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  • Standard Medicare Prescription Drug Benefit, 2013

    Feature

    Standard Medicare Prescription Drug Benefit, 2013 Download Source Kaiser Family Foundation illustration based on CMS standard benefit parameter update for 2013.  Amounts rounded to nearest dollar.

  • Managing Medicaid Pharmacy Benefits: Current Issues and Options

    Report

    This report examines reimbursement, benefit management and cost sharing issues in Medicaid pharmacy programs. The analysis, conducted by researchers from the Foundation's Kaiser Commission on Medicaid and the Uninsured and Health Management Associates, focuses on the potential of several measures recently highlighted by Health and Human Services Secretary Kathleen Sebelius to reduce Medicaid pharmacy costs and is informed, in part, by the perspectives of a group of Medicaid pharmacy administrators convened by the Foundation in…

  • Do People Who Sign Up for Medicare Advantage Plans Have Lower Medicare Spending?

    Issue Brief

    The analysis finds that people who switched from traditional Medicare to Medicare Advantage in 2016 had health spending in 2015 that was $1,253 less, on average, than the average spending for beneficiaries who remained in traditional Medicare (after adjusting for health risk). The findings suggest that the current payment method may systematically overestimate expected costs of Medicare Advantage enrollees. Adjusting payments to reflect Medicare Advantage enrollees’ prior use of health services could potentially lower total…

  • Private Health Coverage of COVID-19: Key Facts and Issues

    Issue Brief

    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…

  • Vaccines Are Free. Covid Care Is Not. Who Should Pay?

    Perspective

    In this commentary for Barron's, Cynthia Cox explores the impact to the American public as the U.S. health insurance system adjusts to the COVID-19 pandemic. She uses the experience of the past year and a half to raise questions about broader issues of fairness in the distribution of health care costs in the country.

  • Analysis: Half of Emergency Ambulance Rides Lead to Out-of-Network Bills for Privately Insured Patients

    News Release

    About 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, a new KFF analysis for the Peterson-KFF Health System Tracker finds. Congress last year enacted the “No Surprises Act,” which prohibits most surprise out-of-network bills when a patient receives out-of-network services during an emergency visit or at an in-network hospital without advance notice starting in 2022. However,…

  • No Surprises Act Implementation: What to Expect in 2022

    Issue Brief

    The “No Surprises Act,” which establishes new federal protections against most surprise out-of-network medical bills when a patient receives out-of-network services during an emergency visit or from a provider at an in-network hospital without advance notice, will take effect next month. A new KFF brief outlines what to expect in 2022.

  • Key Facts About Medicare Part D Enrollment and Costs in 2022

    Issue Brief

    This analysis provides the latest data about Medicare Part D enrollment, premiums, and cost sharing in 2022 and trends over time, including information about stand-alone prescription drug plans (PDPs) and Medicare Advantage prescription drug plans.