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 24 million Medicare beneficiaries (36%) are enrolled in Medicare Advantage plans in 2020. This data analysis 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. The analysis also highlights changes pertaining to Medicare Advantage coverage that have occurred in 2020 in response to the COVID-19 crisis.
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The Real Cost of Health Care: Interactive Calculator Estimates Both Direct and Hidden Household Spending
A new interactive tool from KFF estimates total household health spending for individuals and families in the U.S., including costs that are often less visible to consumers. Users can generate scenarios based on family size, income level, insurance source, and health status. In addition to estimating direct costs like deductibles…
Short-Term Health Insurance Plans Charge Less than Half as Much in Premiums as ACA Plans By Excluding Pre-Existing Conditions and Severely Limiting Benefits
Short-term health insurance plans offer a trade-off for consumers: substantially lower premiums than plans that comply with the Affordable Care Act, but much less protection if they get sick and need care. Just how much cheaper are the premiums and what are consumers giving up to get them? A new…
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.
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.
In 2021, nearly two-thirds of Medicare Advantage enrollees are in plans that do not charge a premium (other than the Part B premium), although the remaining third do pay a premium, averaging about $60 per month. Most enrollees are in plans that provide access to a variety of supplemental benefits, such as eye exams, dental and fitness benefits. Nearly all enrollees are in plans that require prior authorization for some services. Medicare Advantage cost sharing varies across plans and can be lower than traditional Medicare, but that is not always the case. Slightly more than half of all Medicare Advantage enrollees would incur higher costs than beneficiaries in traditional Medicare with no supplemental coverage for a 6-day hospital stay, though cost are generally lower in Medicare Advantage for shorter stays.
After a tumultuous year of unpredictable COVID-19 changes to utilization and spending, a review of early rate filings for individual market insurers participating in the Affordable Care Act Marketplace finds that most are expecting a return to normal in 2022 without the pandemic playing a large role. The review of…
This annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including premiums, worker contributions, cost-sharing provisions, offer rates, and more. This year’s report also looks at how employers changed their mental health, telemedicine and other benefits in response to the COVID-19 pandemic.
Average Family Premiums Rose 4% This Year to Top $22,000; Employers Boost Mental Health and Telemedicine amid COVID-19 Pandemic, Benchmark KFF Survey Finds
Annual family premiums for employer-sponsored health insurance rose 4% to average $22,221 this year, according to the 2021 benchmark KFF Employer Health Benefits Survey released today. On average, workers this year are contributing $5,969 toward the cost of family coverage, with employers paying the rest. This year’s survey also assesses…
Even as the ninth annual Open Enrollment period gets underway, the Affordable Care Act (ACA) Marketplaces continue to evolve and important changes are expected. This issue brief discusses what changes to watch out for in the coming enrollment period.