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  • FAQs on Medicare Coverage and Costs Related to COVID-19 Testing and Treatment

    Issue Brief

    These FAQs provide the latest guidance on testing and treatment related to COVID-19 for Medicare beneficiaries, including questions related to out-of-pocket costs, the COVID-19 vaccine, telehealth, extended supplies of medication, skilled nursing facility stays, and issues for people in private Medicare Advantage plans.

  • Medicaid’s Money Follows the Person Program: State Progress and Uncertainty Pending Federal Funding Reauthorization

    Issue Brief

    Medicaid’s Money Follows the Person (MFP) demonstration has helped seniors and people with disabilities move from institutions to the community by providing enhanced federal matching funds to states since 2007. The program operates in 44 states and has served over 90,000 people as of June 2018. The program is credited with helping many states establish formal institution to community transition programs that did not previously exist by enabling them to develop the necessary service and…

  • Implications of the Expiration of Medicaid Long-Term Care Spousal Impoverishment Rules for Community Integration

    Issue Brief

    To financially qualify for Medicaid long-term services and supports (LTSS), an individual must have a low income and limited assets. In response to concerns that these rules could leave a spouse without adequate means of support when a married individual needs LTSS, Congress created the spousal impoverishment rules in 1988. Originally, these rules required states to protect a portion of a married couple’s income and assets to provide for the “community spouse’s” living expenses when…

  • Two Medicaid-Related Initiatives That Help Promote Long-Term Care at Home and in the Community, Rather Than in Institutions, Are Set To Expire at the End of December

    News Release

    Two initiatives that for years have helped shift Medicaid enrollees away from nursing homes in favor of long-term care at home and in the community face year-end deadlines that could undercut that trend, according to two new KFF issue briefs. While there does not appear to be substantive disagreement over the initiatives like there is with many other federal health programs, their expiration is coming at a time when Congress is engaged in a contentious…

  • 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…

  • How Much Do Medicare Beneficiaries Spend Out of Pocket on Health Care?

    Issue Brief

    This analysis presents the most current data on out-of-pocket health care spending by Medicare beneficiaries, both overall and among different groups of beneficiaries. The analysis explores how much Medicare beneficiaries spend out of pocket in total on health care premiums and health-related services, on average; how much beneficiaries spend out of pocket on different types of health-related services; and what share of income beneficiaries spend on out-of-pocket health care costs.

  • Medicare Beneficiaries Spent an Average of $5,460 Out-of-Pocket for Health Care in 2016, With Some Groups Spending Substantially More 

    News Release

    The average person with traditional Medicare coverage paid $5,460 out of their own pocket for health care in 2016, according to a new KFF analysis and interactive tool. This $5,460 includes about $1,000 in out-of-pocket spending for long-term care facility services, averaged across all traditional Medicare beneficiaries.  Such services are used by only 5 percent of beneficiaries in traditional Medicare. For the 95 percent of beneficiaries living in the community, average out-of-pocket spending on health…

  • Medicare Part D: A First Look at Prescription Drug Plans in 2020

    Issue Brief

    This issue brief provides an overview of the Medicare Part D prescription drug benefit plan landscape for 2020, 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 national Part D plans available in 2020.

  • FAQs on Prescription Drug Importation

    Issue Brief

    These FAQs address questions related to prescription drug importation, including the current status of importation proposals, details of Florida’s importation program recently authorized by the FDA, and concerns and challenges with this approach.

  • 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.