Explaining Health Reform: Benefits and Cost-Sharing for Adult Medicaid Beneficiaries August 9, 2010 Issue Brief This brief provides details of the benefit and cost-sharing rules that will govern the coverage available under health reform to these newly eligible adults Medicaid beneficiaries, and it identifies key considerations for state policymakers making Medicaid benefit design choices.
Medicare Part D 2010 Data Spotlight: Benefit Design and Cost Sharing November 30, 2009 Report The Medicare Modernization Act established a defined standard drug benefit for Part D stand-alone Prescription Drug Plans (PDPs) and Medicare Advantage Prescription Drug (MA-PD) plans, while giving plans flexibility to offer alternative benefit designs. Only about one in 10 PDPs offer the standard benefit in 2010. Plan sponsors can offer…
Workplace Wellness Programs, Healthy Behaviors and Health Reform November 29, 2009 Event Many large employers offer financial incentives to their employees to exercise regularly, improve their diets, lose weight and quit smoking. Health reform proposals would write some of these incentives into law. But some patient advocates say that, depending on how the incentives are structured, they can make coverage more expensive…
The Sleeper in Health Reform: Long-Term Care and the CLASS Act October 1, 2009 Event The Kaiser Family Foundation briefing examines a little-noticed but major provision in two leading health reform bills that would change the way that the U.S. pays for long-term care. The provision, known as the Community Living Assistance Services and Supports (CLASS) Act, would establish a national voluntary insurance program that…
Medicare Prescription Drug Plans in 2009 and Key Changes Since 2006: Summary of Findings May 31, 2009 Issue Brief Since 2006, Medicare beneficiaries have had access to prescription drug coverage offered by private plans, either stand-alone prescription drug plans (PDPs) or Medicare Advantage prescription drug plans (MA-PD plans). Today, more than 26 million Medicare beneficiaries are enrolled in Medicare drug plans, including 17.5 million in stand-alone prescription drug plans…
The Medicare Part D Coverage Gap: Costs and Consequences in 2007 August 1, 2008 Report This study quantifies the number of Medicare Part D plan enrollees in 2007 who reached a gap in their prescription drug coverage known as the “doughnut hole,” as well as the changes in beneficiaries’ use of medications and out-of-pocket spending after they reached that gap.
Medicare Part D 2008 Data Spotlight: Formularies January 2, 2008 Issue Brief This Medicare Part D data spotlight examines the formularies (list of covered drugs) of Medicare stand-alone prescription drug plans in 2008, changes since 2006, and differences in how plans cover brand-name and generic drugs. This is one in a series analyzing key aspects of the 2008 Medicare Part D prescription…
Medicare Part D 2008 Data Spotlight: Benefit Design November 30, 2007 Issue Brief This Medicare Part D data spotlight examines the benefit design of Medicare Part D Prescription Drug Plans (PDP) in 2008, focusing on national plans. It shows that in 2008, as in previous years, only about 10 percent of national prescription drug plans offered the defined standard benefit. The spotlight also…
Medicare Part D 2008 Data Spotlight: The Coverage Gap October 30, 2007 Issue Brief This Medicare Part D data spotlight examines the coverage gap, or “doughnut hole,” in Medicare drug plans available in 2008. Part D enrollees (other than those receiving low-income subsidies) will reach the coverage gap after they incur $2,510 in total drug costs in 2008. At that point, enrollees are required…
Medicaid as a Health Insurer: Current Benefits and Flexibility November 29, 2003 Issue Brief This issue brief focuses on one subset of “flexibility” issues: the current federal benefits and cost-sharing rules that apply with respect to acute care. Issue Paper (.pdf)
