Medicare

New & Noteworthy

What to Know About Medicare Coverage of Telehealth

Congress has repeatedly extended pandemic-era flexibilities around Medicare coverage of telehealth, but most such flexibilities remain temporary. This brief answers key questions about the current scope of Medicare telehealth coverage, including both temporary and permanent changes adopted through legislation and regulation, and future policy considerations.

Examining the Potential Impact of Medicare’s New WISeR Model

A federal initiative to establish new prior authorization requirements in traditional Medicare, called the Wasteful and Inappropriate Service Reduction (WISeR) model, is likely to have only modest impact in its first year.

State Profiles for Dual-Eligible Individuals

This data collection draws on Medicare and Medicaid administrative data to present national and state-level information on people who are covered by both Medicare and Medicaid, referred to as dual-eligible individuals (also known as dually-enrolled beneficiaries).

Data Visualization

The Facts About Medicare Spending

This interactive provides the facts on Medicare spending. Medicare, which serves 67 million people and accounts for 12 percent of the federal budget and 21 percent of national health spending, is often the focus of discussions about health expenditures, health care affordability and the sustainability of federal health programs.

Explore data on enrollment growth, Medicare spending trends overall and per person, growth in Medicare spending relative to private insurance, spending on benefits and Medicare Advantage, Part A trust fund solvency challenges, and growth in out-of-pocket spending by beneficiaries.

Related: FAQs on Medicare Financing and Trust Fund Solvency

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  • Policy Options for Improving Dental Coverage for People on Medicare

    Issue Brief

    Medicare does not cover routine dental care and about half of Medicare beneficiaries do not have dental coverage. This brief examines five potential ways to make oral health care more available and affordable for the Medicare population. This brief reviews the limits of dental coverage permitted under current Medicare law, then describes each of the policy options, with an analysis of likely implications for key stakeholders, including Medicare beneficiaries, taxpayers, insurers, and dental professionals

  • A Look at Recent Proposals to Control Drug Spending by Medicare and its Beneficiaries

    Issue Brief

    In response to higher drug spending growth and heightened attention to drug prices, policymakers have proposed a variety of policy initiatives to lower the cost of prescription drugs in Medicare. This brief examines in detail the range of proposals offered by the Trump Administration and members of Congress for lowering the cost of prescription drugs, their known effects on the federal budget, and their potential implications for beneficiaries and other stakeholders.

  • FAQs on Medicare Financing and Trust Fund Solvency

    Issue Brief

    In discussions of Medicare’s financial condition, attention frequently centers on one specific measure—the solvency of the Medicare Hospital Insurance (HI) trust fund, out of which Medicare Part A benefits are paid. Based on current projections from the Medicare Board of Trustees, the HI trust fund is projected to be depleted in 2036, 12 years from now. These FAQs answer key questions about Medicare financing and trust fund solvency.

  • Is the End of the Long-Term Care Crisis Within Sight? New COVID-19 Cases and Deaths in Long-Term Care Facilities Are Dropping

    Policy Watch

    This analysis compares trends in new COVID-19 cases and deaths among nursing facility residents with trends in all other new COVID-19 cases and deaths excluding nursing facility residents through February 7, 2021. This analysis shows a marked divergence in new cases and deaths per week between nursing facility residents and the rest of the US population since December 2020. This drop in new deaths and cases in nursing facility residents coincides with the start of vaccine administration in LTCFs, suggesting a link between the two, although the trends could also be influenced by other factors.

  • Racial and Ethnic Health Inequities and Medicare

    Report

    This chart collection draws on primary and secondary data analyses by KFF and other sources to examine the characteristics, experiences, and outcomes of the Medicare population by race and ethnicity

  • Medicare and Dental Coverage: A Closer Look

    Issue Brief

    Medicare does not cover routine dental care and about half of Medicare beneficiaries do not have dental coverage. Some beneficiaries have dental coverage through other sources, including Medicare Advantage, but 47% of all beneficiaries have not been to the dentist in the past year and many older adults face high out-of-pocket costs for needed dental care. This brief provides new data on the share of Medicare beneficiaries with dental coverage, the share with a dental visit in the past 12 months, and out-of-pocket spending on dental care. It also takes a closer look at the scope of dental benefits offered to Medicare Advantage enrollees in individual plans in 2021.

  • Millions of Medicare Part D Enrollees Have Had Out-of-Pocket Drug Spending Above the Catastrophic Threshold Over Time

    Issue Brief

    Medicare Part D, the outpatient prescription drug benefit for Medicare beneficiaries, provides catastrophic coverage for high out-of-pocket drug costs, but there is no limit on the total amount that beneficiaries have to pay out of pocket each year. Policymakers on both sides of the aisle support proposals to modify the design of the Part D benefit and establish a hard cap on out-of-pocket prescription drug spending by Part D enrollees. This analysis shows the number of Part D enrollees without low-income subsidies who have exceeded the catastrophic coverage threshold annually, and over multiple years, based on 2007-2019 Part D claims data.