Medicare

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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.

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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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  • Estoy inscrito en un plan de medicamentos independiente de la Parte D de Medicare. ¿Debo hacer algo durante el Período de Inscripción Abierta de Medicare?

    FAQs

    Si está satisfecho con su cobertura actual y su plan continuará ofreciéndose el próximo año, puede mantenerla y no necesita hacer nada durante el Período de Inscripción Abierta de Medicare. Su inscripción continuará automáticamente. Sin embargo, es posible que quiera comparar su cobertura actual con otras opciones de planes en su área para ver si puede obtener una mejor cobertura al cambiar de plan durante el Período de Inscripción Abierta de Medicare. Los planes de…

  • Mi esposo y yo estamos retirados. Él acaba de cumplir 65 años y ahora está cubierto por Medicare, pero yo tengo 62 años y no tengo seguro médico. Como cónyuge de un beneficiario de Medicare, ¿puedo insc...

    FAQs

    No. Aunque su esposo ahora califica para Medicare, usted no calificará para Medicare hasta que cumpla 65. Si ahora no tiene seguro de salud, puede considerar inscribirse en un plan a través del mercado de seguros. Si el ingreso de su hogar es de al menos 100% del nivel federal de pobreza (para comprar cobertura en el mercado para 2026, esto significa un ingreso de $21,150 para una pareja), puede calificar para recibir subsidios para…

  • Insulin Costs and Coverage in Medicare Part D

    Issue Brief

    In light of heightened attention to insulin and the Trump Administration’s new Part D model to address out-of-pocket costs for insulin for Medicare beneficiaries, we analyzed out-of-pocket spending on insulin by beneficiaries enrolled in Part D drug plans, variation in Part D plan formulary coverage and tier placement of insulin products, and trends in prices for insulin.

  • Medicare Part D: A First Look at Medicare Prescription Drug Plans in 2021

    Issue Brief

    This issue brief provides an overview of the Medicare Part D prescription drug benefit plan landscape for 2021, with a focus on stand-alone drug plans. 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 drug plans available in 2021.

  • Medicare Advantage 2021 Spotlight: First Look

    Issue Brief

    For 2021, the average Medicare beneficiary has access to 33 Medicare Advantage plans, the largest number of options available in the last decade, and can choose from plans offered by eight firms. Among the majority of Medicare Advantage plans that cover prescription drugs, 54 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 fitness, dental, vision,…

  • Lower Flu Vaccination Rates Among Black, Hispanic, and Low-Income Seniors Suggest Challenges for COVID-19 Vaccination Efforts

    Issue Brief

    People 65 and older, who have been hardest hit by COVID-19 in terms of hospitalizations and deaths, are also at high risk of severe flu illness and are more likely to die of the flu than younger people. This analysis explores variation in the rate of flu vaccination among adults ages 65 and older covered by Medicare, and reasons cited for not getting vaccinated, based on data from the 2018 Medicare Current Beneficiary Survey.

  • President Trump’s Record on Health Care

    Issue Brief

    This issue brief provides a detailed overview of the Trump Administration’s record on health care issues relating to: the Administration’s response to the COVID-19 pandemic, the ACA and private insurance markets, Medicaid, Medicare, reducing prescription drug and other health care costs, sexual and reproductive health, mental health and substance use, immigration and health, long-term care, HIV/AIDS policy, and LGBTQ health.