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This analysis for the Peterson-KFF Health System Tracker finds that half of emergency ground ambulance rides result in an out-of-network charge for people with private health insurance, potentially leaving patients at risk of getting a surprise bill.
About half of emergency ground ambulance rides result in an out-of-network charge for people with private health insurance, potentially leaving patients at risk of getting a surprise bill, a new KFF analysis for the Peterson-KFF Health System Tracker finds. Congress last year enacted the “No Surprises Act,” which prohibits most surprise out-of-network bills when a patient receives out-of-network services during an emergency visit or at an in-network hospital without advance notice starting in 2022. However,…
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…
The health care costs associated with pregnancy and childbirth average almost $19,000, including $2,854 paid out-of-pocket, a new KFF analysis of large employers’ insurance claims finds. Unlike other analyses that examine costs of specific pregnancy-related services, such as a vaginal or cesarean delivery, this new analysis compares three years of health care claims for reproductive-aged women who gave birth to claims for women who had not given birth. The analysis finds women who give birth…
These FAQs review mental health and substance use disorder coverage and cost sharing in Medicare and discuss recent policy changes related to coverage of mental health and substance use disorder treatments.
This data note explores findings from on an 8-day online search for at home COVID-19 tests at major retailers. The findings are described against the backdrop of the Biden Administration policy requiring plans to cover the cost of these tests. We find that these tests remain hard to find and that this limited availability could negatively affect the success of the reimbursement strategy.
In the face of rising prescription drug costs, a large majority of the public supports federal efforts to lower drug spending. Policymakers are considering several proposals that would lower prescription drug costs. To better understand the potential out-of-pocket cost exposure that Medicare beneficiaries may face for Part B drugs, which are typically administered by physicians and other health care providers, we analyzed cost-sharing liability for these drugs in traditional Medicare and cost-sharing requirements in Medicare…
A current impasse in Congress threatens continued funding for COVID-19 testing, treatment, and vaccines. The lack of additional federal COVID-19 funding has broad implications for access to these services, particularly for the uninsured, and could undermine efforts to ensure equitable access to these resources.
This issue brief provides an overview of the 2018 Medicare Part D stand-alone prescription drug plan landscape, the largest segment of the Part D marketplace, It includes national and state-level data on plan availability, premiums, benefit design, cost sharing, information about premium-free plans for low-income beneficiaries, and information about the top ten Part D plans in 2018.
This brief looks at the extent to which people have enough savings to meet the cost sharing requirements under private health insurance policies, which have risen substantially in recent years.
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