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

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 of Part D enrollees without low-income subsidies who have exceeded the catastrophic coverage threshold annually, and over multiple years, based on 2007-2019 Part D claims data.

Poll: Few are Aware of Hospital Price Transparency Requirements

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, data from the KFF Health Tracking poll shows. Federal regulations that took effect January 1 require this price transparency for hospitals to…

Few Adults Are Aware of Hospital Price Transparency Requirements

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.

Ground Ambulance Rides and Potential for Surprise Billing

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.

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

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…

Medicare Advantage in 2021: Premiums, Cost Sharing, Out-of-Pocket Limits and Supplemental Benefits

In 2021, nearly two-thirds of Medicare Advantage enrollees are in plans that do not charge a premium (other than the Part B premium), although the remaining third do pay a premium, averaging about $60 per month. Most enrollees are in plans that provide access to a variety of supplemental benefits, such as eye exams, dental and fitness benefits. Nearly all enrollees are in plans that require prior authorization for some services. Medicare Advantage cost sharing varies across plans and can be lower than traditional Medicare, but that is not always the case. Slightly more than half of all Medicare Advantage enrollees would incur higher costs than beneficiaries in traditional Medicare with no supplemental coverage for a 6-day hospital stay, though cost are generally lower in Medicare Advantage for shorter stays.

Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2021

The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans, including stand-alone drug plans and Medicare Advantage drug plans. This analysis provides the latest data about Part D enrollment, premiums, and cost sharing in 2021 and trends over time.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.