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This brief examines the evolving requirements for insurers on HealthCare.gov to offer standardized plans that follow set cost sharing rules for covered benefits in addition to other plans they might offer. It also reviews how some state-run marketplaces have used standardized plans to limit cost sharing for insulin, mental health care, and other services.
The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans, including stand-alone drug plans and Medicare Advantage drug plans. This analysis provides the latest data about Part D enrollment, premiums, and cost sharing in 2021 and trends over time.
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.
This brief examines key facts around proposals to align Medicare payments for outpatient services across care settings, otherwise known as “site-neutral payment reforms.”
The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans. This brief analyzes Medicare Part D enrollment and costs in 2023 and trends over time. The analysis highlights the substantial growth of Medicare Advantage drug plans in the marketplace for Part D drug coverage, where enrollment overall is concentrated in a handful of large plan sponsors.
This brief provides an overview of the major health-related COVID-19 federal emergency declarations that have been made since early on in the pandemic, summarizes the flexibilities triggered by each, and identifies the implications for their ending, related to coverage, costs, and payment for COVID-19 testing, treatments, and vaccines; Medicaid coverage and federal match rates; telehealth; access to medical countermeasures through FDA emergency use authorization (EUA); and other Medicaid, Medicare and private health insurance flexibilities.
"What Is Health Care Cost Containment?" Larry Levitt's September 2012 contribution to The JAMA Forum, is now available online.
This July 22, 2013 briefing, Streamlining Cost Sharing in Medicare: The Impact on Beneficiaries, explored the impact on beneficiaries of recent proposals to combine the two main parts of Medicare.
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…
About One In Four Covered Workers Now Face Annual Deductibles Of $1,000 Or More, Including Nearly Half Of Those Employed By Small Businesses WASHINGTON, D.C. -- Workers on average are paying nearly $4,000 this year toward the cost of family health coverage - an increase of 14 percent, or $482, above what they paid last year, according to the benchmark 2010 Employer Health Benefits Survey released today by the Kaiser Family Foundation and the Health…
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