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- Issue Paper This Issue Paper describes the discount card and low-income assistance programs and discusses their implications for low-income Medicare beneficiaries and state Medicaid programs. Issue Paper (.pdf)
This report examines the formulary and cost management provisions of the final Medicare regulations implementing the new Medicare Part D drug benefit that was passed as part of the Medicare Modernization Act of 2003, and their implications for people with Medicare who enroll in new drug plans and their access to medications. It was prepared for the Foundation by Jack Hoadley, Ph.D., of the Health Policy Institute at Georgetown University. Issue Brief (.pdf)
Individuals with disabilities who are eligible for both Medicare and Medicaid must also shift to a Medicare prescription drug benefit in 2006. This report analyzes how younger dual eligibles in Kansas enrolled in work incentive programs differ than other Medicare enrollees in the types of drugs they use and how much drug spending they have to better assess the impact of the Medicare drug benefit on this population. Report (.pdf)
This Medicare Part D Data Spotlight focuses on the availability of drug plans for beneficiaries receiving the Part D low-income subsidy in 2009 and changes since 2006. For 2009, fewer than one in five plans qualify for automatic or facilitated enrollment of low-income subsidy beneficiaries, the lowest share since the inception of the Part D benefit. These plans have monthly premiums below a benchmark amount calculated for each region, enabling low-income subsidy beneficiaries to enroll…
The National ADAP Monitoring Project Annual Report provides the latest data on state AIDS Drug Assistance Programs (ADAPs). ADAPs, part of the Ryan White Program, provide HIV medications to low-income people with HIV/AIDS who have limited or no prescription drug coverage. ADAPs operate in all 50 states, the District of Columbia, and U.S. territories and associated jurisdictions. The 2009 report is the 13th in a series jointly authored by the Kaiser Family Foundation and the…
This initial analysis examines the private stand-alone Part D drug plans will be available to Medicare beneficiaries in 2011 and provides an early look at key trends in the options, premiums, and other plan characteristics. It finds that the average Medicare beneficiary will have a choice of 33 Part D stand-alone prescription drug plans in 2011, despite a 30 percent reduction in the total number of stand-alone plans available nationwide. Monthly premiums for stand-alone prescription…
Employer-provided health insurance is the primary source of insurance coverage in the United States, covering almost 160 million people.1 About 90 percent of the non-elderly privately-insured population is covered by employer-sponsored plans, meaning that employer decisions about whether to offer health benefits will influence overall rates of insurance coverage in the United States. Sixty-nine percent of all firms offered health benefits to their employees in 2010.2 It is well-known that highly-paid workers are more likely to…
This study of Medicare Part D plans offered in 2006 examines formularies, drug costs and utilization management tools in drug plans offered by 14 national and near-national organizations. Collectively, these organizations account for 1,222 of the 1,429 Part D plans available to Medicare beneficiaries. The analysis finds that Medicare’s new, private, stand-alone drug plans vary significantly in terms of covered drugs, out-of-pocket costs for specific medications and restrictions placed on the use of certain drugs. The…
This Kaiser Family Foundation report analyzes the content and frequency of television, print and radio advertisement for private Medicare plans that ran nationally or in one of three local media markets (Miami/Fort Lauderdale, Fla.; Phoenix, Ariz.; and Greensboro, N.C.) during the marketing and enrollment period for 2008 plan offerings. All ads were identified by VMS, a media monitoring service. The study finds that insurers last year placed three times more advertisements to promote Medicare Advantage…
Issues Surrounding the “Clawback” or State Contributions Towards Medicare Drug Coverage: A Conference Call Discussion As part of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 signed into law last year, Congress included a financing provision that requires a monthly payment from each state to the Medicare program beginning in January 2006. MMA’s clawback provision will recapture most of the savings that states would realize when Medicare assumes prescription drug costs for…
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