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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).
The YouToons help consumers understand health insurance by explaining health insurance premiums, out-of-pocket costs, and provider networks. These three videos are excerpts from the 2014 YouToons video, Health Insurance Explained – The YouToons Have It Covered.
The survey, conducted shortly after the close of the Affordable Care Act’s third open enrollment period, is the third in a series exploring the experiences of individuals who purchase their own health insurance in the nongroup market, including coverage purchased both inside and outside the ACA’s marketplaces. It examines enrollees’ satisfaction with their health plans’ premiums, deductibles, and provider networks, their views on affordability, shopping experiences, and problems encountered with their plans.
This brief explains key components of Michigan and Indiana's Medicaid expansions under Section 1115 demonstration waivers and presents insights from stakeholder interviews and focus groups about early implementation experience.
The Trump Administration and new Congress have indicated that they will seek to cap Medicaid financing through a block grant or per capita cap, reduce federal funding for the program, and offer states increased flexibility to manage their programs within this more limited financing structure. The size of the federal reductions as well as which federal program standards would remain in place and what increased flexibility might be provided to states under such proposals would…
This issue brief examines states’ approaches to administering wrap-around benefits and cost-sharing in long-standing Medicaid premium assistance programs and the information available to beneficiaries about how to access these program features.
This analysis focuses on out-of-pocket drug costs for Medicare Part D enrollees in 2016 for specialty, brand, and generic drugs. Part D drug plans differ considerably in the drugs they list on their formularies, their use of formulary tiers, and the level and structure of cost sharing applied to those tiers. Plan decisions affect different beneficiaries in different ways, depending on the drugs they use. The financial consequences for Part D plan enrollees can be…
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…
In his latest column for The Wall Street Journal‘s Think Tank, Drew Altman explains why prescription drug spending may be a larger share of health spending than most people think, depending on how you look at it. All previous columns by Drew Altman are online.
Among the Insured with Medical Bill Problems, 63% Report Using Up Most or All Their Savings and 42% Took on an Extra Job or Worked More Hours Half of People Without Health Insurance Report Problems With Medical Bills, and They Face Similar Financial and Personal Consequences As Those With Insurance Among people with health insurance, one in five (20%) working-age Americans report having problems paying medical bills in the past year that often cause serious…
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