Medicare

Medicare Open Enrollment

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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  • Medicare Advantage Insurers Report Much Higher Gross Margins Per Enrollee Than Insurers in Other Markets

    News Release

    A new analysis of health insurers’ 2021 financial data shows that insurers continue to report much higher gross margins per enrollee in the Medicare Advantage market than in other health insurance markets. The analysis examines insurers’ financial data in the Medicare Advantage, Medicaid managed care, individual (non-group), and fully insured group (employer) markets. In 2021, Medicare Advantage insurers reported gross margins averaging $1,730 per enrollee, at least double the margins reported by insurers in the…

  • As Debate Heats Up in Washington Over Possible Entitlement Cuts, A New KFF Analysis Details the 30% of Federal Spending That Goes to Health Care Programs

    News Release

    As some policymakers in Washington are pushing to reduce the federal deficit and debt, a new KFF resource provides a concise explanation of federal spending for domestic and global health programs and services, which could be part of any conversation about curbing federal spending. Federal spending on health programs and services accounted for 30 percent of net federal spending in fiscal year 2022 -- or $1.7 trillion out of a total of $5.9 trillion. Specifically,…

  • Medicare and People with HIV

    Issue Brief

    This data note provides an overview of the role of the Medicare program for people with and at risk for HIV.

  • Medicare Beneficiaries Rarely Change Their Coverage During Open Enrollment

    Issue Brief

    During the Medicare open enrollment period for 2020, Medicare beneficiaries had an average of 24 Medicare Advantage prescription drug plans and 28 stand-alone Part D prescription drug plans to choose from for their coverage. Despite having so many Medicare options, relatively few Medicare private plan enrollees opted to switch their coverage.

  • Two New KFF Analyses Show That a Relatively Small Share of Medicare Beneficiaries Compared Plan Options Or Switched Plans During a Recent Open Enrollment Period

    News Release

    As Medicare’s annual open enrollment period gets underway, two new analyses from KFF suggest that a relatively small share of the nation’s 65 million Medicare beneficiaries will shop around among the many coverage options for 2023 or switch plans. That decision could have a significant impact on enrollees’ coverage and costs. Results from one new KFF analysis show that only 3 in 10 beneficiaries (29%) compared their current plan with other Medicare plans offered during…

  • Medicare Advantage 2023 Spotlight: First Look

    Issue Brief

    For 2023, the average Medicare beneficiary has access to 43 Medicare Advantage plans and can choose from plans offered by nine firms. Among the majority of Medicare Advantage plans that cover prescription drugs, 66 percent will charge no premium in addition to the monthly Medicare Part B premium. As in previous years, the vast majority of Medicare Advantage plans will offer supplemental benefits, including fitness, dental, vision, and hearing benefits. In addition, virtually all will…

  • The Typical Medicare Beneficiary Has Close to 70 Different Medicare Advantage and Medicare Part D Stand-Alone Plan Options for 2023

    Feature

    The Medicare open enrollment period that runs from October 15 to December 7 each year is an opportunity for Medicare beneficiaries in traditional Medicare and Medicare Advantage to evaluate their current coverage, compare plans, and decide whether to make a change for the coming year. Beneficiaries can compare Medicare Advantage plans, mainly HMOs and PPOs, which provide all Medicare-covered benefits, typically including Part D drug coverage, and may offer other benefits such as vision, dental,…