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  • Standardized Plans in the Health Care Marketplace: Changing Requirements

    Issue Brief

    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.

  • New Alzheimer’s Drugs Spark Hope for Patients and Cost Concerns for Medicare

    Policy Watch

    The Food and Drug Administration granted full approval to Leqembi, a new Alzheimer's drug, on July 6, 2023. This updated policy watch focuses on the implications of Medicare coverage of the drug for program spending as well as equity and affordability issues for beneficiaries, and the potential for the Inflation Reduction Act to address the spending impacts. It also covers additional details from the Centers for Medicare and Medicaid Services about patient registries.

  • What is the Potential Impact of New Drugs for Obesity and Alzheimer’s Disease on Medicare Costs, Coverage and Beneficiaries? 

    News Release

    Two new KFF analyses examine the potential impact of Medicare coverage of new prescription drugs for obesity and Alzheimer’s disease on program spending and beneficiary out-of-pocket costs, as well as the role that the Inflation Reduction Act could play in mitigating these effects. Manufacturers of both types of drugs are lobbying for broad Medicare coverage of them, though they face different challenges. The availability of effective weight-loss drugs, including Novo Nordisk’s Ozempic and Wegovy (semaglutide)…

  • People with Medical Debt are Much More Likely to Experience Other Forms of Financial Stress

    News Release

    People with medical debt are much more likely than those without such debt to show other signs of financial vulnerability, like having no “rainy day” fund, overdrawing a checking account, or relying on costly loans, according to a new KFF analysis of national survey data. Medical debt remains a significant issue in the U.S., including among people with health insurance. In 2021, 23% of U.S. adults had one or more unpaid and past due bills…

  • 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,…

  • What to Know About Medicare Part D Premiums

    Issue Brief

    Changes to the Medicare Part D benefit in the Inflation Reduction Act will mean lower out-of-pocket costs for Part D enrollees but higher costs for Part D plans overall, leading to concerns about possible premium increases. These FAQs provide context for understanding Part D premiums in 2025 and changes in recent years, and describe actions the Centers for Medicare & Medicaid Services (CMS) is taking to mitigate potential premium increases.

  • Coverage of Sexual and Reproductive Health Services in Medicare

    Issue Brief

    This brief describes Medicare coverage of sexual and reproductive health services, including contraception, and compares that coverage with private insurance plans and Medicaid. These benefits are particularly relevant to nearly 1 million women of reproductive age (20-49) who are eligible for Medicare due to having a long-term disability.

  • KFF’s Kaiser Health News and NPR Launch Diagnosis: Debt, a Yearlong Reporting Partnership Exploring the Scale, Impact, and Causes of the Health Care Debt Crisis in America

    News Release

    KFF’s Kaiser Health News (KHN) and NPR today launched a yearlong investigative project that explores the scale, impact, and causes of the health care debt crisis in the United States. Drawing upon a special KFF poll conducted for the project, original data analysis, and hundreds of interviews, the investigation reveals a problem far more pervasive than previously reported. That’s because much of the medical debt is hidden as monthly installments paid via credit card, loans…