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This brief describes Medicare coverage of sexual and reproductive health services, including contraception, and compares that coverage with private insurance plans and Medicaid. These benefits are particularly relevant to nearly 1 million women of reproductive age (20-49) who are eligible for Medicare due to having a long-term disability.
Most patients do not know about the new surprise billing protections and likely also do not know of resources available to seek recourse for incorrect medical bills. This brief provides resources to privately insured patients who receive surprise balance bills and also summarizes relevant policies and how they apply to balance billing.
Patient-provider email messaging accelerated early in the COVID-19 pandemic as more patients sought medical care remotely, and the addition of billing codes for digital health services and subsequent changes in insurers’ payment policies have enabled providers to bill insurers and patients for messaging.
Note: This content was updated on February 28, 2024 to incorporate new FAQs from CMS. Tables 1 and 2 were also updated to include updated recommendations. It has been more than ten years since the Affordable Care Act (ACA) required private insurance plans to cover recommended preventive services without any patient cost-sharing.
People with medical debt are much more likely than those without such debt to show other signs of financial vulnerability, like having no “rainy day” fund, overdrawing a checking account, or relying on costly loans, according to a new KFF analysis of national survey data.
This analysis of government data finds that people with medical debt are much more likely to have other forms of financial distress than those without medical debt, like having no “rainy day” fund, overdrawing a checking account, or relying on costly loans.
This analysis uses government data to examine the burden of medical debt, including variations based on state, age, race and ethnicity, and health status. It estimates that people in the United States owe at least $220 billion in medical debt.
A KFF analysis shows that a new out-of-pocket spending cap in Medicare Part D could translate into savings for well over 1 million beneficiaries when it takes effect next year, including more than 100,000 people each in California, Florida and Texas, based on analyses of drug spending in 2021.
In 2025, Medicare beneficiaries will pay no more than $2,000 out of pocket for prescription drugs covered under Part D, Medicare’s outpatient drug benefit, due to a provision in the Inflation Reduction Act of 2022. This analysis examines how many Medicare Part D enrollees spent $2,000 or more out of pocket in 2021 and over multiple years, both nationally and at the state level, to show how many people over time could benefit from the new Part D spending cap.
Under the Inflation Reduction Act, the federal government for the first time will negotiate directly with drug companies to determine the prices that Medicare will pay for certain high expenditure drugs covered under Medicare Part D (starting in 2026) and Part B (starting in 2028).
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