the 1,689 stand-alone Medicare Part D plans that will be offered in markets across the country in 2009. The analysis finds premiums charged for Part D plans range widely, from $10.30 per month to $136.80 per month. If current enrollees remain in their current plan for next year, the weighted average monthly premium for PDPs would increase by $7.40 per month, from $29.89 in…

  • Medicare Part D 2009 Data Spotlight: The Coverage Gap

    Report

    This Medicare Part D data spotlight examines the coverage gap, or "doughnut hole," in Medicare drug plans available in 2009. While in the gap in coverage, Part D enrollees (other than those receiving low-income subsidies) are required to pay 100 percent of total drug costs until they reach the catastrophic coverage level. In 2009, nearly all Part D plans have a coverage gap, though one in four plans offer limited coverage in the gap --…

  • Medicare Part D 2009 Data Spotlight: Low-Income Subsidy Plan Availability

    Issue Brief

    This Medicare Part D Data Spotlight focuses on the availability of drug plans for beneficiaries receiving the Part D low-income subsidy in 2009 and changes since 2006. For 2009, fewer than one in five plans qualify for automatic or facilitated enrollment of low-income subsidy beneficiaries, the lowest share since the inception of the Part D benefit. These plans have monthly premiums below a benchmark amount calculated for each region, enabling low-income subsidy beneficiaries to enroll…

  • Medicare Part D 2008 Data Spotlight: Ten Most Common Brand-Name Drugs

    Issue Brief

    This Medicare Part D Data Spotlight examines the variation in 2008 Part D plan coverage, cost sharing and utilization management tools for the 10 prescriptions most commonly used by Medicare beneficiaries, including treatments for cholesterol, cardiovascular health, osteoporosis, dementia, gastrointestinal reflux and ulcers. It looks at data from the 47 stand-alone prescription drug plans available nationwide in 2008. This data spotlight is one in a series analyzing key aspects of the 2008 Medicare Part D…

  • Medicare Part D 2008 Data Spotlight: Low-Income Subsidy Plan Availability

    Issue Brief

    This Medicare Part D Data Spotlight focuses on the availability of drug plans for beneficiaries receiving the Part D low-income subsidy in 2008 and changes since 2006. It looks at data from the 47 stand-alone prescription drug plans available nationwide in 2008. This is one in a series analyzing key aspects of the 2008 Medicare Part D prescription drug plan choices. The analysis was conducted jointed by Jack Hoadley of Georgetown University, Elizabeth Hargrave of NORC…

  • Medicare Prescription Drug Plans in 2008 and Key Changes Since 2006: Summary of Findings

    Issue Brief

    This synthesis of key findings from analysis presented in a series of eight Medicare Part D 2008 Data Spotlights describes key features of stand-alone prescription drug plans offered in 2008 and trends since 2006. The synthesis covers a range of topics, including premiums, the coverage gap, benefit design, cost sharing, specialty tiers, formularies, utilization management, the top 10 brand-name prescription drugs, and the availability of low-income subsidy plans. The analysis was conducted jointed by Jack…

  • Medicare Part D 2008 Data Spotlight: Utilization Management

    Issue Brief

    This Medicare Part D data spotlight examines three common techniques used by Medicare stand-alone prescription drug plans in 2008 to manage enrollees’ use of formulary drugs, such as quantity limits, prior authorization, and step therapy rules. This is one in a series analyzing key aspects of the 2008 Medicare Part D prescription drug plan choices. It analyzes data from the 47 stand-alone prescription drug plans available nationwide using a sample of 169 commonly-used and high-cost…