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A Dozen Facts About Medicare Advantage in 2019

Medicare Advantage enrollment has grown rapidly over the past decade, and Medicare Advantage plans have taken on a larger role in the Medicare program. More than 22 million Medicare beneficiaries (34%) are enrolled in Medicare Advantage plans in 2019. This data note provides updated information about Medicare Advantage enrollment trends, premiums, and out-of-pocket limits. It also includes analyses of Medicare Advantage plans’ extra benefits and prior authorization requirements.

Medicare Advantage

This fact sheet includes the latest information and data about the Medicare Advantage program, including enrollment, plan information, spending and financing for the program, and payment and program changes made by the Affordable Care Act as well as other laws.

10 Things to Know About Medicare Part D Coverage and Costs in 2019

The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans. This analysis provides the latest data about Medicare Part D coverage and costs in 2019 and trends over time, including enrollment, premiums, cost sharing, and participation in the low-income subsidy program.

The Silent Affordability Crisis Facing Sick People

In this Axios column, Drew Altman shows that employer coverage for lower wage workers is much worse than ACA marketplace coverage for similar populations. It’s a bigger problem we need to talk about more, he says.

Do People Who Sign Up for Medicare Advantage Plans Have Lower Medicare Spending?

The analysis finds that people who switched from traditional Medicare to Medicare Advantage in 2016 had health spending in 2015 that was $1,253 less, on average, than the average spending for beneficiaries who remained in traditional Medicare (after adjusting for health risk). The findings suggest that the current payment method may systematically overestimate expected costs of Medicare Advantage enrollees. Adjusting payments to reflect Medicare Advantage enrollees’ prior use of health services could potentially lower total Medicare spending by billions of dollars over a decade.

Household Health Spending Calculator

A new interactive tool highlights how much individuals and families in the U.S. spend on health. Users can generate scenarios based on family size, income level, insurance source, and health status. The calculator estimates direct costs, like premiums, out-of-pocket costs, and state and federal taxes that fund health programs, as well as less…

10 Essential Facts About Medicare and Prescription Drug Spending

Prescription drugs play an important role in medical care for 60 million seniors and people with disabilities, and account for nearly $1 out of every $5 in Medicare spending. This chart series examines trends in Medicare and beneficiary out-of-pocket spending on prescription drugs, and what the public thinks about different options for keeping drug costs down.

Testimony: Pre-Existing Conditions and Health Insurance

KFF’s Karen Pollitz testimony before the U.S. House Committee on Ways and Means on Jan. 29, 2019 examines the prevalence of pre-existing conditions, the impact of the Affordable Care Act’s prohibition against medical underwriting and other provisions aimed at stabilizing the insurance risk pool, and the trade-offs involved in relaxing those provisions.