221-230 of 1,791 results

  • 3 Charts: Medicare Drug Price Negotiations

    News Release

    Under the Inflation Reduction Act, the federal government for the first time will negotiate directly with drug companies to determine the prices that Medicare will pay for certain high expenditure drugs covered under Medicare Part D (starting in 2026) and Part B (starting in 2028). Part D covers retail prescription drugs and Part B covers physician-administered medications. This new requirement is the culmination of years of debate among lawmakers in Congress, and the Centers for…

  • 5 Key Facts About Medicaid and Veterans

    Issue Brief

    Medicaid helps fill gaps in coverage for veterans who are low-income, have disabilities, or are otherwise ineligible for military health benefits. It supports those with complex health needs and reduces out-of-pocket expenses. This brief presents five key facts about veterans with Medicaid and how policy changes in Congress could affect their coverage and access to care.

  • I am about to turn 65 and sign up for Medicare but I’m not sure what my options are for coverage. Where can I go for more information?

    FAQs

    To learn more about your coverage options under Medicare, including the Medicare Advantage plans, Part D prescription drug plans, and Medicare supplement policies (Medigap) available in your area, and how to enroll, you can go to the Medicare coverage comparison website, a searchable tool on the Medicare.gov website, or call 1-800-MEDICARE (1-800-633-4227). You can also contact the State Health Insurance Assistance Program (SHIP) in your state or the Social Security Administration. SHIPs offer local, personalized…

  • Explaining Cost-Sharing Reductions and Silver Loading in ACA Marketplaces

    Policy Watch

    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.

  • I have a Medigap policy now, but I want to buy a different one. Can I switch Medigap policies during the Medicare Open Enrollment period?

    FAQs

    The annual Medicare Open Enrollment period is designed for enrolling in or switching Medicare Advantage and Part D prescription drug plans, not Medigap policies. In most states, insurance companies can deny you a different Medigap policy and you won’t have guaranteed issue rights, unless you are either eligible to switch under certain limited circumstances or you purchased your Medigap policy less than 6 months ago. This means that in many situations, insurance companies that agree…

  • Millions of Medicare Beneficiaries Use Prescription Drugs That Could Be Subject to Price Negotiation, But Build Back Better Act Provision Exempts Many Drugs With High Federal Spending

    News Release

    Twenty drugs and dozens of insulin products used by 8.5 million Medicare beneficiaries would be subject to government drug price negotiation if the Build Back Better Act (BBBA) were enacted and fully implemented in 2022, according to a new KFF analysis. The 20 drugs include 18 drugs available to beneficiaries covered under Medicare Part D (typically drugs purchased at the pharmacy) and two drugs covered under Medicare Part B (physician-administered drugs). The list includes drugs…

  • The Facts About the $35 Insulin Copay Cap in Medicare

    Policy Watch

    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.

  • What is a Medicare Advantage plan? How does it differ from traditional Medicare?

    FAQs

    Medicare Advantage plans are private health plans, such as HMOs or PPOs, that are offered by health insurers that have contracts with the Medicare program to offer benefits to people with Medicare. The plans provide all Medicare-covered benefits under Parts A and B, and usually provide Part D prescription drug benefits as well. Most Medicare Advantage plans also provide benefits that are not covered under traditional Medicare, such as eyeglasses, some dental care, or gym…

  • What to Know About Medicare Part D Premiums

    Issue Brief

    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.

  • I want to switch from Medicare Advantage to traditional Medicare, but I still want drug coverage. What do I need to do?

    FAQs

    If you switch from a Medicare Advantage plan to traditional Medicare and you want drug coverage, you can sign up during the Medicare Open Enrollment period for a stand-alone prescription drug plan in your area. Your new coverage will take effect on January 1. You can also switch from Medicare Advantage to traditional Medicare during the Medicare Advantage Open Enrollment period between January 1 and March 31, when you can sign up for a stand-alone…