The analysis examines enrollment in Medicare Advantage plans during beneficiaries’ first year on Medicare and finds that less than one-third or 29% enrolled in these private health plans, including HMOs or PPOs. The majority of people new to Medicare are choosing traditional Medicare in the year they first go on Medicare. The study looks at how these findings vary across age, Medicaid status, states, and counties.
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This analysis shows that more than half of Medicare beneficiaries do not compare coverage options annually during the open enrollment period, despite the fact that Medicare Advantage and Part D plans often change from one year to the next, which could lead to unexpected and avoidable costs for beneficiaries who do not review their options annually. It also highlights that many beneficiaries have difficulty understanding the Medicare program and comparing coverage options. Further, it shows that most beneficiaries do not use Medicare’s official information resources.
This issue brief provides an overview of the Medicare Part D prescription drug benefit plan landscape for 2021, with a focus on stand-alone drug plans. It includes national and state-level data on plan availability, premiums, benefit design, cost sharing, information about premium-free plans for low-income beneficiaries, and information about the national Part D drug plans available in 2021.
Medicare Part D plan sponsors, which provide drug coverage to 45 million older adults and people with disabilities, have the option to relax their ‘refill too soon’ restrictions in response to the COVID-19 pandemic, as part of efforts to ensure adequate access to medications in disasters or emergencies. This analysis examines the share of Part D enrollees who currently have access to extended supplies of generic, brand-name, and specialty-tier drugs covered by their plan in 2020, prior to relaxation of any early-fill restrictions in response to the COVID-19 outbreak.
Federal spending on Medicare Advantage bonus payments will reach at least $10 billion in 2022, as the majority of Medicare Advantage enrollees are in plans that are receiving bonus payments. The average bonus payment per enrollee is highest for Medicare beneficiaries in employer sponsored plans and lowest for those enrolled in special needs plans.
The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans, including stand-alone drug plans and Medicare Advantage drug plans. This analysis provides the latest data about Part D enrollment, premiums, and cost sharing in 2021 and trends over time.
Cost-Related Problems Are Less Common Among Beneficiaries in Traditional Medicare Than in Medicare Advantage, Mainly Due to Supplemental Coverage
This analysis examines health care cost-related problems among Medicare beneficiaries, comparing beneficiaries in traditional Medicare, including those with and without supplemental coverage, to those in Medicare Advantage, with a focus on racial equity. We compare rates of cost-related problems among White, Black, and Hispanic beneficiaries, those in fair or poor health, and those under age 65 with long-term disabilities. The measure of cost-related problems include problems getting care due to cost, delays seeking care due to cost, and problems paying medical bills among people with Medicare.
Although Their Share of the Market Varies By State, Enrollment in Medicare Advantage Plans Has More Than Doubled Over the Past Decade, with More than 4 in 10 Medicare Beneficiaries Now Enrolled in the Private Plans
The private plans known as Medicare Advantage now cover more than 4 in 10 Medicare beneficiaries, reflecting a more than doubling of enrollment over the past decade even as the plans remain a far larger presence in some states than others, according to a new KFF analysis. More than 26…
A Small Share of People with Medicare Advantage or Stand-alone Medicare Part D Coverage Voluntarily Switch Plans During Open Enrollment
A new KFF analysis finds that a relatively small share of people with Medicare Advantage or stand-alone Medicare Part D prescription drug coverage voluntarily switch plans during Medicare’s open enrollment period, which runs annually from Oct. 15 to Dec. 7. With less than a week remaining for beneficiaries to make…
In this brief, we analyze third quarter data from 2018 to 2020 to examine how insurance markets performed financially through the end of September. Average margins remained relatively high compared to the same point in recent years, suggesting many insurers remained profitable even as non-COVID-related care returned in the summer and fall.