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Short-term health insurance plans are able to charge premiums 54 percent lower than ACA-compliant 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.
Our analysis of CMS data for states that use Healthcare.gov insurance exchanges revealed that marketplace premium changes vary dramatically state-to-state in 2019.
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 than in recent years.
This report examines the share of doctors participating in the provider networks of Qualified Health Plans (QHPs) offered in the individual market in the federal and state Marketplaces in 2021, and how network breadth affected costs for enrollees.
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.
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.
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.
This brief provides an overview of the Medicare Advantage plans that are available for 2025 and key trends over time. The average Medicare beneficiary will have the option of 34 Medicare Advantage prescription drug (MA-PD) plans in 2025, 2 fewer than the 36 options available in 2024. The average Medicare beneficiary can choose among plans offered by 8 firms in 2025, the same as in 2024.
This brief provides an overview of the Medicare Part D prescription drug benefit, including current data on plan availability, enrollment, and spending and financing, and highlights recent changes under the Inflation Reduction Act.
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