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This brief examines how the CMS Innovation Center (also known as CMMI) and Section 402 demonstration authority could become pathways for the Biden Administration to implement policy changes related to prescription drug costs.
This data note examines the effects of rising EpiPen prices on Medicare and beneficiaries. We analyze EpiPen spending, in the aggregate and per user, in Medicare Part D between 2007 (the year after the Part D drug benefit took effect, and the year Mylan acquired the product) and 2014 (the most recent year of data available).
In light of heightened attention to insulin and the Trump Administration’s new Part D model to address out-of-pocket costs for insulin for Medicare beneficiaries, we analyzed out-of-pocket spending on insulin by beneficiaries enrolled in Part D drug plans, variation in Part D plan formulary coverage and tier placement of insulin products, and trends in prices for insulin.
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.
With open enrollment less than a month away, a new KFF analysis suggests that the vast majority of the nation’s 67 million Medicare beneficiaries will not shop around among the coverage options for 2025 or switch plans. It’s a decision that could have a significant impact on enrollees’ coverage and costs. The analysis of federal data shows that nearly 7 in 10 Medicare beneficiaries (69%) did not compare their Medicare coverage with other Medicare options…
This report, written by Marilyn Moon and Matthew Storeygard of the Urban Institute, estimates the potential cost of targeting drug benefits to low-income Medicare beneficiaries and those with catastrophic drug expenses and discusses some of the key programmatic issues that could arise under this approach. The authors predict that a targeted and comprehensive drug benefit would likely help more than half of the 11.3 million low-income beneficiaries who lack drug coverage through Medicaid or an…
This data spotlight examines trends in benefits and cost-sharing for Medicare Advantage plans in 2010, including the wide variations found across plans and the rapid increase in cost sharing requirements for some benefits, including stays in skilled nursing facilities. It also examines the annual limits on out-of-pocket spending set by most Medicare Advantage plans and the availability of coverage for drugs in the Medicare drug benefit's coverage gap, or "doughnut hole." This data spotlight is…
This document, prepared by Health Policy Alternatives, Inc., provides a detailed side-by-side comparison of the prescription drug provisions of the House and Senate Medicare proposals, as passed on June 27, 2003. Along with these provisions, the side-by-side compares the major provisions relating to the role of private health plans in Medicare. This document includes a more in-depth description of the bills, which were previously summarized in publication #6095, which is also available on the Foundation?s…
This survey documents the increasing costs of retiree benefits for both large private-sector employers and their retirees. It also provides an early look at the response of large employers to the Medicare prescription drug law and the subsidies it provides for maintaining retiree drug coverage. Download Full Report (.pdf) Chartpack (.pdf)
Note: 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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