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  • Managing Medicaid Pharmacy Benefits: Current Issues and Options

    Report

    This report examines reimbursement, benefit management and cost sharing issues in Medicaid pharmacy programs. The analysis, conducted by researchers from the Foundation's Kaiser Commission on Medicaid and the Uninsured and Health Management Associates, focuses on the potential of several measures recently highlighted by Health and Human Services Secretary Kathleen Sebelius to reduce Medicaid pharmacy costs and is informed, in part, by the perspectives of a group of Medicaid pharmacy administrators convened by the Foundation in…

  • Health Care Costs: A Primer

    Issue Brief

    This primer on health care spending in the United States reviews the growth in health care spending since 1970 and the impact of health care costs on families and employers.

  • Adding an Out-of-Pocket Spending Maximum to Medicare: Implementation Issues and Challenges

    Issue Brief

    In an effort to simplify Medicare’s cost-sharing requirements, provide beneficiaries with catastrophic protection, and achieve program savings, some have proposed to restructure Medicare’s benefit design. Several recent proposals would create a unified deductible for Medicare Parts A and B, simplify cost-sharing requirements above the deductible, and add an annual limit on beneficiary out-of-pocket spending—a benefit feature typical of larger employer plans, but lacking in traditional Medicare. This issue brief describes the options for adding an…

  • New Analysis Highlights Variations and Trends in Medicare Beneficiaries’ Out-of-Pocket Spending

    News Release

    A new Kaiser Family Foundation analysis and chartbook break down what beneficiaries with traditional Medicare pay for their health care, including insurance premiums, and costs for medical and long-term care services. The analysis highlights the significant variations in what people pay based on the services they use, and their age, gender and other characteristics, and highlights trends in out-of-pocket spending. Based on the latest available data from a nationally representative survey of people on Medicare,…

  • Medicare Part D in Its Ninth Year: The 2014 Marketplace and Key Trends, 2006-2014

    Report

    This report presents findings from an analysis of the Medicare Part D marketplace in 2014 and changes in features of the drug benefit offered by Part D plans since 2006. It examines the latest information and trends related to Part D enrollment and plan availability, premiums, benefit design and cost sharing, pharmacy networks, the Low-Income Subsidy Program, and plan performance ratings.

  • Report Examines Trends in the Medicare Part D Plan Marketplace

    News Release

    A new comprehensive Kaiser Family Foundation report analyzes key trends that have shaped the Medicare Part D marketplace since the program launched nine years ago, providing a detailed assessment of changes in plan availability, enrollment, premiums and cost sharing in both private stand-alone drug plans, and Medicare Advantage drug plans.

  • Tax Subsidies for Private Health Insurance

    Issue Brief

    This brief describes the different forms of tax assistance for private health insurance, including subsidies offered through the Affordable Care Act's marketplaces and benefits for people who are self-employed or who have employer-based coverage. The brief also provides examples of how the subsidies work and how the amounts may differ by income and type of coverage.

  • El seguro de salud, explicado: ¡los YouToons lo tienen cubierto!

    Video

    El seguro de salud, explicado: ¡los YouToons lo tienen cubierto! desglosa conceptos de seguros como primas, deducibles y redes de proveedores.  Explica cómo las personas pagan por su cobertura y cómo obtener cuidado médico y medicamentos recetados con distintos tipos de seguros de salud, incluyendo HMOs y PPOs.

  • Medigap Reforms: Potential Effects of Benefit Restrictions on Medicare Spending and Beneficiary Costs

    Report

    As part of several debt-reduction and Medicare-reform proposals, some policymakers propose to prohibit Medicare supplemental insurance policies (known as Medigap) from covering all of enrollees' out-of-pocket Medicare costs, which some believe leads to higher use of services and higher Medicare spending. Such changes would expose Medigap enrollees – currently about one in six Medicare beneficiaries – to a larger share of Medicare's cost-sharing requirements. This analysis commissioned by the Kaiser Family Foundation examines three potential…

  • Payments for Cost Sharing Increasing Rapidly Over Time

    Issue Brief

    This Kaiser Family Foundation analysis finds that for workers covered by their employer's health plans, out-of-pocket costs including deductibles and coinsurance have been increasing significantly faster than costs paid by insurers, reflecting a decade-long trend toward slightly less generous coverage.