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This brief describes current coverage of GLP-1s in Medicare and Medicaid, the Centers for Medicare & Medicaid Services’ (CMS) efforts to expand access and lower costs for GLP-1s through temporary demonstration programs including the BALANCE Model, and potential impacts on beneficiaries and program budgets.
This policy watch examines monthly premiums for Medicare Part D stand-alone drug plans in 2025, as changes to the Part D benefit are being implemented in 2025, including a new $2,000 cap on out-of-pocket drug spending.
This issue brief provides an overview of the Medicare Part D marketplace in 2023 and key trends over time, focusing primarily on stand-alone Medicare drug plans, including plan availability, premiums, and cost sharing. The brief also describes the prescription drug provisions in the Inflation Reduction Act of 2022 that affect the Medicare Part D marketplace beginning in 2023
This issue brief provides an overview of the Medicare Part D prescription drug benefit plan landscape, with a focus on stand-alone drug plans, the largest segment of the Part D market. 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 top ten Part D plans for 2019.
Voluntary efforts by drug companies to lower prices on selected medications, such as this new discounted price for Eliquis and previous price reductions on certain insulin products, could expand access to lower-priced drugs for some patients, but are not likely to improve prescription drug affordability in the U.S. on a widespread basis.
CMS’s efforts to expand Medicare coverage of GLP-1s for obesity could provide substantial benefits to millions of Medicare beneficiaries, given the potential demand for these highly effective medications…There are potential drawbacks to the short-term program, however.
This brief presents key facts and analysis about affordability of health care costs among people with Medicare, including younger adults with long-term disabilities, drawing on data from various sources.
This issue brief provides an overview of the Medicare Part D prescription drug benefit plan landscape for 2020, with a focus on stand-alone drug plans, the largest segment of the Part D market. 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 plans available in 2020.
Since 2006, Medicare beneficiaries have had access through Medicare Part D to prescription drug coverage offered by private plans, either stand-alone prescription drug plans (PDPs) or Medicare Advantage prescription drug plans (MA-PD plans). Now in its tenth year, Part D has evolved due to changes in the private plan marketplace and the laws and regulations that govern the program. This report presents findings from an analysis of the Medicare Part D marketplace in 2015 and…
The private plans that offer the Medicare Part D benefit - stand-alone drug plans and Medicare Advantage drug plans - are increasingly are competing on uneven terms, in part because the payment system for Medicare Advantage plans enables them to lower Part D premiums or reduce Part D cost sharing, making drug coverage from Medicare Advantage plans appear considerably cheaper, or even premium-free, to the beneficiary. This brief discusses the growing instability of the Part…
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