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This brief describes current coverage of GLP-1s in Medicare and Medicaid, the Centers for Medicare & Medicaid Services’ (CMS) efforts to expand access and lower costs for GLP-1s through temporary demonstration programs including the BALANCE Model, and potential impacts on beneficiaries and program budgets.
This slideshow captures key data from the 2024 KFF Employer Health Benefits Survey survey, providing a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing, abortion coverage, offer rates, wellness programs, and other employer practices.
The Medicare Part D program provides an outpatient prescription drug benefit to more than 50 million older adults and people with long-term disabilities in Medicare who enroll in private plans, including stand-alone prescription drug plans (PDPs) to supplement traditional Medicare and Medicare Advantage prescription drug plans (MA-PDs) that include drug coverage and other Medicare-covered benefits. This brief analyzes Medicare Part D enrollment and costs in 2025 and trends over time, based on data from the…
Revamping traditional Medicare’s benefit design and restricting “first-dollar” supplemental coverage could reduce federal spending, simplify cost sharing, protect against high medical costs, decrease out-of-pocket spending for many beneficiaries, and provide more help to those with low incomes -- but would be unlikely to achieve all of these goals simultaneously.
In this Wall Street Journal Think Tank column, Drew Altman discusses why adequacy of health coverage will rise as an issue when the political world moves on from its focus on the Affordable Care Act.
Higher cost sharing in private insurance has been credited with helping to slow the growth of health care costs in recent years. For families with low incomes or moderate incomes, however, high deductibles, out-of-pocket limits and other cost sharing can be a potential barrier to care and may lead these families to significant financial difficulties. This issue brief uses information from the Federal Reserve Board's 2013 Survey of Consumer Finances to look at how household…
This blog post revisits an earlier analysis of the drug Sovaldi (sofosbuvir) using new data released by the Centers for Medicare and Medicaid Services, and considers both the ongoing impact of hepatitis C drugs for Medicare Part D and the broader implications for Medicare of new high-priced drugs entering the market.
With Medicare Part D nearing the end of its tenth year, the program -- which now provides drug coverage to 72 percent of all Medicare beneficiaries -- has experienced no growth in average premiums in recent years but some notable increases in cost-sharing, according to a new report from the Kaiser Family Foundation. At a time of heightened public concern about the cost of prescription drugs, the report, Medicare Part D at Ten Years: The…
This note illustrates the impact of the cost-sharing reductions in current law by looking at how they affect average deductibles and out-of-pocket maximum limits in benchmark silver plans in 2017 in states using the federally facilitated marketplace.
A record 3,834 Medicare Advantage plans will be available across the country as alternatives to traditional Medicare for 2022, a new KFF analysis finds. That’s an increase of 8 percent from 2021, and the largest number of plans available in more than a decade. At the same time, the number of Medicare Part D stand-alone prescription drug plans that will be offered in 2022 is decreasing by 23 percent to 766 plans, primarily the result…
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