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All qualified health plans offered in the Marketplace cover the "essential health benefits" (EHB), including: Ambulatory patient services (outpatient care you get without being admitted to a hospital) Emergency services Hospitalization Maternity and newborn care (care before and after your baby is born) Mental health and substance use disorder services, including behavioral health treatment Prescription…
This volume examines findings about trusted sources of vaccine information from the latest KFF Tracking Poll on Health Information and Trust. It also explores how the misrepresentation of studies and policy developments contribute to health narratives around vaccines, HIV and PrEP. Lastly, it summarizes new research on the use of generative AI to counteract vaccine misinformation.
Based on your current income and asset amounts, you may qualify for Medicaid. Under the current rules, Medicaid helps many low-income people on Medicare with their Medicare premiums and cost-sharing requirements and may also cover some benefits that are not covered by Medicare, such as dental services and long-term services and supports.
This data note analyzes five national surveys to assess trends in retiree health coverage among people ages 65 and older. These five surveys produce somewhat different estimates of retiree health coverage, but together paint a clear picture: the share of Medicare-age adults with employer- or union-sponsored retiree health coverage has been shrinking and appears to be on the way to extinction.
This issue brief describes how Medicaid home care operates—including who is eligible and the systems in place to promote program integrity in its delivery—and the challenges of using new CMS data to identify unusual billing patterns or potential fraud in the program.
The annual Medicare Open Enrollment period is designed for enrolling in or switching Medicare Advantage and Part D prescription drug plans, not Medigap policies.
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.
This brief analyzes Medicaid enrollment and spending trends for FY 2024 and FY 2025, based on data provided by state Medicaid directors as part of the 24th annual survey of Medicaid directors.
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).
Although all Marketplace health plans are required to cover the ten categories of essential health benefits, insurers in many states have flexibility to modify coverage for some of the specific services within each category, subject to approval by their Marketplace.
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