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  • Millions of Medicare Part D Enrollees Have Had Out-of-Pocket Drug Spending Above the Catastrophic Threshold Over Time

    Issue Brief

    Medicare Part D, the outpatient prescription drug benefit for Medicare beneficiaries, provides catastrophic coverage for high out-of-pocket drug costs, but there is no limit on the total amount that beneficiaries have to pay out of pocket each year. Policymakers on both sides of the aisle support proposals to modify the design of the Part D benefit and establish a hard cap on out-of-pocket prescription drug spending by Part D enrollees. This analysis shows the number of Part D enrollees without low-income subsidies who have exceeded the catastrophic coverage threshold annually, and over multiple years, based on 2007-2019 Part D claims data.

  • A Look at Recent Proposals to Control Drug Spending by Medicare and its Beneficiaries

    Issue Brief

    In response to higher drug spending growth and heightened attention to drug prices, policymakers have proposed a variety of policy initiatives to lower the cost of prescription drugs in Medicare. This brief examines in detail the range of proposals offered by the Trump Administration and members of Congress for lowering the cost of prescription drugs, their known effects on the federal budget, and their potential implications for beneficiaries and other stakeholders.

  • What’s in the Administration’s 5-Part Plan for Medicare Part D and What Would it Mean for Beneficiaries and Program Savings?

    Issue Brief

    With rising concern over increases in prescription drug costs, the Trump Administration has proposed what it calls a “5-part plan” that would change several features of the Medicare Part D drug benefit. This brief describes the Administration’s five Part D proposals and discusses the potential implications for people with Part D prescription drug coverage and Medicare program spending, based on estimates from the Congressional Budget Office.

  • Medicare Advantage 2015 Spotlight: Enrollment Market Update

    Issue Brief

    This Data Spotlight reviews national and state-level enrollment trends as of March 2015 and examines variation in enrollment by plan type and firm. It analyzes the most recent data on premiums, out-of-pocket limits, Part D cost-sharing for drugs, and plans’ quality ratings for Medicare Advantage enrollees.

  • Mail Delays Could Affect Mail-Order Prescriptions for Millions of Medicare Part D and Large Employer Plan Enrollees

    Issue Brief

    Potential changes in mail service delivery could be a concern for people who receive prescription drugs from mail-order pharmacies. To understand who may be most affected by delays in the delivery of prescription drugs, we analyzed use of mail order in Medicare Part D and large group employer plans, and identified the therapeutic classes and specific drugs with the highest volume of fills by mail-order pharmacies in each market.

  • An Overview of Medicare

    Issue Brief

    This issue brief provides an overview of Medicare, the health insurance program for people ages 65 and over and younger people with long-term disabilities. The brief review the characteristics of people on Medicare, what Medicare covers, benefit gaps and supplemental coverage, beneficiaries' out-of-pocket health care spending, program spending and financing, payment and delivery system reform, and issues for the future of Medicare.

  • How Much Has Medicare Spent on the EpiPen Since 2007?

    Issue Brief

    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).