• Your Selections:

Refine Results

date

Topics

Content Type

Tags

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.

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.

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.

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.

2021 Employer Health Benefits Survey

This annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including premiums, worker contributions, cost-sharing provisions, offer rates, and more. This year’s report also looks at how employers changed their mental health, telemedicine and other benefits in response to the COVID-19 pandemic.

Average Family Premiums Rose 4% This Year to Top $22,000; Employers Boost Mental Health and Telemedicine amid COVID-19 Pandemic, Benchmark KFF Survey Finds

Annual family premiums for employer-sponsored health insurance rose 4% to average $22,221 this year, according to the 2021 benchmark KFF Employer Health Benefits Survey released today. On average, workers this year are contributing $5,969 toward the cost of family coverage, with employers paying the rest. This year’s survey also assesses…

The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

www.kff.org | Email Alerts: kff.org/email | facebook.com/KaiserFamilyFoundation | twitter.com/kff

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