Medicare

Medicare Open Enrollment

Medicare Advantage Plan Availability Varies Widely by County for 2027

Medicare Advantage prescription drug plan (MA-PD) availability varies widely by county in 2027, with a modest reduction in the share of enrollees with more than 40 plans to choose from and some major insurers exiting many more counties than they are entering. 1 in 5 Medicare beneficiaries (20%) can choose from among more than 40 MA-PDs for 2027, down from 27% in 2026. 1% of all beneficiaries will have no plan option for 2027.

Medicare Open Enrollment and Coverage Options: Key Questions and Answers

Each year, Medicare beneficiaries have an opportunity to make changes to how they receive their Medicare coverage during the nearly 8-week annual open enrollment period, which runs from October 15 through December 7. This brief answers key questions about the Medicare open enrollment period and Medicare coverage options.

Medigap

Medigap Guaranteed Issue Requirements: An Overview of Federal and State Rules

This issue brief analyzes federal and state rules related to guaranteed issue requirements for Medigap policies and how they impact beneficiaries’ access to Medigap, including the implications for Medicare beneficiaries with pre-existing medical conditions and those under age 65 with long-term disabilities.

NEW AND NOTEWORTHY

Decoding Medicare Advantage Coding Intensity

Federal payments to Medicare Advantage plans, and adjustments for health status, have come under increased scrutiny. This brief answers key questions about coding intensity, recent steps taken by CMS, the effects on beneficiaries, and other proposals to improve payment accuracy.

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. Explore 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.

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  • The Olmstead Decision: Implications for Medicaid

    Issue Brief

    In June, 1999, the Supreme Court rule in Olmstead v L.C. that states were required to provide services to persons with disabilities in community settings rather than institutions, if certain conditions were met. This Policy Brief provides an overview of the Olmstead case, including the facts, the court ruling, and the disposition of the case. In addition, the brief describes the issues surrounding implementation and the implications this ruling could have for state Medicaid programs.…

  • Prescription Drug Coverage for Medicare Beneficiaries: A Side-by-Side Comparison

    Other Post

    This document, prepared by Health Policy Alternatives, Inc., provides a side-by-side comparison of five major federal proposals under consideration to provide outpatient prescription drug coverage to Medicare beneficiaries. It includes both a summary and a detailed comparison of the following major proposals: S. 357, The Medicare Preservation and Improvement Act of 2001 (Breaux/Frist I), S. 358, The Medicare Prescription Drug and Modernization Act of 2001 (Breaux-Frist II), H.R. 4680, The Medicare Rx 2000 Act (passed…

  • Medicare Beneficiaries and HMOs: A Case Study of the Portland Market

    Report

    This case study of the evolution of Medicare managed care in Portland, Oregon, is part of a series of four case studies being prepared for the Kaiser Family Foundation to learn more about the factors influencing, and consequences of, the growth of Medicare managed care. Portland was one of the first markets to implement a Medicare managed care program, with the Kaiser Foundation Health Plan beginning its Medicare HMO in 1978 and all four of…

  • Medicare Beneficiaries and Their Assets: Implications for Low-Income Programs

    Report

    This report, prepared by Marilyn Moon of The Urban Institute and Robert Friedland and Lee Shirey of Georgetown University's Center on an Aging Society, reviews the income and assets of the current Medicare population, provides an overview of asset tests used to determine eligibility for programs assisting low-income Medicare beneficiaries, and considers how alternative policy options would affect eligibility for these programs. The authors find that beneficiaries with low incomes tend to have minimal assets.…

  • Disability, Health Coverage, and Welfare Reform

    Report

    This report analyzes data from a survey of 42 low-income families with children with moderate or severe disabilities to better understand the impact of welfare reform on health coverage for these families. Report

  • Medicare Beneficiaries: A Population At Risk – Findings from the Kaiser/Commonwealth 1997 Survey of Medicare Beneficiaries – Report

    Report

    Medicare Beneficiaries: A Population at RiskFindings from the Kaiser/Commonwealth Fund 1997 Survey of Medicare Beneficiaries Cathy Schoen, Patricia Neuman, Michelle Kitchman, Karen Davis, and Diane RowlandDecember 1998 Table Of ContentsExecutive Summary Findings from the Kaiser/Commonwealth 1997 Survey of Medicare Beneficiaries Medicare Beneficiaries: Health Status and Income Health Insurance Coverage Satisfaction, Access, and Financial Burden: Variations by Income Prescription Drugs: Use and Cost Exposure Satisfaction, Access, and Financial Burden: Variations by Type of Insurance Coverage HMOs:…

  • Medicaid Managed Care for Persons With Disabilities: State Profiles-2114

    Report

    Medicaid Managed Care for Persons With Disabilities: State Profiles This report provides state estimates of the number of Medicaid disabled enrolled in managed care and profiles these programs. It provides detailed comparative state information on enrollment, program features, rate setting, quality issues, and special enrollment features for the disabled in Medicaid managed care. It also highlights individual state profiles on the Medicaid managed care programs that include persons with disabilities. Report

  • Standard Medicare Drug Benefit, 2006 Chart

    Report

    Standard Medicare Drug Benefit, 2006 Out-of-pocket drug spending for Medicare beneficiaries under the standard Medicare drug benefit described in the Medicare Modernization Act of 2003. Chart (.pdf)

  • The New Medicare Prescription Drug Law:  Issues for Dual Eligibles with Disabilities and Serious Conditions

    Issue Brief

    The New Medicare Prescription Drug Law: Issues for Dual Eligibles with Disabilities and Serious Conditions The new issue paper discusses the challenges the new Medicare drug program faces in meeting the needs of dual eligible individuals with disabilities, who tend to have extensive, complex and varying needs. The brief examines four key questions about how the new benefit will serve dual eligibles with disabilities and profiles some individuals from this population for whom prescription drugs…