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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…

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.

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…

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.

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%.

Surprise Bills Often Hit in Emergencies

In an Axios column, Drew Altman previews new data highlighting that people with critical health issues are especially vulnerable to these bills. 

Web Briefing for Media: 2019 Employer Health Benefits Survey

The Kaiser Family Foundation held a reporters-only web briefing on Wednesday, Sept. 25 to release the 2019 benchmark Employer Health Benefits Survey. This 21st annual survey provides a detailed look at the current state of employer-based coverage and trends in private health insurance for both large and small firms. Key…

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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.