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This brief reviews research from 65 papers published between 2000 and March 2017 on the effects of premiums and cost sharing on low-income populations in Medicaid and CHIP. This research has primarily focused on how premiums and cost sharing affect coverage and access to and use of care; some studies also have examined effects on safety net providers and state savings.
Since 1973, the program has also provided coverage to millions of people with permanent disabilities who are younger than age 65. This data note compares average per capita Medicare spending and service use for beneficiaries under age 65 to spending among those over age 65.
This data note examines the effects of rising EpiPen prices on Medicare and beneficiaries. We analyze EpiPen spending, in the aggregate and per user, in Medicare Part D between 2007 (the year after the Part D drug benefit took effect, and the year Mylan acquired the product) and 2014 (the most recent year of data available).
This brief explains key components of Michigan and Indiana's Medicaid expansions under Section 1115 demonstration waivers and presents insights from stakeholder interviews and focus groups about early implementation experience.
In an effort to simplify Medicare’s cost-sharing requirements, provide beneficiaries with catastrophic protection, and achieve program savings, some have proposed to restructure Medicare’s benefit design. Several recent proposals would create a unified deductible for Medicare Parts A and B, simplify cost-sharing requirements above the deductible, and add an annual limit on beneficiary out-of-pocket spending—a benefit feature typical of larger employer plans, but lacking in traditional Medicare. This issue brief describes the options for adding an out-of-pocket spending limit to Medicare and examines the operational issues that could arise in implementing both a uniform and an income-based out-of-pocket spending limit. Because the implementation of an income-related out-of-pocket maximum would pose somewhat greater complexity for Medicare, the operational issues associated with this approach are discussed in greater detail.
This 10-question quiz tests your knowledge about the coronavirus and COVID-19, including issues around symptoms, testing, number of cases and deaths, and cost sharing for treatment.
This data note captures February 2020 poll findings on the public's worries about and experiences with unexpected and surprise medical bills.
When it comes to family budget concerns, unexpected medical bills top Americans’ list of worries, with two-thirds (65%) of the public saying they are at least somewhat worried, including 35% who say they are “very” worried, the latest KFF Health Tracking Poll finds.
New federal legislation will require most private health plans to cover testing for the coronavirus with no cost sharing. Some states have adopted similar requirements for insurers they regulate, and many private insurance companies will voluntarily expand coverage for testing. However, some private coverage will not be subject to these requirements. To date, fewer changes have been adopted or considered with respect to treatment for complications from the disease. This brief reviews current coverage standards for private health plans and how these may change in response to the COVID-19 pandemic.
In light of heightened attention to insulin and the Trump Administration’s new Part D model to address out-of-pocket costs for insulin for Medicare beneficiaries, we analyzed out-of-pocket spending on insulin by beneficiaries enrolled in Part D drug plans, variation in Part D plan formulary coverage and tier placement of insulin products, and trends in prices for insulin.
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