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This data note examines the latest data and trends in the Medicare Part D coverage gap, where enrollees must pay a greater share of their prescription drug costs. The note includes data about how many Part D enrollees reached the coverage gap, their average out-of-pocket spending, the value of manufacturer discounts, and recent and proposed changes affecting out-of-pocket costs for Part D enrollees who reach the gap.
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
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…
A quarter of people in traditional Medicare had private, supplemental health insurance in 2015—also known as Medigap—to help cover their Medicare deductibles and cost-sharing requirements, as well as protect themselves against catastrophic expenses for Medicare-covered services. This issue brief examines implications for older adults with pre-existing medical conditions who may be unable to purchase a Medigap policy or change their supplemental coverage after their initial open enrollment period.
This issue brief examines the latest facts about Medicare spending and financing, including the most recent historical and projected Medicare spending data from the Centers for Medicare and Medicaid Services (CMS) Office of the Actuary (OACT), the 2018 annual report of the Boards of Medicare Trustees, and the 2018 Medicare baseline and projections from the Congressional Budget Office (CBO). It discusses historical and projected spending trends, program financing, Medicare’s financial condition, and the future outlook.
What’s in the Administration’s 5-Part Plan for Medicare Part D and What Would it Mean for Beneficiaries and Program Savings?
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
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…
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.
In response to higher drug spending growth and heightened attention to drug prices, some policymakers have proposed allowing Medicare to negotiate the price of prescription drugs. This issue brief provides a short history of this proposal, describes various approaches, and assessments of their potential savings from the Congressional Budget Office (CBO), and considers the prospects for action in the future.
How Many Seniors Are Living in Poverty? National and State Estimates Under the Official and Supplemental Poverty Measures in 2016
This analysis presents national and state estimates of poverty under two different measures of poverty for adults ages 65 and older. Current estimates of poverty based on the Supplemental Poverty Measure–which takes into account financial resources and liabilities, out-of-pocket medical spending, and geographic variation in housing costs–indicate that the share (and number) of older adults who are struggling financially is larger than is conveyed by the official poverty measure.