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  • Medigap Reforms: Potential Effects of Benefit Restrictions on Medicare Spending and Beneficiary Costs

    Report

    As part of several debt-reduction and Medicare-reform proposals, some policymakers propose to prohibit Medicare supplemental insurance policies (known as Medigap) from covering all of enrollees' out-of-pocket Medicare costs, which some believe leads to higher use of services and higher Medicare spending. Such changes would expose Medigap enrollees – currently about one in six Medicare beneficiaries – to a larger share of Medicare's cost-sharing requirements. This analysis commissioned by the Kaiser Family Foundation examines three potential…

  • What resources are available for privately insured patients who get surprise balance bills?

    Issue Brief

    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.

  • Copay Adjustment Programs: What Are They and What Do They Mean for Consumers?

    Issue Brief

    Drug makers sometimes offer copay coupons to lower consumers’ out-of-pocket costs for their brand-name prescriptions, though how private health plans treat those coupons can substantially limit their value to consumers. This issue brief provides an overview of such copay adjustment programs, stakeholder arguments for and against their use, their prevalence, and federal and state efforts to address them.

  • Medicare 101: What You Need To Know

    Event Date:
    Event

    Hosted by the Kaiser Family Foundation and the Alliance for Health Reform, this briefing reviewed basic questions about the Medicare program, such as: What services does Medicare provide, and how does Medicare pay for these services? How is Medicare financed? What changes did the Affordable Care Act (ACA) make to Medicare? How fast is Medicare spending growing? What are current proposals to strengthen Medicare for the future, and what are prospects for action in the…

  • Coverage of Contraceptive Services: A Review of Health Insurance Plans in Five States

    Report

    The Patient Protection and Affordable Care Act (ACA) requires most private plans to provide coverage for women’s preventive health care, including all prescribed FDA-approved contraceptive services, without cost sharing. To better understand how this provision is being implemented by health plans, Kaiser Family Foundation (KFF) staff, with the Lewin Group, reviewed the insurance plan coverage policies for 12 prescribed contraceptive methods (excluding oral contraceptives). This report presents information from 20 different insurance carriers in five…

  • Minimum Contraceptive Coverage Requirements Clarified by HHS Guidance

    Issue Brief

    New HHS clarification on ACA contraceptive coverage requirement specifies that insurance plans must cover at no cost to women all of the 18 contraceptive methods approved by the FDA.  If a provider recommends a specific option or product, plans must cover it at no cost as well. Minimum Contraceptive Coverage Requirements Clarified by HHS GuidanceContraceptive MethodProducts/OptionsMust CoverSurgical sterilizationAlso called tubal ligation√Implant sterilizationOnly Essure available√Implantable RodMultiple√ at least 1IUD - CopperOnly ParaGard available√IUD - ProgestinMultiple√ at least 1InjectionMultiple√ at…

  • 2015 Employer Health Benefits Survey

    Report

    This annual Employer Health Benefits Survey (EHBS) provides a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing provisions, and other relevant information. The 2015 EHBS survey finds average family health premiums rose 4 percent in 2015, relatively modest growth by historical standards.

  • Medicare’s Drug Benefit Is Firmly-Established After Its First Decade, With Flat Premiums in Recent Years but Higher Cost-Sharing Over Time 

    News Release

    With Medicare Part D nearing the end of its tenth year, the program -- which now provides drug coverage to 72 percent of all Medicare beneficiaries -- has experienced no growth in average premiums in recent years but some notable increases in cost-sharing, according to a new report from the Kaiser Family Foundation. At a time of heightened public concern about the cost of prescription drugs, the report, Medicare Part D at Ten Years: The…

  • Harvard and Growth in Health Care Cost Sharing

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman explains why recent discussion of Harvard University’s introduction of new health insurance cost sharing measures amounted to “making a mountain out of a mole hill”.