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This fall a new rule takes effect requiring all private health plans to offer a uniform, simple to read, summary of benefits and coverage (SBC). The SBC will provide consumers with standardized information about how plans cover essential health benefits and what coverage limits and cost sharing applies.
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.
This report examines reimbursement, benefit management and cost sharing issues in Medicaid pharmacy programs.
Following the Supreme Court ruling upholding the Affordable Care Act (ACA) and as 2014 approaches, many states are moving into high gear to prepare for implementation of the major provisions of the law, including a new streamlined Medicaid enrollment system and, at states' option, the expansion of Medicaid.
Medicaid covers nearly 60 million Americans. Because the population covered by the program is low-income, federal law limits the extent to which states can charge premiums and cost-sharing amounts, particularly for pregnant women, children and adults with incomes below poverty.
The Alliance for Health Reform and the Kaiser Family Foundation present a briefing to discuss the basics of Medicaid and its role in the health care system.
A new animated video features the YouToons as they get ready for Obamacare and explore health insurance changes under the Affordable Care Act (ACA). The cartoon serves as a health reform tutorial for consumers and organizations.
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.
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.
This analysis examines the potential costs for COVID-19 testing that some consumers may face once the COVID-19 public health emergency ends on May 11, 2023., depending on whether they have insurance and how their insurance covers testing.
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