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  • The Future of Medicare Advantage: Are We on the Right Path?

    Event Date:
    Event

    This June 10 briefing looked at Medicare Advantage and changes affecting it, including revised calculations of payments from CMS, and the Affordable Care Act's reduced payments to Medicare Advantage plans. Speakers discussed how Medicare Advantage plans are expected to respond to payment changes; if quality bonus payments created significant changes in patient care or plan choices; and what implications could these decisions have on beneficiaries with regard to premiums, benefits and more.

  • Medigap: Spotlight on Enrollment, Premiums and Recent Trends

    Report

    Medicare supplemental insurance, also known as "Medigap," is an important source of supplemental coverage for nearly one in four people on Medicare. Traditional Medicare has cost-sharing requirements and significant gaps in coverage; Medigap helps make health care costs more predictable and stable for beneficiaries by covering some or all Medicare costs, including deductibles and cost-sharing. This policy brief provides an overview of the Medigap market, national trends in enrollment and premiums, variations across plan types…

  • The Flip Side of Higher Premiums: Better Coverage

    Perspective

    Time Magazine's recent cover story on health care – "Bitter Pill" by Steven Brill – has focused attention on hospital prices, especially for people paying out of their own pockets. This is not a new issue, but certainly one that deserves attention. However, what has been lost in the ensuing commentary on high hospital prices is that Brill’s article is as much about inadequate insurance, which is the reason why the patients he writes about…

  • Health Insurance Premiums in the Individual Market in 2010

    Feature

    Health Insurance Premiums in the Individual Market in 2010 Download Source Kaiser Family Foundation analysis of 2010 insurer filings to the National Association of Insurance Commissioners using the Mark Farrah Associates Health Coverage Portal. The Average premium is calculated as total premium revenues in a state divided by the number of total member months. The per member per month premium is an average across adults and children, so will be lower than a premium typically…

  • Premiums and Cost-Sharing in Medicaid: A Review of Research Findings

    Issue Brief

    Medicaid covers nearly 60 million Americans. Because the population covered by the program is low-income, federal law limits the extent to which states can charge premiums and cost-sharing amounts, particularly for pregnant women, children and adults with incomes below poverty. Yet there is renewed interest in the use of premiums and cost-sharing in Medicaid given the continued focus on cost-containment due to ongoing state budget pressures as well as recently proposed changes to federal regulations…

  • Why Premiums Will Change for People Who Now Have Nongroup Insurance

    Perspective

    The federal government recently released draft regulations that address the benefits, market rules, and rating practices for nongroup coverage. Before reform, the nongroup market was widely acknowledged to be broken, with restricted access, limited benefits, high administrative costs, and frequent and large premium increases subject to inadequate oversight. Recent requests for large premium hikes for nongroup coverage in some states, at a time when the group market is experiencing very low increases, have revived concerns about current pricing…

  • Implementing New Private Health Insurance Market Rules

    Issue Brief

    With the Jan. 1, 2014 effective date for implementing major changes in the private insurance market under the Affordable Care Act (ACA) approaching, this brief looks at three proposed federal regulations released in late November 2012 that detail how the ACA’s rules will operate in the following areas: private insurance market reforms, essential health benefits and actuarial value, and wellness programs offered or required by employers under group health plans. These regulations deal with aspects…

  • Medicare Part D: A First Look at Part D Plan Offerings in 2013

    Report

    This data spotlight examines the stand-alone Part D drug plan options available to Medicare beneficiaries in 2013 during the open enrollment period, which runs from October 15 to December 7, 2012. The analysis is the first in a series of planned reports examining the private plan choices available to Medicare beneficiaries for 2013. It is authored by Jack Hoadley and Laura Summer of Georgetown University, Juliette Cubanski and Jennifer Huang of the Kaiser Family Foundation,…

  • What Do They Mean When They Talk About Pre-Existing Health Conditions?

    Perspective

    One health care issue about which the presidential candidates acknowledge they have differences is how the health care system should treat people with pre-existing health conditions. People who have a health condition (such as an illness or pregnancy) or who are at higher than average risk of needing health care are referred to as having a pre-existing health condition. The insurance reform provisions of the Affordable Care Act (ACA), when they take effect in 2014, will…