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  • 3 Charts: Medicare Drug Price Negotiations

    News Release

    Under the Inflation Reduction Act, the federal government for the first time will negotiate directly with drug companies to determine the prices that Medicare will pay for certain high expenditure drugs covered under Medicare Part D (starting in 2026) and Part B (starting in 2028). Part D covers retail prescription drugs and Part B covers physician-administered medications. This new requirement is the culmination of years of debate among lawmakers in Congress, and the Centers for…

  • 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…

  • Prices for COVID-19 Testing

    Issue Brief

    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.

  • After the COVID-19 Public Health Emergency Ends on May 11, Some Consumers Could Face High Prices for COVID-19 Testing

    News Release

    After the public health emergency ends on May 11, private health plans will no longer be required to cover the full cost of COVID-19 tests ordered or administered by a clinician or to reimburse consumers for at-home rapid tests. To estimate what consumers might have to pay for tests, KFF’s new analysis draws on claims data showing what private insurers have paid for different types of COVID-19 tests, as well as hospitals’ published “self-pay” prices…

  • 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 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.

  • Medicare Part D in 2024: A First Look at Prescription Drug Plan Availability, Premiums, and Cost Sharing

    Issue Brief

    Medicare Part D prescription drug coverage is available for people with Medicare who enroll in private plans, either a stand-alone prescription drug plan (PDP) for people in traditional Medicare, or a Medicare Advantage plan that covers all Medicare benefits, including prescription drugs (MA-PD). This issue brief provides an overview of Part D plan availability and premiums in 2024 and key trends over time.

  • With Medicare Open Enrollment Underway, Beneficiaries Typically Will Have a Choice of 43 Medicare Advantage Plans for 2024, Consistent with 2023 But More than Double The Number From 2018

    News Release

    With open enrollment underway, Medicare beneficiaries have until December 7th to review and select their coverage for 2024. They also have a lot of options to choose from, as two new KFF analyses show. For many beneficiaries, the first decision is whether to enroll in traditional Medicare (often with supplemental coverage and a stand-alone prescription drug plan) or Medicare Advantage, the private plans sponsored by insurance companies that now cover more than half of all…

  • Preventive Services Use Among People with Private Insurance Coverage

    Issue Brief

    This analysis of claims data estimates that six in ten people with private health insurance - or about 100 million people - used at least one preventive service covered without any out-of-pocket costs through a provision of the Affordable Care Act (ACA) in a typical year prior to the COVID-19 pandemic (2018). The provision that requires most private health plans to cover many preventive services without any cost-sharing for their enrollees is being challenged in…