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JAMA Forum: Don’t Be Surprised if the Next Big Health Care Debate Is About Drug Prices
In this post for The JAMA Forum, Larry Levitt examines both the Democratic candidates’ proposals and the Trump administration’s record on lowering drug prices, which remains a top issue for the public with bi-partisan support.
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Health Affairs Article: Medicare Part D Plans Rarely Cover Brand-Name Drugs When Generics Are Available
In an article in Health Affairs, KFF’s Juliette Cubanski, Sarah True and Tricia Neuman, and several other co-authors, explore how often brand-name drugs receive favorable formulary inclusion relative to generics in the Medicare Part D program’s prescription drug plans.
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Cost-Sharing Waivers and Premium Relief by Private Plans in Response to COVID-19 (Nov. 2020 Update)
An updated issue brief estimates the number of enrollees in individual and fully-insured group market plans that have waived cost-sharing – out-of-pocket costs including coinsurance, copayments, and deductibles – for COVID-19 treatment. The analysis also estimates the number of enrollees whose insurer is offering various forms of premium payment relief.…
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Medicare Advantage 2021 Spotlight: First Look
For 2021, the average Medicare beneficiary has access to 33 Medicare Advantage plans, the largest number of options available in the last decade, and can choose from plans offered by eight firms. Among the majority of Medicare Advantage plans that cover prescription drugs, 54 percent will charge no premium in addition to the monthly Medicare Part B premium. As in previous years, the vast majority of Medicare Advantage plans will offer supplemental fitness, dental, vision, and hearing benefits. In addition, virtually all will also offer telehealth benefits in 2021.
Issue Brief Read More 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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Do People Who Sign Up for Medicare Advantage Plans Have Lower Medicare Spending?
The analysis finds that people who switched from traditional Medicare to Medicare Advantage in 2016 had health spending in 2015 that was $1,253 less, on average, than the average spending for beneficiaries who remained in traditional Medicare (after adjusting for health risk). The findings suggest that the current payment method may systematically overestimate expected costs of Medicare Advantage enrollees. Adjusting payments to reflect Medicare Advantage enrollees’ prior use of health services could potentially lower total Medicare spending by billions of dollars over a decade.
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Tracking the Rise in Premium Contributions and Cost-Sharing for Families with Large Employer Coverage
An analysis of large employer health coverage on the Peterson-Kaiser Health System Tracker finds that the cost to families for health coverage and care has risen more than two times faster than wages and three times faster than inflation over the last decade.
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New Analysis of Large Employer Health Coverage: The Cost to Families for Health Coverage and Care Has Risen More Than 2X Faster Than Wages and 3X Faster Than Inflation Over the Last Decade
A new KFF analysis that looked at both premiums and other out-of-pocket costs shows that families with coverage through a large employer paid 67 percent more for their health benefits and care in 2018 than a decade earlier. In 2018, a typical family of four with large employer coverage spent…
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Benchmark Employer Survey Finds Average Family Premiums Now Top $20,000
Annual family premiums for employer-sponsored health insurance rose 5% to average $20,576 this year, according to the 2019 benchmark KFF Employer Health Benefits Survey released today. Workers’ wages rose 3.4% and inflation rose 2% over the same period. On average, workers this year are contributing $6,015 toward the cost of family coverage, with employers paying the rest.
News Release Read More 2019 Employer Health Benefits Survey
Annual premiums for employer-sponsored family health coverage reached $20,576 this year, up 5% from last year, with workers on average paying $6,015 toward the cost of their coverage. The average deductible among covered workers in a plan with a general annual deductible is $1,655 for single coverage. Fifty-six percent of small firms and 99% of large firms offer health benefits to at least some of their workers, with an overall offer rate of 57%.
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