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The 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.
No. Drug coverage from the VA (Veterans Affairs) is considered creditable prescription drug coverage, which means the coverage is at least as good as what Medicare drug plans provide, so you do not need to enroll in a Medicare Part D plan. Other sources of creditable drug coverage include the Federal Employee Health Benefits (FEHB) program, TRICARE (military health benefits), and Indian Health Services (IHS). People with creditable coverage should receive a notice from the…
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%.
There are two ways you can get drug coverage. If you have traditional Medicare, you can sign up for a stand-alone prescription drug plan. Or you can join a Medicare Advantage plan that covers all your Medicare benefits including the prescription drug benefit. Whichever you choose, your costs and coverage can vary from one plan to another. In picking the drug coverage that best meets your needs, you can compare plan costs for the premium,…
This 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.
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…
KFF today launched a new side-by-side comparison tool of the records and policy positions of President Biden and former President Trump across a range of key health policy issues. In a related “Beyond the Data” column, KFF President and CEO Drew Altman examines why the election represents a “fork in the road” on the federal government’s role in health care. While this is not an election like in the past where health care reform is…
For most people with retiree health benefits, it makes sense to sign up for Medicare when you are first eligible to do so. Retiree health plans are typically designed to supplement Medicare, and might not pay your medical costs during any period that you were eligible for Medicare but not signed up for it. You should review any information provided by your employer to be sure you understand how your retiree health benefits coordinate with…
This brief examines the final CMS regulations governing prior authorization in Medicare Advantage, Marketplace, Medicaid, and other plans, how they might address some current consumer concerns, and some issues that remain.
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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