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  • Navigating Medicare and Medicaid: Interaction Between Medicare and Medicaid – online version

    Other Post

    Supplemental Medicaid Coverage for Low-Income Medicare Beneficiaries How does an individual become a dual eligible? How are dual eligibles different from other Medicare beneficiaries? What does it mean to be a primary and/or secondary payor? In 2003, Congress enacted a Medicare reform law that included a prescription drug benefit. How does this law affect dual eligibles? More than 7 million people receive both Medicare and Medicaid; these individuals are called “dual eligibles” or “dual enrollees.”…

  • Section 9: Prescription Drugs and Mental Health Benefits

    Report

    Exhibit 9.1 Exhibit 9.5 Exhibit 9.2 Exhibit 9.6 Exhibit 9.3 Exhibit 9.7 Exhibit 9.4 Exhibit 9.8 9 There are fewer observations for estimating the average copayment for four-tier drugs compared to other drug types.

  • Dual Eligibles:  Medicaid’s Role for Low-Income Medicare Beneficiaries

    Fact Sheet

    Dual Eligibles: Medicaid's Role for Low-Income Medicare Beneficiaries This fact sheet and set of tables describe the over 7 million “dual eligibles,” the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid. The fact sheet describes why this population needs Medicaid, what services they receive from Medicaid, and the current policy challenges related to dual eligibles, including the new Medicare prescription drug benefit. The set of tables, prepared by the…

  • Keeping Medicare and Medicaid When You Work: Additional Work Incentives Available to People with Disabilities on SSDI- online version

    Other Post

    Earnings-Related Incentives What is a trial work period? What is the extended period of eligibility? Health Coverage Incentives Can someone on SSDI continue Medicare coverage when they return to work? Can people with disabilities who work buy into Medicare once their eight and a half years of premium-free coverage runs out? Will people with disabilities who return to work be eligible for Part D? Can people with disabilities on SSDI who return to work buy…

  • One State’s Medicaid Managed Care Formulary Operations:  A Look at Pennsylvania, 2001-2002

    Report

    One State’s Medicaid Managed Care Formulary Operations: A Look at Pennsylvania, 2001-2002 This report examines formulary implementation under mandatory Medicaid managed care in Pennsylvania between 2001 and 2002. It looks at one state during a yearlong period; formulary operations are likely to vary across states and programs and over time. The report includes findings about Pennsylvania’s formulary operation and observations about improving the system. Report (.pdf)

  • 2005 Health Care Agenda and Election

    Poll Finding

    Embargoed for release until:January 11, 2005, 9:30 a.m. EST For further information contact:Craig Palosky, KFF, (202) 347-5270Chris Peacock, KFF, (650) 854-9400 AMERICANS FAVOR MALPRACTICE REFORM AND DRUG IMPORTATION, BUT RANK THEM LOW ON HEALTH PRIORITY LIST FOR THE CONGRESS AND PRESIDENT Lowering Health Care Costs Overall Seen as Top U.S. Health Priority Washington, D.C. – The public favors reducing jury awards in malpractice lawsuits and allowing drugs to be imported from Canada, but ranks them…

  • Navigating Medicare and Medicaid: Medicaid – online version

    Other Post

    Back to the Top What does it mean to be “medically needy”? Thirty-five states plus the District of Columbia operate medically needy programs. The medically needy option allows states to provide Medicaid to certain groups of individuals who are ineligible because of excess income, but who have high medical expenses. States often use the medically needy program to expand coverage primarily to persons who spend down by incurring medical expenses so that their income minus…

  • The Distributional Consequences of  Medicare Premium Support Proposal

    Other Post

    The Distributional Consequences of a Medicare Premium Support Proposal This article analyzes the expected distributional impact of enacting a premium support proposal for Medicare based on legislation introduced by Sen. Breaux and Sen. Frist in 1999. This legislation suggested that the Federal Employees Health Benefits plan be used as a model for Medicare. The article simulates impacts in three areas: among beneficiaries who choose to retain fee-for-service coverage, between different geographic areas, and according to…