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This brief provides an overview of the Medicare Advantage plans that are available for 2025 and key trends over time. The average Medicare beneficiary will have the option of 34 Medicare Advantage prescription drug (MA-PD) plans in 2025, 2 fewer than the 36 options available in 2024. The average Medicare beneficiary can choose among plans offered by 8 firms in 2025, the same as in 2024.
This brief provides an overview of premiums and benefits in Medicare Advantage plans that are available for 2025 and key trends over time. Two-thirds of all Medicare Advantage plans with Part D prescription drug coverage (MA-PDs) (67%) will charge no premium (other than the Part B premium) in 2025, similar to 2024 (66%). Nearly all Medicare Advantage plans (97% or more) are offering vision, dental and hearing, as they have in previous years. However, the…
This analysis examines who was eligible for Medicare and/or Medicaid between 2002 and 2022 because they received disability benefits from one of the country's Social Security disability programs, Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). Many who receive SSDI and SSI qualify for both Medicare and Medicaid, known as dual-eligible individuals.
This report highlights certain policies in place in state Medicaid programs in FY 2024 and policy changes implemented or planned for FY 2025, which began on July 1, 2024 for most states.
Medicare Advantage plans denied 3.4 million prior authorization requests for health care services in whole or in part in 2022, or 7.4% of the 46.2 million requests submitted on behalf of enrollees that year, according to a new KFF analysis of federal data. That was a higher share of denials than in recent years. The share of all prior authorization requests denied by Medicare Advantage plans increased from 5.7% in 2019, 5.6% in 2020 and…
This analysis examines the extent to which states are providing health benefits to their Medicare-eligible retirees through Medicare Advantage arrangements. In 2024, a majority of states offer Medicare Advantage plans to their state retirees, with 13 offering Medicare Advantage exclusively.
In 2023, 5.2 million dual-eligible individuals were enrolled in a Medicare Advantage plan designed specifically for dual-eligible individuals, known as Dual-Eligible Special Needs Plans (D-SNPs). This brief highlights 10 things to know about D-SNPs, including national and state enrollment trends, plan availability, insurer participation, benefits, and prior authorization rates and denials
A KFF analysis shows that a new out-of-pocket spending cap in Medicare Part D could translate into savings for well over 1 million beneficiaries when it takes effect next year, including more than 100,000 people each in California, Florida and Texas, based on analyses of drug spending in 2021. The $2,000 cap, part of the Inflation Reduction Act of 2022, will lead to thousands of dollars in savings for Medicare patients who take high-cost drugs…
In 2025, Medicare beneficiaries will pay no more than $2,000 out of pocket for prescription drugs covered under Part D, Medicare’s outpatient drug benefit, due to a provision in the Inflation Reduction Act of 2022. This analysis examines how many Medicare Part D enrollees spent $2,000 or more out of pocket in 2021 and over multiple years, both nationally and at the state level, to show how many people over time could benefit from the…
For 2024, the average Medicare beneficiary has access to 43 Medicare Advantage plans and can choose from plans offered by 8 firms. Among the majority of Medicare Advantage plans that cover prescription drugs, 66 percent will charge no premium in addition to the monthly Medicare Part B premium. As in previous years, the vast majority of Medicare Advantage plans will offer supplemental benefits, including fitness, dental, vision, and hearing benefits.
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