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This issue brief analyzes the number and variety of Medicare Advantage plan choices available to beneficiaries in 2017. It describes trends in number of Medicare Advantage plans and plan quality ratings, and new information on plan premiums, out-of-pocket expense limits, and other plan features. This spotlight is part of a series of spotlights tracking key changes in the Medicare Advantage program.
This analysis presents the most current data on out-of-pocket health care spending by Medicare beneficiaries, both overall and among different groups of beneficiaries. The analysis explores how much Medicare beneficiaries spend out of pocket in total on health care premiums and health-related services, on average; how much beneficiaries spend out of pocket on different types of health-related services; and what share of income beneficiaries spend on out-of-pocket health care costs.
The average person with traditional Medicare coverage paid $5,460 out of their own pocket for health care in 2016, according to a new KFF analysis and interactive tool. This $5,460 includes about $1,000 in out-of-pocket spending for long-term care facility services, averaged across all traditional Medicare beneficiaries. Such services are used by only 5 percent of beneficiaries in traditional Medicare. For the 95 percent of beneficiaries living in the community, average out-of-pocket spending on health…
Millions of current enrollees in stand-alone Medicare Part D prescription drug plans will face premium and other cost increases next year unless they switch to lower-cost plans during the open enrollment period that began Oct. 15 and ends on Dec. 7, a new KFF analysis finds. This includes two-thirds of Part D stand-alone drug plan enrollees not receiving low-income subsidies—nine million enrollees—who will face higher monthly premiums if they keep their current plan in 2020.…
Annual premiums for employer-sponsored family health coverage reached $20,576 this year, up 5% from last year, with workers on average paying $6,015 toward the cost of their coverage. The average deductible among covered workers in a plan with a general annual deductible is $1,655 for single coverage. Fifty-six percent of small firms and 99% of large firms offer health benefits to at least some of their workers, with an overall offer rate of 57%.
A new KFF analysis that looked at both premiums and other out-of-pocket costs shows that families with coverage through a large employer paid 67 percent more for their health benefits and care in 2018 than a decade earlier. In 2018, a typical family of four with large employer coverage spent $4,706 on their share of health premiums and $3,020 on cost sharing (such as deductibles, copayments and coinsurance) for a combined cost to the family…
Medicare Advantage enrollment is lower, but has grown more rapidly in recent years in rural areas than in metropolitan areas. In 2023, nearly 40% of eligible Medicare beneficiaries in rural areas are in Medicare Advantage. Rural Medicare beneficiaries can choose from 27 Medicare Advantage plans on average and most are enrolled in a plan that charges no additional premium.
With the start of the 2024 Affordable Care Act open enrollment, the Marketplaces have been operating for a full decade and are heading into their eleventh year. This policy watch outlines changes to watch out for during 2024 Open Enrollment.
This analysis of preliminary rate filings submitted by 105 ACA Marketplace insurers in 19 states and DC shows that ACA Marketplace insurers are requesting a median premium increase of 15% for 2026, which would represent the largest hike in premiums since 2018, the last time policy uncertainty contributed to sharp premium growth. The scheduled expiration of enhanced tax credits and impact of tariffs on some drugs, medical equipment, and supplies are among the factors pushing…
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…
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