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  • Does my health plan have to cover all birth control methods with a prescription? Do I have to pay a copay?

    FAQs

    Most employer plans and all Marketplace plans must cover at least one form of all FDA-approved, granted, or cleared birth control (“contraceptive”) services and supplies for women, without cost sharing. This includes sterilization services, insertion and removal of long-acting reversible birth control methods, and follow-up services. While some birth control methods are available over the counter without a prescription, plans typically require a prescription to trigger coverage. Though it is up to an insurer’s discretion,…

  • A Look at People Who Have Persistently High Spending on Health Care

    Issue Brief

    This analysis looks at the amounts and types of health spending for people with employer-based health insurance who have continuing high health care spending. It finds that, among people with three consecutive years of coverage from a large employer, just 1.3 percent of enrollees accounted for almost 20 percent of overall spending in 2017. This group – people in the top five percent of spending in each of the three years from 2015 to 2017…

  • What Initiatives Are States Considering To Control Prescription Drug Costs in Medicaid?

    News Release

    Rising Medicaid spending on prescription drugs has prompted many states to look for new ways to control such costs. Although drug spending increased more slowly in 2016 than in the previous two years, and although such expenditures constitute only six percent of all Medicaid spending (compared to 10% of national health spending), the high cost of specialty drugs continues to be a particular concern among Medicaid policy directors. A new issue brief from the Kaiser…

  • 10 Things to Know About Medicare Part D Coverage and Costs in 2019

    Issue Brief

    The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans. This analysis provides the latest data about Medicare Part D coverage and costs in 2019 and trends over time, including enrollment, premiums, cost sharing, and participation in the low-income subsidy program.

  • Kaiser Health Tracking Poll – March 2018: Views on Prescription Drug Pricing and Medicare-for-all Proposals

    Feature

    More than a year into President Trump’s presidency, the March Kaiser Health Tracking Poll gauges the public’s top priorities for the president and Congress to do in the coming months. This month’s poll also measures perceptions on the cost of prescription drugs, attitudes towards policymakers’ actions to address drug prices, and views of pharmaceutical companies. In addition, with the 2018 midterm elections less than 8 months away, the KFF poll asks how important a national…

  • I bought emergency contraception over-the-counter (OTC) at my pharmacy and thought it would be covered by my insurance, but I ended up having to pay the full cost out-of-pocket. Why wasn’t it cove...

    FAQs

    Emergency contraception is one of the FDA-approved methods for women that must be covered by most health plans, including those sold on the Marketplace, but it has to be prescribed by a health care provider in order for most insurance plans to cover it. If you don’t have a prescription, you will likely have to pay the full cost out-of-pocket. However, you can ask your provider (or pharmacist if your state allows it) for a prescription…

  • I am covered by Medicare, but I don’t take any medications. Do I need to sign up for a drug plan?

    FAQs

    Even if you aren’t taking any medications right now, it makes sense to enroll in a drug plan so that you have coverage in case your needs change in the future. If you don’t have coverage and the Medicare Open Enrollment period has ended, you won’t be able to sign up for coverage until the next Medicare Open Enrollment period begins, and your coverage wouldn’t take effect until January 1 of the following year. This…

  • What You Need to Know About the Medicaid Fiscal Accountability Rule (MFAR)

    Issue Brief

    On November 18, 2019, the Trump Administration released a proposed rule called the Medicaid Fiscal Accountability Regulation (MFAR). This brief provides some context on Medicaid financing, an overview of current state payment and financing rules, the provisions in the rule and potential implications for considerations.