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  • Medicare’s Income-Related Premiums Under Current Law and Changes for 2019

    Issue Brief

    Most people with Medicare pay the standard monthly premium for Part B and Part D coverage, which is set to cover 25 percent of per capita program costs, but a relatively small share of beneficiaries with higher incomes are required to pay higher premiums. This issue brief describes the legislative history of Medicare's income-related premiums and changes to these premiums that will take effect in 2019, based on a provision in the Bipartisan Budget Act…

  • Medicare Part D: A First Look at Prescription Drug Plans in 2019

    Issue Brief

    This issue brief provides an overview of the Medicare Part D prescription drug benefit plan landscape, with a focus on stand-alone drug plans, the largest segment of the Part D market. It includes national and state-level data on plan availability, premiums, benefit design, cost sharing, information about premium-free plans for low-income beneficiaries, and information about the top ten Part D plans for 2019.

  • Medicare Advantage 2019 Spotlight: First Look

    Issue Brief

    In 2019, more than 20 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 issue brief provides an overview of the Medicare Advantage plans that will be available in 2019, 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…

  • In All But Four States, Seniors on Medicare Can Be Denied a Medigap Policy Due to Pre-existing Conditions, Except During Specified Windows of Opportunity

    News Release

    In all but four states, insurance companies can deny private Medigap insurance policies to seniors after their initial enrollment in Medicare because of a pre-existing medical condition, such as diabetes or heart disease, except under limited, qualifying circumstances, a Kaiser Family Foundation analysis finds. Medigap policies provide supplemental health insurance to help cover the deductibles and coinsurance for Medicare covered services. One in four people in traditional Medicare had a Medigap policy in 2015. This…

  • What’s in the Administration’s 5-Part Plan for Medicare Part D and What Would it Mean for Beneficiaries and Program Savings?

    Issue Brief

    With rising concern over increases in prescription drug costs, the Trump Administration has proposed what it calls a “5-part plan” that would change several features of the Medicare Part D drug benefit. This brief describes the Administration’s five Part D proposals and discusses the potential implications for people with Part D prescription drug coverage and Medicare program spending, based on estimates from the Congressional Budget Office.

  • Three firms Account for Over Half of All Medicare Part D Enrollees in 2018, and Pending Mergers Would Further Consolidate the Marketplace

    News Release

    In 2018, three Medicare Part D plan sponsors—UnitedHealth, Humana, and CVS Health—account for more than half of the program’s 43 million Part D enrollees (55%) and two-thirds of all stand-alone drug plan enrollees, indicating a marketplace that is dominated by a handful of major insurers, according to a new Kaiser Family Foundation analysis of Part D enrollment, premiums and cost-sharing data. The proposed mergers of CVS Health and Aetna, and Cigna and Express Scripts would…

  • Medicare Part D in 2018: The Latest on Enrollment, Premiums, and Cost Sharing

    Issue Brief

    This brief about the 2018 Medicare Part D marketplace analyzes the latest data on Medicare drug coverage and trends over time, including both stand-alone prescription drug plans and Medicare Advantage drug plans. The analysis focuses on enrollment, premiums, cost sharing, and the low-income subsidy.

  • More Than One-Third of People with Traditional Medicare Spent at Least 20 Percent of Their Total Income on Health Care in 2013 

    News Release

    Health care costs are a substantial and growing burden for many people on Medicare and are projected to consume a larger share of total income over time, according to a new analysis from the Kaiser Family Foundation. The study, Medicare Beneficiaries’ Out-of-Pocket Health Care Spending as a Share of Income Now and Projections for the Future, finds that more one-third of people with traditional Medicare spent at least 20 percent of their total income on…

  • One Million Medicare Part D Enrollees Had Out-of-Pocket Drug Costs above the Catastrophic Threshold in 2015

    News Release

    One million Medicare beneficiaries had out-of-pocket drug spending above the Part D catastrophic threshold in 2015, and the number with such high spending has risen sharply in recent years, according to a new analysis by the Kaiser Family Foundation. While the Part D drug benefit has helped make drugs more affordable for people with Medicare, the lack of a hard cap on annual out-of-pocket spending under Part D exposes enrollees to significant costs, unless they…