Cost Sharing

This data note provides an overview of programs that help beneficiaries with modest incomes with their Medicare costs, including the Medicare Savings Programs and the Part D Low-Income Subsidy, and highlights findings from corresponding state-level profiles of eligibility and enrollment.

When the federal government ends COVID-19 emergency declarations that were declared in the early days of the pandemic, it will bring to a close several changes that were enacted temporarily to enable the U.S. health care system to better deal with the crisis. A new KFF resource details a number…

This brief provides an overview of the major health-related COVID-19 federal emergency declarations that have been made since early on in the pandemic, summarizes the flexibilities triggered by each, and identifies the implications for their ending, related to coverage, costs, and payment for COVID-19 testing, treatments, and vaccines; Medicaid coverage and federal match rates; telehealth; access to medical countermeasures through FDA emergency use authorization (EUA); and other Medicaid, Medicare and private health insurance flexibilities.

A current impasse in Congress threatens continued funding for COVID-19 testing, treatment, and vaccines. The lack of additional federal COVID-19 funding has broad implications for access to these services, particularly for the uninsured, and could undermine efforts to ensure equitable access to these resources.

This analysis of insurance claims data finds that Congressional proposals to set a $35 per month cap on what people pay out of pocket for insulin would provide financial relief to at least 1 out of 5 insulin users with different types of private health insurance.

In the face of rising prescription drug costs, a large majority of the public supports federal efforts to lower drug spending. Policymakers are considering several proposals that would lower prescription drug costs. To better understand the potential out-of-pocket cost exposure that Medicare beneficiaries may face for Part B drugs, which are typically administered by physicians and other health care providers, we analyzed cost-sharing liability for these drugs in traditional Medicare and cost-sharing requirements in Medicare Advantage plans.

Americans Likely Owe Hundreds of Billions of Dollars in Total Medical Debt A new KFF analysis of government data estimates that nearly 1 in 10 adults (9%) – or roughly 23 million people – owe medical debt. This includes 11 million who owe more than $2,000 and 3 million people…

This analysis uses government data to examine the burden of medical debt, including variations based on age, race and ethnicity, and health status . It estimates 9% of adults – or roughly 23 million people -owe medical debt, including 11 million who owe more than $2,000.

A new federal law provides new consumer protections against “surprise” medical bills beginning this year. Test your knowledge about its provisions with this 12-question quiz.

This data note explores findings from on an 8-day online search for at home COVID-19 tests at major retailers. The findings are described against the backdrop of the Biden Administration policy requiring plans to cover the cost of these tests. We find that these tests remain hard to find and that this limited availability could negatively affect the success of the reimbursement strategy.