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  • A New Use for Wegovy Opens the Door to Medicare Coverage for Millions of People with Obesity

    Issue Brief

    The FDA recently approved a new use for Wegovy, the blockbuster anti-obesity drug, to reduce the risk of heart attacks and stroke in people with cardiovascular disease who are overweight or obese - a decision that opens the door to Medicare coverage of Wegovy, which is prohibited by law from covering drugs used for obesity. This brief analyses how many Medicare beneficiaries could be eligible for the new use of Wegovy and the potential impact on Medicare spending.

  • FAQs on Medicare Financing and Trust Fund Solvency

    Issue Brief

    In discussions of Medicare’s financial condition, attention frequently centers on one specific measure—the solvency of the Medicare Hospital Insurance (HI) trust fund, out of which Medicare Part A benefits are paid. Based on current projections from the Medicare Board of Trustees, the HI trust fund is projected to be depleted in 2036, 12 years from now. These FAQs answer key questions about Medicare financing and trust fund solvency.

  • Health Insurer Financial Performance in 2023

    Issue Brief

    Using health insurer financial data for 2023, we find that in 2023, per enrollee gross margins were highest in the Medicare Advantage market, and medical loss ratios were lowest in the individual insurance market. Across most markets, gross margins have been relatively stable in recent years.

  • Medicare Beneficiaries Without Supplemental Coverage Are at Risk for Out-of-Pocket Costs Relating to COVID-19 Treatment

    Policy Watch

    Most Medicare Advantage enrollees are in plans that have waived cost sharing for COVID-19 treatment, and many other beneficiaries in traditional Medicare have their cost sharing covered by supplemental insurance. This blog post discusses the 6 million Medicare beneficiaries without supplemental coverage who would face out-of-pocket costs if they require treatment for COVID-19.

  • Most Medicare Beneficiaries Lack Dental Coverage, and Many Go Without Needed Care

    News Release

    Almost two-thirds of Medicare beneficiaries (65%), or nearly 37 million people, do not have dental coverage and many go without needed care, according to a new KFF brief on dental coverage and costs for Medicare beneficiaries. Rates are even higher among black and Hispanic beneficiaries, and those with low incomes.

  • Drilling Down on Dental Coverage and Costs for Medicare Beneficiaries

    Issue Brief

    Medicare does not cover routine dental care and the majority of Medicare beneficiaries do not have dental coverage. Some beneficiaries have dental coverage through other sources, including Medicare Advantage, Medicaid, and private plans, but almost half of all beneficiaries have not been to the dentist in the past year and many older adults face high out-of-pocket costs for needed dental care. The brief reviews the state of oral health for people on Medicare, describing the consequences of foregoing dental care, current sources of dental insurance, use of dental services, and beneficiaries’ out-of-pocket spending.

  • Medicare Advantage Hospital Networks: How Much Do They Vary?

    Report

    This report takes an in-depth look at Medicare Advantage plans’ hospital networks. The analysis draws upon data from 409 Medicare Advantage plans serving beneficiaries in 20 diverse counties that together accounted for about one in seven (14%) Medicare Advantage enrollees nationwide in 2015. The report examines the size and composition of plans’ hospital networks, the variation across counties, the inclusion of Academic Medical Centers and NCI-Designated Cancer Centers, and the relationship between network size and other plan features, including premiums, quality star ratings, per capita Medicare spending, parent organization, and plan tax status.

  • Medicare Advantage Plans in 2017: Short-term Outlook is Stable

    Issue Brief

    This issue brief analyzes the number and variety of Medicare Advantage plan choices available to beneficiaries in 2017. It describes trends in number of Medicare Advantage plans and plan quality ratings, and new information on plan premiums, out-of-pocket expense limits, and other plan features. This spotlight is part of a series of spotlights tracking key changes in the Medicare Advantage program.