Medicare

NEW AND NOTEWORTHY

What to Know About Medicare Coverage of Telehealth

Congress has repeatedly extended pandemic-era flexibilities around Medicare coverage of telehealth, but most such flexibilities remain temporary. This brief answers key questions about the current scope of Medicare telehealth coverage, including both temporary and permanent changes adopted through legislation and regulation, and future policy considerations.

Changes to the Medicare Advantage Program Enhance Some Consumer Protections But Roll Back Others

CMS recently finalized policies as part of the 2027 Medicare Advantage final rule that both enhance consumer protections and roll back changes to the Medicare Advantage program that were intended to protect consumers. These changes have gotten less attention than payment issues and changes to the star ratings system, which also affect plan payments, but could have implications for Medicare beneficiaries.

Examining the Potential Impact of Medicare’s New WISeR Model

A federal initiative to establish new prior authorization requirements in traditional Medicare, called the Wasteful and Inappropriate Service Reduction (WISeR) model, is likely to have only modest impact in its first year.

State Profiles for Dual-Eligible Individuals

This data collection draws on Medicare and Medicaid administrative data to present national and state-level information on people who are covered by both Medicare and Medicaid, referred to as dual-eligible individuals (also known as dually-enrolled beneficiaries).

Data Visualization

The Facts About Medicare Spending

This interactive provides the facts on Medicare spending. Medicare, which serves 67 million people and accounts for 12 percent of the federal budget and 21 percent of national health spending, is often the focus of discussions about health expenditures, health care affordability and the sustainability of federal health programs. u003cbru003eu003cbru003eExplore data on enrollment growth, Medicare spending trends overall and per person, growth in Medicare spending relative to private insurance, spending on benefits and Medicare Advantage, Part A trust fund solvency challenges, and growth in out-of-pocket spending by beneficiaries.u003cbru003eu003cbru003eu003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022 data-type=u0022linku0022 data-id=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003eRelated:u003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003e FAQs on Medicare Financing and Trust Fund Solvencyu003c/au003eu003c/au003e

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  • Medicare Part D 2008 Data Spotlight: Premiums

    Issue Brief

    This Medicare Part D data spotlight analyzes the premiums charged by the 1,824 stand-alone Medicare Part D plans that will be offered in markets across the country in 2008. The analysis finds premiums charged for Part D plans range widely, from $9.80 per month to $107.50 per month. The average monthly premium would increase from $27.39 in 2007 to $31.99 if enrollees remain in their current plans next year – a 17 percent increase. Nearly…

  • Medicare Part D 2008 Data Spotlight: The Coverage Gap

    Issue Brief

    This Medicare Part D data spotlight examines the coverage gap, or “doughnut hole,” in Medicare drug plans available in 2008. Part D enrollees (other than those receiving low-income subsidies) will reach the coverage gap after they incur $2,510 in total drug costs in 2008. At that point, enrollees are required to pay 100 percent of drug costs until they qualify for catastrophic coverage. The analysis finds that in 2008, more than a quarter of stand-alone…

  • How Much ‘Skin In The Game’ Do Medicare Beneficiaries Have? The Increasing Financial Burden of Health Care Spending, 1997-2003

    Issue Brief

    This study evaluated the changes in Medicare beneficiaries' health care spending between 1997 and 2003, and found beneficiaries spent a growing share of their income on health care. The results showed that median out-of-pocket health spending increased from 11.9% of income in 1997 to 15.5% in 2003, and about four in 10 beneficiaries spent at least one-fifth of their income on health care in 2003. Researchers using data from the Medicare Current Beneficiary Survey found…

  • Benefit improvements for low-income Medicare beneficiaries

    Report

    Benefit Improvements for Low-Income Medicare Beneficiaries The Kaiser Family Foundation has prepared a summary showing how the House-passed Children’s Health and Medicare Protection (CHAMP) Act legislation would change current law regarding assistance for low-income Medicare beneficiaries. The summary describes proposed changes to current programs that provide assistance to low-income Medicare beneficiaries, including the Medicare Savings Program and the Medicare Part D Low-Income Subsidy (LIS) Program. The summary reviews how the CHAMP Act would modify each…

  • The Burden of Out-of-Pocket Health Spending Among Older Versus Younger Adults: Analysis from the Consumer Expenditure Survey, 1998-2003

    Issue Brief

    UPDATED: An updated version of this analysis is now available online. Recent policy debate has focused on the issue of rising health care costs and whether it might be possible to control costs by requiring consumers to pay a larger share of their health care costs out of pocket. While most of the policy discussion has focused on people of working age, rising health care costs and the burden of out-of-pocket spending also affects seniors,…

  • Medicare Prescription Drug Benefit Progress Report: Findings From A 2006 National Survey of Seniors

    Event Date:
    Event

    The share of seniors without drug coverage dropped significantly under Medicare’s new drug benefit, according to this August 2007 Health Affairs Web Exclusive article based on a Kaiser Family Foundation, Commonwealth Fund and Tufts-New England Medical Center survey of more than 16,000 seniors. Seniors with drug coverage from any source were less likely to face high monthly drug costs or to skip prescribed medications due to cost than seniors who remained without drug coverage. However,…

  • Learning From History: Deinstitutionalization of People with Mental Illness As Precursor to Long-Term Care Reform

    Report

    This report examines what policy lessons can be learned from the deinstitutionalization of people with mental illnesses and applied to potential long-term care reform for the elderly or those with significant disabilities. The study assesses the reforms that took place under deinstitutionalization, their impact and what mistakes were made. It also discusses the take-away lessons for long-term care policy, with a focus on planning, financing, living situations and the role of families, workplace issues, and…

  • The Role of State Pharmaceutical Assistance Programs in Serving Low-Income Medicare Beneficiaries Following the Implementation of Medicare Part D

    Issue Brief

    The Role of State Pharmaceutical Assistance Programs in Serving Low-Income Medicare Beneficiaries Following the Implementation of Medicare Part D Prior to January 1, 2006, State Pharmaceutical Assistance Programs helped to fill a critical gap in coverage for Medicare beneficiaries without prescription drug coverage, targeting resources to beneficiaries with relatively low incomes. With the inception of the Medicare prescription drug benefit, the role of SPAPs began to change. This policy brief examines the role of state…