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  • The Exceptions and Appeals Process: Issues and Concerns in Obtaining Coverage Under the Medicare Part D Prescription Drug Benefit

    Issue Brief

    This issue brief describes how Medicare beneficiaries navigate the Medicare Part D exceptions, appeals, and grievances processes to get access to medically necessary prescriptions not covered under their Medicare prescription drug plans. It identifies and describes policy issues that may make it difficult for beneficiaries to utilize the processes. Issue Brief (.

  • Medicare Advantage 2020 Spotlight: First Look

    Issue Brief

    In 2020, more than 22 million Medicare beneficiaries (34%) are enrolled in Medicare Advantage plans, which are mainly HMOs and PPOs offered by private insurers as an alternative to the traditional Medicare program. This data note provides an overview of the Medicare Advantage plans that will be available in 2020, including the variation in the number of plans available by county and plan type. The brief also examines the insurers entering the Medicare Advantage market for the first time and also examines the insurers exiting the market.

  • Medicare Advantage 2014 Spotlight: Enrollment Market Update

    Issue Brief

    This Data Spotlight provides an overview of Medicare Advantage enrollment patterns in March 2014, and examines variations by plan type, state, and firm. It also analyzes trends in premiums paid by beneficiaries enrolled in Medicare Advantage plans and describes the changes in limits on out-of-pocket expenses and prescription drug coverage in the Part D “donut hole” provided by the plans in 2014.

  • The Federal Government’s Authority To Regulate Advertising in Medicare

    Issue Brief

    This policy brief, prepared for the Kaiser Family Foundation by Vicky Gottlich at the Center for Medicare Advocacy, explains the Centers for Medicare & Medicaid Services’ legal authority to regulate advertising and other information issued by the private companies that contract with the government to provide Medicare benefits.

  • Medicare Advantage Plan Switching: Exception or Norm?

    Issue Brief

    The Medicare open enrollment period allows enrollees to compare plans, stick with their current plan, switch to another plan, or shift to traditional Medicare. This analysis examines the extent to which Medicare Advantage enrollees change plans when given the opportunity. It also analyzes the variation in the rate of plan switching by enrollee and plan characteristics and whether people who voluntarily switch plans tend to move to plans with lower premiums, lower out-of-pocket limits, or higher quality ratings.

  • Prescription Drugs: Results from a National Survey

    Fact Sheet

    Prescription drugs have become an integral part of medical practice - they help keep people healthy and save lives. But rising prescription drug costs have placed a growing burden on consumers, employers, and public programs. The issue of drug coverage for seniors under Medicare has moved to center stage in the Presidential election.