Cost Sharing - Research and Data from KFF

Women who Give Birth Incur Nearly $19,000 in Additional Health Costs, Including $2,854 More that They Pay Out of Pocket

Jul 13, 2022

News Release

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…

The Commercialization of Covid Vaccines Is Coming. Here’s What It Means.

Feb 18, 2023

Perspective

In this commentary for Barron's, KFF's Cynthia Cox and Jennifer Kates explore what will happen with costs to COVID-19 vaccines for people with and without insurance once the relevant public health emergency ends on May 11.

The Average Medicare Beneficiary Has a Choice of 43 Medicare Advantage Plans and 24 Part D Stand-Alone Plans for Coverage in 2023

Nov 10, 2022

News Release

For 2023, the typical beneficiary has a choice of 43 Medicare Advantage plans as an alternative to traditional Medicare, a new KFF analysis finds. That’s an increase of 5 plans on average from 2022, adding even more choices to the Medicare Advantage marketplace, which is poised to become the dominant way Medicare beneficiaries get their health coverage and care. In addition, the typical beneficiary has a choice of 24 Medicare Part D stand-alone prescription drug…

Although Their Share of the Market Varies By State, Enrollment in Medicare Advantage Plans Has More Than Doubled Over the Past Decade, with More than 4 in 10 Medicare Beneficiaries Now Enrolled in the Private Plans

Jun 21, 2021

News Release

The private plans known as Medicare Advantage now cover more than 4 in 10 Medicare beneficiaries, reflecting a more than doubling of enrollment over the past decade even as the plans remain a far larger presence in some states than others, according to a new KFF analysis. More than 26 million of the nation’s nearly 63 million Medicare beneficiaries are enrolled in Medicare Advantage plans in 2021. The share varies considerably by state, ranging from…

Few Adults Are Aware of Hospital Price Transparency Requirements

Jun 28, 2021

Issue Brief

This data note for the Peterson-KFF Health System Tracker shows that few Americans realize that starting this year hospitals are required to post prices of common health services on their websites in a format patients can access and use.

Millions of Medicare Part D Enrollees Have Had Out-of-Pocket Drug Spending Above the Catastrophic Threshold Over Time

Jul 23, 2021

Issue Brief

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…

Medicare Part D: A First Look at Medicare Prescription Drug Plans in 2022

Nov 2, 2021

Issue Brief

This issue brief provides an overview of the Medicare Part D prescription drug benefit market for 2022, with a primary focus on stand-alone drug plans. 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 national Part D drug plans available in 2022.

A Record 3,834 Medicare Advantage Plans Will be Available in 2022, Up 8 Percent From 2021, While the Number of Medicare Part D Stand-Alone Plans is Decreasing Mainly Due to Firm Consolidations

Nov 2, 2021

News Release

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…

Charges for Emails with Doctors and other Healthcare Providers

Mar 6, 2024

Issue Brief

Patient-provider email messaging accelerated early in the COVID-19 pandemic as more patients sought medical care remotely, and the addition of billing codes for digital health services and subsequent changes in insurers’ payment policies have enabled providers to bill insurers and patients for messaging. This analysis examines the typical cost of patient-provider email messaging in 2020 and 2021 using private health insurance claims data. The typical cost for an email messaging claim was $39 in 2021,…

Lower-Income People with Employer Coverage are More Likely to Report Negative Outcomes Due to Insurance Problems Than Their Higher-Income Peers

Dec 19, 2023

News Release

Lower-income adults with employer coverage are more likely than their higher-income peers to report negative outcomes due to problems using their insurance, a new KFF analysis shows. Drawing on data from the KFF Survey of Consumer Experiences with Health Insurance, the analysis shows that similar shares of lower- and higher-income adults with employer coverage report having common problems with their insurance such as denied claims or prior authorization issues. At the same time, those with lower incomes…

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