How Medicare Pays Medicare Advantage Plans: Issues and Policy Options
This brief explains how Medicare Advantage payments are determined and provides an overview of policy options to change the Medicare Advantage payment system.
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New $2,000 Medicare Part D Cap Could Reduce Out-of-Pocket Drug Costs for Over One Million Beneficiaries Beginning Next Year, Including Tens of Thousands of Beneficiaries in Most States
News ReleaseA 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…
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How Does Medical Inflation Compare to Inflation in the Rest of the Economy?
Issue BriefThis 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%.
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I am age 60 and have been receiving Social Security disability insurance (SSDI) payments for two years. My Medicare coverage just started and I would like to get a Medicare supplement insurance policy....
FAQsIt depends on the state where you live. Some states require insurance companies to sell Medigap supplement policies to people under age 65, but not all states do. Insurance companies may still voluntarily sell Medigap policies to people under age 65, even in states that do not require insurance companies to sell Medigap policies to people under age 65. However, premiums may be much higher than premiums for people ages 65 and older. If you…
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The Medical Frailty Exemption from Medicaid Work Requirements: Key Takeaways from the CMS Interim Final Rule
Issue BriefThis brief describes new guidance and potential challenges states will face in operationalizing the medical frailty exemption.
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A Look at Variation in Medicaid Spending Per Enrollee by Group and Across States
Issue BriefBecause states have flexibility in designing their programs, state Medicaid spending and enrollment varies across states. This data note provides an overview of total Medicaid spending per enrollee by eligibility group and state.
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Health Costs Consume a Large Portion of Income for Millions of People with Medicare
Issue BriefTo document the affordability challenges posed by out-of-pocket health care costs for people with Medicare, this brief analyzes out-of-pocket health care costs as a share of Social Security income and total income, including other sources of income in addition to Social Security.
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Explaining Cost-Sharing Reductions and Silver Loading in ACA Marketplaces
Policy WatchThe House of Representatives recently passed a budget reconciliation bill that would appropriate funding for cost-sharing reductions that insurers are required to provide to low-income enrollees in the Affordable Care Act marketplace. This policy watch explains what these cost-sharing reductions are, how they relate to federal spending, and what effect appropriating funding might have on premiums and the uninsured rate.
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Coverage of Sexual and Reproductive Health Services in Medicare
Issue BriefThis brief describes Medicare coverage of sexual and reproductive health services, including contraception, and compares that coverage with private insurance plans and Medicaid. These benefits are particularly relevant to nearly 1 million women of reproductive age (20-49) who are eligible for Medicare due to having a long-term disability.
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Why Do We Hear More About High Drug Prices Than About Hospital Prices?
PerspectiveIn this JAMA Health Forum post, KFF's Larry Levitt outlines four reasons why high drug prices are in the spotlight more than hospital prices, even though hospitals accounted for 40% of the growth in national health spending from 2022 to 2024, and explores the potential for policy action to restrain them.