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Insulin Out-of-Pocket Costs in Medicare Part D

Addressing the cost of insulin continues to be at the forefront of policy discussions around prescription drugs. This analysis describes out-of-pocket spending on insulin products by Medicare beneficiaries enrolled in Part D drug plans, along with state-level use and spending data.

State Profiles Highlight Variations in How Many Low-Income Medicare Beneficiaries Get Additional Help with Their Medicare Costs

Medicare beneficiaries with low incomes and modest assets can qualify for additional financial help with Medicare premiums and cost sharing through both the Medicare Savings Programs and Medicare’s Part D Low-Income Subsidy for prescription drug coverage. A new analysis and collection of interactive profiles highlight variations across states in the…

Help with Medicare Premium and Cost-Sharing Assistance Varies by State

This data note provides an overview of programs that help beneficiaries with most incomes with their Medicare costs, including the Medicare Savings Programs and the Part D Low-Income Subsidy, and highlights findings from corresponding state-level profiles of eligibility and enrollment.

Medicare State Profiles

These state profiles capture the variations across states in the number and characteristics of Medicare beneficiaries through the Medicare Savings Programs and Medicare’s Part D Low-Income Subsidy.

What Happens When COVID-19 Emergency Declarations End? Implications for Coverage, Costs, and Access

This brief provides an overview of the major health-related COVID-19 federal emergency declarations that have been made since early on in the pandemic, summarizes the flexibilities triggered by each, and identifies the implications for their ending, related to coverage, costs, and payment for COVID-19 testing, treatments, and vaccines; Medicaid coverage and federal match rates; telehealth; access to medical countermeasures through FDA emergency use authorization (EUA); and other Medicaid, Medicare and private health insurance flexibilities.

Prices Increased Faster Than Inflation for Half of all Drugs Covered by Medicare in 2020

Recent legislation would require drug companies to pay rebates to the federal government when annual increases in prescription drug prices for Medicare and private insurance exceed the rate of inflation. As context for understanding the possible impact of this proposal, this analysis compares price changes for drugs covered by Medicare Part B (administered by physicians) and Part D (retail prescription drugs) between 2019 and 2020 to the inflation rate over the same period.

FAQs on Medicare Coverage and Costs Related to COVID-19 Testing and Treatment

These FAQs provide the latest guidance on testing and treatment related to COVID-19 for Medicare beneficiaries, including questions related to out-of-pocket costs, the COVID-19 vaccine, telehealth, extended supplies of medication, skilled nursing facility stays, and issues for people in private Medicare Advantage plans.

Millions of Medicare Beneficiaries Use Prescription Drugs That Could Be Subject to Price Negotiation, But Build Back Better Act Provision Exempts Many Drugs With High Federal Spending

Twenty drugs and dozens of insulin products used by 8.5 million Medicare beneficiaries would be subject to government drug price negotiation if the Build Back Better Act (BBBA) were enacted and fully implemented in 2022, according to a new KFF analysis. The 20 drugs include 18 drugs available to beneficiaries…

Simulating the Impact of the Drug Price Negotiation Proposal in the Build Back Better Act

The Build Back Better Act (BBBA) includes a range of health and other proposals supported by President Biden, including a proposal to allow the federal government to negotiate the price of some prescription drugs covered under Medicare Part B (administered by physicians) and Medicare Part D (retail outpatient drugs). This brief illustrates the potential scope of the drug price negotiation proposal in the BBBA. This analysis is designed to highlight the types of Medicare-covered drugs that could be subject to negotiation, and which of the current top-spending drugs covered by Part B and Part D could be subject to price negotiation, and in what years, if the BBBA is enacted.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.