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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In an Axios column, Drew Altman previews new data highlighting that people with critical health issues are especially vulnerable to these bills.
A new issue brief looks at the prevalence of potential surprise medical bills based on patient diagnosis, emergency visits, and type of inpatient admission.
This summarizes key provisions of the No Surprises Act, enacted in December 2020 to address the problem of unexpected medical bills, and issues that could arise during implementation ahead of its Jan. 1, 2022 effective date.
Annual Updates on Eligibility Rules, Enrollment and Renewal Procedures, and Cost-Sharing Practices in Medicaid and CHIP
Since 2000, KFF’s Program on Medicaid and the Uninsured has issued regular updates examining changes and trends in the eligibility rules, enrollment and renewal procedures and cost-sharing practices in Medicaid and CHIP. Those reports are compiled here.
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.
The brief examines the potential impact of Aduhelm, a newly approved drug for Alzheimer’s disease, on state and federal Medicaid costs and looks at potential policy actions that could limit Medicaid’s potential costs.
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.
Potential Savings for Medicare Part D Enrollees Under Proposals to Add a Hard Cap on Out-of-Pocket Spending
Medicare Part D, the outpatient prescription drug benefit for Medicare beneficiaries, provides coverage above a catastrophic threshold for high out-of-pocket drug costs, but there is no cap on total out-of-pocket drug costs that beneficiaries pay each year. Recent legislative proposals would add a cap on out-of-pocket spending under Part D. This analysis focuses on the potential impact of different out-of-pocket spending caps in terms of how many beneficiaries would be affected and how much they could save.