View the Latest: Medicare Part D
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What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge
Issue BriefThis 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.
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Medicare Part D Premiums Are Increasing for Many But Not All Stand-Alone Plans in 2025, Reflecting Effects of New Premium Stabilization Demonstration
Policy WatchThis 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.
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A Current Snapshot of the Medicare Part D Prescription Drug Benefit
Issue BriefThis brief provides an overview of the Medicare Part D prescription drug benefit, including current data on plan availability, enrollment, and spending and financing, and highlights changes made under the Inflation Reduction Act.
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Potential Costs and Impact of Health Provisions in the Build Back Better Act
Issue BriefA summary of 10 of the major health coverage and financing provisions of the current Build Back Better Act, with discussion of the potential implications for people and the federal budget.
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Options to Make Medicare More Affordable For Beneficiaries Amid the COVID-19 Pandemic and Beyond
ReportMedicare provides significant health and financial protections to more than 60 million Americans, but there are gaps in coverage and high cost-sharing requirements that can make health care difficult to afford. This report analyzes several policy options that could help make health care more affordable for people covered by Medicare, especially beneficiaries with relatively low incomes: adding an out-of-pocket limit to traditional Medicare, adding a hard out-of-pocket cap to Part D, expanding financial assistance through…
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The Role of State Pharmaceutical Assistance Programs in Serving Low-Income Medicare Beneficiaries Following the Implementation of Medicare Part D
Issue BriefThe Role of State Pharmaceutical Assistance Programs in Serving Low-Income Medicare Beneficiaries Following the Implementation of Medicare Part D Prior to January 1, 2006, State Pharmaceutical Assistance Programs helped to fill a critical gap in coverage for Medicare beneficiaries without prescription drug coverage, targeting resources to beneficiaries with relatively low incomes. With the inception of the Medicare prescription drug benefit, the role of SPAPs began to change. This policy brief examines the role of state…
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Prescription Drug Sources Among Medicare Beneficiaries
ReportNote: Estimates are rounded to the nearest whole number, therefore do not sum to total. (1) Includes Veterans Administration, Indian Health Service, employer plans without retiree subsidies, employer plans for active workers, and state pharmaceutical assistance programs. (2) Includes employer/union, FEHB, and TRICARE coverage. (3) Approximately 0.5 million dual eligibles are enrolled in Medicare Advantage drug plans and are reported in this category. Source: HHS, January 30, 2007. Data as of January 16, 2007.
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Analysis of Medicare Prescription Drug Plans In 2012 And Key Trends Since 2006
ReportThis report presents findings from an analysis of the Medicare Part D marketplace in 2012 and changes in drug coverage and costs since 2006. It presents key findings related to Medicare drug plan plan availability, premiums, cost-sharing, the coverage gap and availability for low-income beneficiaries, the coverage gap, benefit design and cost sharing, formularies, and utilization management, based on data from CMS for all plans participating in Part D. The analysis was conducted jointly by…
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The 4 Arguments You Will Hear Against Drug Price Negotiation
PerspectiveAs the Biden administration begins the process of negotiation drug prices for Medicare as authorized in the Inflation Reduction Act, KFF's Larry Levitt probes some of the arguments against it and the policy and political implications of the debate in this New York Times op-ed column.