Medicaid Pharmacy Benefits State Fact Sheets
These state fact sheets offer a snapshot of the administration and delivery of Medicaid pharmacy benefits in each state.
Amid heightened public concern, the cost of prescription drugs is the focus of renewed attention by the Trump administration, the Biden campaign and lawmakers in Congress and state capitals. Proposed actions range from sweeping health care system changes to targeted initiatives that could affect Medicare, Medicaid and private insurance. See KFF’s research, analysis and public opinion data, as well as Kaiser Health News’ journalism, related to prescription drugs and their costs.
Featured Prescription Drugs Resources
KFF Health Tracking Poll – October 2019: Health Care In The Democratic Debates, Congress, And The Courts
This poll examines health care issues in the Democratic presidential primary , government negotiation of prescription drug prices, party trust on health care, Medicare-for-all, and the pending Texas v. US lawsuit affecting the Affordable Care Act and pre-existing condition protections.
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Related Prescription Drugs Resources
- Assessing Drug Price Increases in Medicare Part D and the Implications of Inflation Limits
- 10 FAQs on Prescription Drug Importation
- Pricing and Payment for Medicaid Prescription Drugs
- Management and Delivery of the Medicaid Pharmacy Benefit
- Understanding the Medicaid Prescription Drug Rebate Program
- A Look at Recent Proposals to Control Drug Spending by Medicare and its Beneficiaries
- Kaiser Health News Coverage of Prescription Drug Issues
- What are the recent and forecasted trends in prescription drug spending?
- What’s the Latest on Medicare Drug Price Negotiations?
- How Will The Medicare Part D Benefit Change Under Current Law and Leading Proposals?
- Medicaid’s Prescription Drug Benefit: Key Facts
- Public Opinion on Prescription Drugs and Their Prices
- Prescription Drug Rebates, Explained
- Who is Most Likely to Have High Prescription Drug Costs?
- Snapshots of Recent State Initiatives in Medicaid Prescription Drug Cost Control
- 10 Essential Facts About Medicare and Prescription Drug Spending
- Utilization and Spending Trends in Medicaid Outpatient Prescription Drugs
- How Does Prescription Drug Spending and Use Compare Across Large Employer Plans, Medicare Part D, and Medicaid?
What’s the Latest on Prescription Drug Proposals from the Trump Administration, Congress, and the Biden Campaign?
This slideshow explains the similarities and differences among major proposals to lower prescription drug costs introduced by the Trump Administration, members of Congress, and the Biden campaign.
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When Is the Open Enrollment period for Medicare?
The Medicare Open Enrollment period runs from October 15 through December 7 each year. During this period, people on Medicare have the opportunity to make a change in their coverage. If you are covered by Medicare, and you are interested in reviewing and comparing your Medicare coverage options, make sure…
I am in traditional Medicare and don’t want to make any changes to my coverage. How does the Medicare Open Enrollment period affect me?
If you are happy with your coverage under traditional Medicare, you do not need to take any action during the Medicare Open Enrollment period. If you do nothing during the Medicare Open Enrollment period, your coverage under traditional Medicare will continue next year.
Is it better for people to switch sooner rather than later during the Medicare Open Enrollment period?
The timing of enrollment does not matter, as long as you enroll before the Medicare Open Enrollment period ends on December 7. Keep in mind that it can take some time to compare plans, and you may want to have a list of all the medications you take and the…
I have Medicare Part A and Part B. I’ve heard about Part C and Part D, but I don’t know what those are. Do I need to sign up for those during the Medicare Open Enrollment period?
Medicare Part C plans, also known as Medicare Advantage plans, are private health insurance plans, mainly HMOs and PPOs, for people enrolled in Medicare. If you enroll in a Medicare Advantage plan, you still have Medicare, but you get all of your Medicare-covered benefits through a private plan. Most Medicare…
I live alone without family or close friends nearby, and I don’t have a computer. Where can I get help learning about the Medicare drug plans and Medicare Advantage plans in my area?
You can learn about your coverage options by calling 1-800-MEDICARE (1-800-633-4227), or by speaking with someone at your local State Health Insurance Assistance Program (SHIP). SHIPs offer local, personalized counseling and assistance to people with Medicare and their families. You can call 877-839-2675 to get the phone number for the…
What changes can I make to my Medicare coverage during the Medicare Open Enrollment period?
During the Medicare Open Enrollment period, from October 15 to December 7, you can make many changes to your Medicare coverage, depending on the coverage you already have. You can change from traditional Medicare to a Medicare Advantage plan (or vice versa). If you prefer Medicare Advantage, you can choose…
Can I change my Medicare coverage outside of the Medicare Open Enrollment period?
You can, but generally only under special circumstances that qualify you for a Special Enrollment Period (SEP). These circumstances include (but are not limited to) moving to a new location that is outside of your current plan’s service area or where additional plan options are available, moving back into the…
Is there a lifetime limit on the number of times a person can switch Medicare Advantage and Medicare Part D plans, or can I shop around and switch every year if I want to?
You may switch Medicare Advantage and Part D plans every year during the annual Medicare Open Enrollment period (October 15 through December 7), and, if you are enrolled in a Medicare Advantage plan, you can also switch during the Medicare Advantage Open Enrollment period (January 1 through March 31). It…
I am turning 65 in a few months and want to go on Medicare. Will I be automatically enrolled in Parts A and B or do I need to sign up?
It depends. If you’re receiving benefits from Social Security or the Railroad Retirement Board (RRB) at least four months before you turn 65, you do NOT need to sign up; you’ll automatically get Part A and Part B starting the first day of the month that you turn 65. You…