KFF Analysis Finds Physician Networks in ACA Marketplace Plans Vary Widely, and Enrollees Typically Pay More in Premiums to Access Broader Networks August 26, 2024 News Release A KFF analysis of physician networks in the Affordable Care Act’s Marketplace plans finds wide variations in the share of local practicing physicians who participate, with the least costly plans generally having a smaller share of physicians than more expensive plans. The analysis examines the breadth of physician networks listed…
Medicare Advantage Plans Denied a Larger Share of Prior Authorization Requests in 2022 Than in Prior Years August 8, 2024 News Release Medicare Advantage plans denied 3.4 million prior authorization requests for health care services in whole or in part in 2022, or 7.4% of the 46.2 million requests submitted on behalf of enrollees that year, according to a new KFF analysis of federal data. That was a higher share of denials…
Medicare Advantage in 2024: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization August 8, 2024 Issue Brief This brief provides information about Medicare Advantage plans in 2024, including premiums, out-of-pocket limits, supplemental benefits, and prior authorization, as well as trends over time.
How Much and Why ACA Marketplace Premiums Are Going Up in 2025 August 5, 2024 Issue Brief This analysis of insurers’ preliminary rate filings shows that ACA Marketplace insurers are requesting a median premium increase of 7% for 2025, similar to the 6% premium increase filed for 2024. Insurers cite growing health care prices – particularly for hospital care – as a key driver of premium growth in 2025.
What to Know About Medicare Part D Premiums August 1, 2024 Issue Brief Changes to the Medicare Part D benefit in the Inflation Reduction Act will mean lower out-of-pocket costs for Part D enrollees but higher costs for Part D plans overall, leading to concerns about possible premium increases. These FAQs provide context for understanding Part D premiums in 2025 and changes in recent years, and describe actions the Centers for Medicare & Medicaid Services (CMS) is taking to mitigate potential premium increases.
Inflation Reduction Act Health Insurance Subsidies: What is Their Impact and What Would Happen if They Expire? July 26, 2024 Issue Brief Enhanced premium subsidies were first made available under the American Rescue Plan Act and extended until the end of 2025 under the Inflation Reduction Act. This analysis shows the impact that enhanced subsidies have had on enrollment and premium payments, and the potential implications if the enhanced subsidies expire.
ACA Marketplace Enrollees Will See Steep Increases in Premium Payments in 2026 if Enhanced Subsidies Expire July 26, 2024 News Release Without the enhanced subsidies in the Inflation Reduction Act (IRA), Affordable Care Act (ACA) Marketplace enrollees in 12 of the states that use HealthCare.gov would see their annual premium payments at least double on average, according to a new KFF analysis. Enrollees in three states would see the steepest annual…
Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2024 July 2, 2024 Issue Brief This brief analyzes 2024 Medicare Part D enrollment, premiums, and cost sharing. The analysis highlights the continued growth in Medicare Advantage enrollment in the Part D marketplace and substantially higher average monthly premiums for stand-alone Part D drug plan coverage. Changes to the Part D benefit included in the Inflation Reduction Act are helping to lower out-of-pocket costs for patients but could also contribute to higher-priced Part D coverage.
In 2024, A Majority of States Offer Medicare Advantage Plans to Their State Retirees, with 13 Offering Medicare Advantage Exclusively July 2, 2024 Issue Brief This analysis examines the extent to which states are providing health benefits to their Medicare-eligible retirees through Medicare Advantage arrangements. In 2024, a majority of states offer Medicare Advantage plans to their state retirees, with 13 offering Medicare Advantage exclusively.
How ACA Marketplace Premiums Changed by County in 2024 June 6, 2024 Issue Brief This analysis details how ACA marketplace premiums changed by county from 2023 to 2024, after taking into account expanded subsidies available under the Inflation Reduction Act.