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  • Charges for Emails with Doctors and other Healthcare Providers

    Issue Brief

    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. This analysis examines the typical cost of patient-provider email messaging in 2020 and 2021 using private health insurance claims data. The typical cost for an email messaging claim was $39 in 2021,…

  • Lower-Income People with Employer Coverage are More Likely to Report Negative Outcomes Due to Insurance Problems Than Their Higher-Income Peers

    News Release

    Lower-income adults with employer coverage are more likely than their higher-income peers to report negative outcomes due to problems using their insurance, a new KFF analysis shows. Drawing on data from the KFF Survey of Consumer Experiences with Health Insurance, the analysis shows that similar shares of lower- and higher-income adults with employer coverage report having common problems with their insurance such as denied claims or prior authorization issues. At the same time, those with lower incomes…

  • The Burden of Medical Debt: Results from the Kaiser Family Foundation/New York Times Medical Bills Survey

    Report

    To date, there has been little research providing a quantitative look at the causes of medical bill problems and the impacts they have on people’s families, their finances, and their access to health care. To fill this gap, the Kaiser Family Foundation and The New York Times conducted an in-depth survey with 1,204 adults ages 18-64 who report that they or someone in their household had problems paying or an inability to pay medical bills…

  • Patient Cost-Sharing in Marketplace Plans, 2016

    Issue Brief

    This brief and accompanying slides examine cost sharing - deductibles, copayments and coinsurance - in 2016 insurance plans sold on the Affordable Care Act's (ACA) federally-facilitated marketplaces. The analysis looks at out-of-pocket limits, as well as cost sharing for hospital stays, physician visits, emergency room visits, and prescription drugs, for plans across the metal levels (platinum, gold, silver and bronze).

  • Although a Small Share of Medicare Part D Enrollees Take Specialty Drugs, A New Analysis Finds Those Who Do Can Face Thousands of Dollars in Out-of-Pocket Drug Costs Despite Plan Limits on Catastrophic Expenses

    News Release

    Some Medicare Part D enrollees can expect to pay thousands of dollars out-of-pocket for a single specialty drug in 2016, even though Part D plans provide substantial protection against catastrophic costs, according to a new analysis from the Kaiser Family Foundation. The findings illustrate how high prescription drug prices, one of the public's top health care concerns, pose a financial challenge not only for Medicare and other federal health programs but for people on Medicare…

  • Medicare Part D Enrollees with Serious Health Conditions Can Face Thousands of Dollars in Out-of-Pocket Costs Annually for Specialty Drugs

    News Release

    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 drugs used to treat four health conditions -- cancer, hepatitis C, multiple sclerosis and rheumatoid arthritis – based on coverage and costs in national and…

  • 10 Things to Know About Medicare Part D Coverage and Costs in 2019

    Issue Brief

    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 analysis provides the latest data about Medicare Part D coverage and costs in 2019 and trends over time, including enrollment, premiums, cost sharing, and participation in the low-income subsidy program.

  • Round 2 on the Legal Challenges to Contraceptive Coverage: Are Nonprofits “Substantially Burdened” by the “Accommodation”?

    Issue Brief

    The Affordable Care Act (ACA) requires most private health insurance plans to provide coverage for a broad range of preventive services including Food and Drug Administration (FDA) approved prescription contraceptives and services for women. Since the implementation of the ACA contraceptive coverage requirement in 2012, over 200 corporations have filed lawsuits claiming that including coverage for contraceptives or opting for an “accommodation” from the federal government violates their religious beliefs. This brief explains the legal…

  • Survey of Non-Group Health Insurance Enrollees, Wave 2

    Poll Finding

    The survey is the second in a series exploring the experiences and perceptions of people who purchase their own health insurance, the group perhaps most affected by the Affordable Care Act's reforms to the individual insurance market and tax subsidies to make such coverage more affordable. It includes people in ACA-compliant plans sold both inside and outside the federal and state marketplaces, as well as those still in non-compliant plans, which took effect prior to…