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  • Medicare Part B Drugs: Cost Implications for Beneficiaries in Traditional Medicare and Medicare Advantage

    Issue Brief

    In the face of rising prescription drug costs, a large majority of the public supports federal efforts to lower drug spending. Policymakers are considering several proposals that would lower prescription drug costs. To better understand the potential out-of-pocket cost exposure that Medicare beneficiaries may face for Part B drugs, which are typically administered by physicians and other health care providers, we analyzed cost-sharing liability for these drugs in traditional Medicare and cost-sharing requirements in Medicare…

  • The Growth in Share of Medicare Advantage Spending

    Feature

    Earlier this week, the Biden Administration announced the final Medicare Advantage rates for 2023, which are projected to result in an average increase in Medicare Advantage plan revenue of 8.5% compared to 2022 - the highest average expected increase in recent years. Payments to Medicare Advantage plans as a share of total Medicare spending on Part A and Part B services have increased from 26% in 2010 to 45% in 2020, and are expected to…

  • Ending COVID-19 Emergency Declarations Will Bring an End to Flexibilities that Aided Patients, Providers, Insurers, and Public Programs in Responding to the Pandemic

    News Release

    When the federal government ends COVID-19 emergency declarations that were declared in the early days of the pandemic, it will bring to a close several changes that were enacted temporarily to enable the U.S. health care system to better deal with the crisis. A new KFF resource details a number of those flexibilities and lays out what it will mean for people, providers and federal health programs when they go away. One of the key…

  • Medicare Advantage in 2021: Star Ratings and Bonuses

    Issue Brief

    In 2021, 81 percent of all Medicare Advantage enrollees are in plans that receive a bonus payment from Medicare based on star quality ratings (or because they are new), substantially higher than the share in 2015 (55 percent). Annual bonus payments from the federal government to Medicare Advantage insurers have increased correspondingly, quadrupling from $3 billion in 2015 to $11.6 billion in 2021.

  • Dental, Hearing, and Vision Costs and Coverage Among Medicare Beneficiaries in Traditional Medicare and Medicare Advantage

    Issue Brief

    This analysis builds on our prior work – Medicare and Dental Coverage: A Closer Look – by analyzing hearing and vision use, out-of-pocket spending and cost-related barriers to care among Medicare beneficiaries as well as hearing and vision benefits in Medicare Advantage plans. It also incorporates top-level findings from the analysis of dental services to provide a comprehensive profile of dental, hearing, and vision benefits in Medicare.

  • Prior Authorization in Medicare Advantage Plans: How Often Is It Used?

    Issue Brief

    Medicare Advantage enrollees are encouraged to select their plan based on a number of factors, including premiums, cost-sharing, extra benefits, drug coverage, quality of care, and provider networks, but a potentially overlooked factor is access to covered services and the potential impact of prior authorization requirements. In this data note, we examine the share of Medicare Advantage enrollees that are in plans requiring prior authorization and approval before covering the costs of services.

  • Three firms Account for Over Half of All Medicare Part D Enrollees in 2018, and Pending Mergers Would Further Consolidate the Marketplace

    News Release

    In 2018, three Medicare Part D plan sponsors—UnitedHealth, Humana, and CVS Health—account for more than half of the program’s 43 million Part D enrollees (55%) and two-thirds of all stand-alone drug plan enrollees, indicating a marketplace that is dominated by a handful of major insurers, according to a new Kaiser Family Foundation analysis of Part D enrollment, premiums and cost-sharing data. The proposed mergers of CVS Health and Aetna, and Cigna and Express Scripts would…

  • Analyzing Changes in Medicare Part D Enrollment for 2026

    Issue Brief

    The Medicare Part D prescription drug benefit is provided by private plans, either Medicare Advantage plans that offer drug coverage (MA-PDs) or, for those in traditional Medicare, stand-alone prescription drug plans (PDPs). New data from CMS shows that 56 million people are enrolled in Part D plans as of February 2026, with more in MA-PDs than PDPs, reflecting higher overall enrollment in Medicare Advantage than in traditional Medicare. Enrollment in group MA-PD plans decreased while…