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  • Medicare 101

    Feature

    This Health Policy 101 chapter explores Medicare, a federal health insurance program covering more than 68 million people, established in 1965 for people age 65 or older and later expanded to cover people under age 65 with long-term disabilities. In addition to detailing Medicare eligibility, coverage, and spending, the chapter examines the increased role of private plans in providing benefits and the financing challenges posed by increasing health care costs and an aging population.

  • 10 Key Facts About Women with Medicare

    Issue Brief

    This brief examines 10 key facts about women with Medicare and presents new statistics on the health, economic and functional status of women with Medicare.

  • 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.