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  • Medicare Advantage 2020 Spotlight: First Look

    Issue Brief

    In 2020, more than 22 million Medicare beneficiaries (34%) are enrolled in Medicare Advantage plans, which are mainly HMOs and PPOs offered by private insurers as an alternative to the traditional Medicare program. This data note provides an overview of the Medicare Advantage plans that will be available in 2020, including the variation in the number of plans available by county and plan type. The brief also examines the insurers entering the Medicare Advantage market…

  • List Prices Increased As Much As 9 Times Faster Than Inflation for 20 of the Top 25 Part D Drugs, Suggesting Potential for Savings Under Proposed Inflation Rebate Policies

    News Release

    A new KFF analysis finds that the list prices for most of the top Medicare Part D drugs by total spending increased as much as nine times the rate of inflation (1.7%) between 2016 and 2017, suggesting recent Congressional proposals targeting such increases could generate savings for Medicare and Part D enrollees. The analysis finds 20 of the top 25 drugs, all of which were brand-name medications, had price increases between three and more than…

  • Data Note: Prescription Drugs and Older Adults

    Issue Brief

    This data note explores the attitudes and experiences of older adults, ages 65 and up, when it comes to prescription drugs and related policy proposals being discussed. Experiences across different demographic groups are explored, such as household income and health status.

  • Financial Performance of Medicare Advantage, Individual, and Group Health Insurance Markets

    Issue Brief

    Three key private health insurance markets -- Medicare Advantage, the individual market and the fully-insured group market -- appear to be financially healthy and attractive to insurers. The private Medicare Advantage market generates significantly larger gross margins per person than the individual market or fully-insured market. The future of these markets has become a focus for policymakers amid the debate over Medicare for All.

  • What Steps Are Washington Policymakers Pursuing to Control Medicare Prescription Drug Spending?

    News Release

    As policymakers in Washington discuss ways to curb the rising cost of prescription drugs, KFF has released a summary and analysis of proposals and recently finalized initiatives that affect Medicare prescription drug spending.  Medicare, the federal health program that covers more than 60 million seniors and younger people with disabilities, accounts for 30 percent of the nation’s retail prescription drug spending. A Look at Recent Proposals to Control Drug Spending by Medicare and its Beneficiaries…

  • How Many Medicare Part D Enrollees Had High Out-of-Pocket Drug Costs in 2017?

    Issue Brief

    The Medicare Part D prescription drug benefit has helped improve the affordability of medications for people with Medicare. Yet Part D enrollees can face relatively high out-of-pocket costs because the Part D benefit does not have a hard cap on out-of-pocket spending. This analysis presents the latest data on out-of-pocket drug spending among Medicare Part D enrollees without low-income subsidies who have costs above the catastrophic coverage threshold.

  • What Percent of New Medicare Beneficiaries Are Enrolling in Medicare Advantage?

    Issue Brief

    The analysis examines enrollment in Medicare Advantage plans during beneficiaries’ first year on Medicare and finds that less than one-third or 29% enrolled in these private health plans, including HMOs or PPOs. The majority of people new to Medicare are choosing traditional Medicare in the year they first go on Medicare. The study looks at how these findings vary across age, Medicaid status, states, and counties.

  • 10 Things to Know About Medicare Part D Coverage and Costs in 2019

    Issue Brief

    The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans. This analysis provides the latest data about Medicare Part D coverage and costs in 2019 and trends over time, including enrollment, premiums, cost sharing, and participation in the low-income subsidy program.

  • New Analysis Compares Prescription Drug Spending and Use Across Large Employer Plans, Medicare, and Medicaid

    News Release

    As policymakers debate how to address the high cost of prescription drugs, a new KFF analysis compares data on prescription drug spending and use across large employer plans, Medicare Part D and Medicaid, and provides context for policy discussions about different approaches to curb rising drug costs that would affect people covered by each of the three major payers. The data show that private insurers, Medicare and Medicaid account for 82 percent of retail prescription…