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This Medicare Part D data spotlight finds prices for some commonly used brand-name drugs rising in 2010 for beneficiaries who reach the coverage gap (or “doughnut hole”), with increases since 2006 far exceeding the growth in inflation.
This study quantifies the number of Medicare Part D plan enrollees in 2007 who reached a gap in their prescription drug coverage known as the “doughnut hole,” as well as the changes in beneficiaries’ use of medications and out-of-pocket spending after they reached that gap.
The analysis examines enrollment in Medicare Advantage plans during beneficiaries’ first year on Medicare and finds that less than one-third or 29% enrolled in these private health plans, including HMOs or PPOs. The majority of people new to Medicare are choosing traditional Medicare in the year they first go on Medicare. The study looks at how these findings vary across age, Medicaid status, states, and counties.
The Medicare Part D prescription drug benefit has helped improve the affordability of medications for people with Medicare. Yet Part D enrollees can face relatively high out-of-pocket costs because the Part D benefit does not have a hard cap on out-of-pocket spending. This analysis presents the latest data on out-of-pocket drug spending among Medicare Part D enrollees without low-income subsidies who have costs above the catastrophic coverage threshold.
Source KFF analysis of CMS National Health Expenditure Data for Historical (CY2005-2017) and Projected (CY2018-2026) Retail Prescription Drug Expenditures.
Most people with Medicare pay the standard monthly premium for Part B and Part D coverage, which is set to cover 25 percent of per capita program costs, but a relatively small share of beneficiaries with higher incomes are required to pay higher premiums. This issue brief describes the legislative history of Medicare's income-related premiums and changes to these premiums that will take effect in 2019, based on a provision in the Bipartisan Budget Act…
Despite Medicare’s protections, Part D enrollees with serious health conditions can face thousands of dollars in annual out-of-pocket costs for expensive specialty drugs, a new KFF anaylsis finds. The analysis draws on data from Medicare’s Plan Finder website to calculate expected annual 2019 costs for more than two dozen specialty tier drugs used to treat four health conditions -- cancer, hepatitis C, multiple sclerosis and rheumatoid arthritis – based on coverage and costs in national and…
This animation explains how rebates for prescription drugs work and why they matter in the debate about lowering drug costs. The video breaks down how prescription drug rebates are determined, who benefits from them, how they affect spending by insurers and consumers and the role of pharmacy benefit managers in the process.
A new KFF animation explains how rebates for prescription drugs work, including how they are determined, who benefits from them, how they affect spending by insurers and consumers and the role of pharmacy benefit managers in the process. The Trump Administration had proposed banning such rebates in Medicare Part D, but dropped the proposal amid concerns that it would lead to higher costs for insurers, consumers and the Medicare program. It is still possible that…
This data note explores the attitudes and experiences of older adults, ages 65 and up, when it comes to prescription drugs and related policy proposals being discussed. Experiences across different demographic groups are explored, such as household income and health status.
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