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An Overview of Medicare

This issue brief provides an overview of Medicare, the health insurance program for people ages 65 and over and younger people with long-term disabilities. The brief review the characteristics of people on Medicare, what Medicare covers, benefit gaps and supplemental coverage, beneficiaries’ out-of-pocket health care spending, program spending and financing, payment and delivery system reform, and issues for the future of Medicare.

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The Out-of-Pocket Cost Burden for Specialty Drugs in Medicare Part D in 2019

Medicare Part D has helped to make prescription drugs more affordable for people with Medicare, yet many beneficiaries continue to face high out-of-pocket costs for their medications. Specialty tier drugs are a particular concern for Part D enrollees in this context. This analysis draws on data from Medicare’s Plan Finder website to calculate expected annual 2019 out-of-pocket costs for 30 specialty tier drugs used to treat four health conditions—cancer, hepatitis C, multiple sclerosis, and rheumatoid arthritis.

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The Henry J. Kaiser Family Foundation

Medicare Part D Enrollees with Serious Health Conditions Can Face Thousands of Dollars in Out-of-Pocket Costs Annually for Specialty Drugs

Despite Medicare’s protections, Part D enrollees with serious health conditions can face thousands of dollars in annual out-of-pocket costs for expensive specialty drugs, a new KFF anaylsis finds. The analysis draws on data from Medicare’s Plan Finder website to calculate expected annual 2019 costs for more than two dozen specialty tier…

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Initiative 18|11: What Can We Do About The Cost Of Health Care?

This conference report summarizes discussions at a March 2018 conference in Washington with 30 leaders from the health care community to launch Initiative 18/11, a partnership between the Society of Actuaries and KFF to address the rising cost of health care in the United States. It also lays out the next steps for the initiative.

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Cost-Sharing for Plans Offered in the Federal Marketplace for 2019

This analysis documents average deductibles and out-of-pocket limits for 2019 Affordable Care Act marketplace plans available on Healthcare.gov on all metal tiers, including silver plans after cost-sharing reductions are applied.

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The Henry J. Kaiser Family Foundation

New England Journal of Medicine: Medicare Advantage Checkup

In this November 2018 New England Journal of Medicine article, KFF’s Tricia Neuman and Gretchen Jacobson examine the extent to which Medicare Advantage plans are achieving goals with respect to benefits, out-of-pocket costs, plan choice, federal spending and quality.

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Medicare Part D: A First Look at Prescription Drug Plans in 2019

This issue brief provides an overview of the Medicare Part D prescription drug benefit plan landscape, with a focus on stand-alone drug plans, the largest segment of the Part D market. 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 for 2019.

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The Henry J. Kaiser Family Foundation

Web Briefing for Media: 2018 Employer Health Benefits Survey

The Kaiser Family Foundation held a reporters-only web briefing on Oct. 3, 2018, to release the 2018 benchmark Employer Health Benefits Survey. This 20th annual survey provides a detailed look at the current state of employer-based coverage and trends in private health insurance for both large and small firms. Key…

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