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This issue brief provides an overview of the Medicare Part D marketplace in 2023 and key trends over time, focusing primarily on stand-alone Medicare drug plans, including plan availability, premiums, and cost sharing. The brief also describes the prescription drug provisions in the Inflation Reduction Act of 2022 that affect the Medicare Part D marketplace beginning in 2023
For 2023, the average Medicare beneficiary has access to 43 Medicare Advantage plans and can choose from plans offered by nine firms. Among the majority of Medicare Advantage plans that cover prescription drugs, 66 percent will charge no premium in addition to the monthly Medicare Part B premium. As in previous years, the vast majority of Medicare Advantage plans will offer supplemental benefits, including fitness, dental, vision, and hearing benefits. In addition, virtually all will…
This issue brief provides an overview of the Medicare Part D prescription drug benefit plan landscape, with a focus on stand-alone drug plans, the largest segment of the Part D market. It includes national and state-level data on plan availability, premiums, benefit design, cost sharing, information about premium-free plans for low-income beneficiaries, and information about the top ten Part D plans for 2019.
Illustrative-Plan-Designs-for-Single-Coverage-HEALTHREFORM Download Source Kaiser Family Foundation
How Much " Skin in the Game " is Enough? The Financial Burden of Health Spending for People on Medicare Medicare extends health security and financial protection to seniors and younger people with disabilities. However, premiums, relatively high cost-sharing requirements, and gaps in the benefit package result in some beneficiaries spending a significant share of their income on health expenses. This data spotlight examines the burden out-of-pocket expenses placed on Medicare beneficiaries between 1997 and…
This analysis documents average deductibles for Affordable Care Act Marketplace plans available on Healthcare.gov in 2026 for all metal tiers, including silver plans after cost-sharing reductions are applied, as well as trend data since 2014.
Based on stakeholder interviews and early data on coverage, reduced uncompensated care costs, and other topics, this issue brief provides an initial look at implementation of Arkansas' Section 1115 Medicaid expansion demonstration waiver to require most adults newly eligible for Medicaid through the Affordable Care Act's Medicaid expansion to enroll in Marketplace plans.
A new Kaiser Family Foundation report released today finds how health insurance carriers are interpreting and implementing the Affordable Care Act's contraceptive coverage requirement varies, limiting contraceptive options for some women. The ACA requires most private health insurance plans to cover a range of preventive services for women, including prescribed FDA-approved contraceptives and services without cost sharing. The report reviews how health carriers are applying medical management limitations to contraceptive coverage that affect women’s contraceptive…
This report examines the causes and contributors to medical debt, medical bankruptcy, and other difficulties with medical bills among people with insurance. Through in-depth interviews of nearly two-dozen people and quantitative analysis of national survey data, the authors of this report find that in-network and out-of-net-work cost sharing primarily contribute to medical debt among the insured.
Until Congress passes the reconciliation bill, Marketplace insurers will face uncertainty regarding the regulatory landscape and may find it difficult to set premiums for 2026.
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