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This brief analyzes leading federal approaches to address Medicaid prescription drug spending, discusses (where available) a range of cost estimates for each policy, and assesses what drives those estimates or where there is uncertainty in them.
Prescription drug spending in Medicaid and other health programs has returned to the national policy debate. This analysis examines Medicaid outpatient prescription drug utilization and spending before rebates over the 2015 to 2019 period, which is helpful for understanding recent cost drivers and areas for targeted policy action.
This brief provides an overview of premiums and benefits in Medicare Advantage plans that are available for 2025 and key trends over time. Two-thirds of all Medicare Advantage plans with Part D prescription drug coverage (MA-PDs) (67%) will charge no premium (other than the Part B premium) in 2025, similar to 2024 (66%). Nearly all Medicare Advantage plans (97% or more) are offering vision, dental and hearing, as they have in previous years. However, the…
This brief describes the facts about actions taken under both the Trump and Biden Administrations related to capping insulin copayments for people with Medicare and explains the differences between their approaches.
A KFF analysis shows that a new out-of-pocket spending cap in Medicare Part D could translate into savings for well over 1 million beneficiaries when it takes effect next year, including more than 100,000 people each in California, Florida and Texas, based on analyses of drug spending in 2021. The $2,000 cap, part of the Inflation Reduction Act of 2022, will lead to thousands of dollars in savings for Medicare patients who take high-cost drugs…
At the start of 2025, many issues are at play that will affect Medicaid coverage, financing, and access to care. While Medicaid was not discussed much on the campaign trail, Congress may consider big changes as part of tax and spending debates and the Trump administration may make changes to Medicaid through executive actions. Amid the potential changes, this brief highlights ten key things to know about Medicaid.
This brief examines the income, assets, and home equity of Medicare beneficiaries, overall and by age, race and ethnicity, and gender. Most Medicare beneficiaries live on relatively low incomes and have modest financial resources to draw upon if they need costly care or long-term services and supports.
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.
This brief analyzes prices for medical care compared to other goods and services using consumer price index (CPI) and producer price index (PPI) data. Overall prices grew by 3.5% in March 2024 from the previous year, while prices for medical care increased by only 2.2%.
If you qualify for the full premium subsidy for your Medicare prescription drug plan, are enrolled in traditional Medicare, and your current prescription drug plan will not be offered next year, you will be automatically reassigned by Medicare to a new prescription drug plan for coverage in the next year. But you won’t be reassigned automatically if your current plan is terminating and you chose your current plan. In that case, you will have to…
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