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  • Implications of CMS’s New “Healthy Adult Opportunity” Demonstrations for Medicaid

    Issue Brief

    On January 30, 2020, the Centers for Medicare and Medicaid Services (CMS) released guidance inviting states to apply for new Section 1115 demonstrations known as the “Healthy Adult Opportunity” (HAO). These demonstrations would permit states “extensive flexibility” to use Medicaid funds to cover Affordable Care Act (ACA) expansion adults and other nonelderly adults covered at state option who do not qualify on the basis of disability, without being bound by many federal standards related to…

  • 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,…

  • Analysis Finds Record 3,148 Medicare Advantage Plans Will be Available in 2020

    News Release

    A record 3,148 Medicare Advantage plans will be available across the country as alternatives to traditional Medicare, a new KFF analysis finds. That’s up 15% from last year’s 2,734 plans and results in a typical beneficiary having 28 plans available to them in their local market for the 2020 Medicare open enrollment period, which began Oct. 15 and runs until Dec. 7. About 22 million Medicare beneficiaries - a third of all beneficiaries - are…

  • 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…

  • Medicaid Work Requirements and People with HIV

    Issue Brief

    This data note examines the potential implications of work requirements for people with HIV, a population that relies heavily on Medicaid and for whom there are important clinical and public health reasons for maintaining consistent access to insurance coverage and HIV care.

  • 2019 Employer Health Benefits Survey

    Report

    Annual premiums for employer-sponsored family health coverage reached $20,576 this year, up 5% from last year, with workers on average paying $6,015 toward the cost of their coverage. The average deductible among covered workers in a plan with a general annual deductible is $1,655 for single coverage. Fifty-six percent of small firms and 99% of large firms offer health benefits to at least some of their workers, with an overall offer rate of 57%.

  • Key Questions: HIV and COVID-19

    Issue Brief

    This brief examines and summarizes what we know about COVID-19 and HIV including, what we know about COVID-19 risk, disease severity, vaccination, and federal response. It also explores how people with HIV are overly represented in many of the demographic groups hardest hit by the pandemic.

  • Blue Wall Voices Project

    Report

    This partnership polling report from KFF and The Cook Political Report examining the attitudes and experiences of voters in in four states (Michigan, Minnesota, Pennsylvania, and Wisconsin) that were previously considered Democratic strongholds. It probes voters’ views of President Trump and the Democratic primaries, their motivations for voting, and issues including health care, the economy, immigration and trade a year out from the 2020 general election.