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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  • Quality Ratings of Medicare Advantage Plans: Key Changes in the Health Reform Law and 2010 Enrollment Data

    Issue Brief

    NEW: Foundation brief looks at implications of 2011 quality ratings for Medicare Advantage plans. This Kaiser Family Foundation issue brief examines the key changes in this year’s health reform law that will reward bonuses to private Medicare Advantage plans based on quality rating. Medicare currently rates plans on a five-star scale, with five stars representing the highest quality. The brief analyzes plans based on their quality rating for the current year and also examines enrollment…

  • Briefing Examines High Medicare Spending for Beneficiaries in Long-Term Care

    Event Date:
    Event

    These three reports examine the relatively high use of hospital and other Medicare-covered services and the associated costs of medical care for Medicare beneficiaries who live in nursing homes and other long-term-care facilities. They also explore the potential for delivery system reforms to improve quality and reduce costs. Medicare Spending and Use of Medical Services for Beneficiaries in Nursing Homes and Other Long-Term Care Facilities: A Potential for Achieving Medicare Savings and Improving the Quality…

  • Medicare Chartbook, 2010

    Report

    This chartbook provides the most recent and reliable data available about the Medicare program and the 47 million seniors and younger people with disabilities who get health insurance coverage through the program. Topics covered include: Medicare beneficiaries; the program's benefits, utilization, and access to care; prescription drugs; the Medicare Advantage program; the role of Medicaid for Medicare beneficiaries; supplemental insurance coverage; out-of-pocket spending; and Medicare spending and financing. Printable Chartbook (.pdf)

  • Income-Relating Medicare Part B and Part D Premiums: How Many Medicare Beneficiaries Will Be Affected?

    Issue Brief

    Income-Relating Medicare Part B and Part D Premiums: How Many Medicare Beneficiaries Will Be Affected? New in February 2012: Brief Examines Proposals to Further Expand Medicare's Income-Related Premiums This new analysis from the Kaiser Family Foundation examines the number of Medicare beneficiaries who will pay higher Part B or Part D premiums as a result of newly enacted provisions included the 2010 health reform law. Part B Premiums. The health reform law modifies a requirement…

  • Medicare Advantage 2011 Data Spotlight: Medicare Advantage Enrollment Market Update

    Issue Brief

    This data spotlight examines enrollment trends in Medicare Advantage plans in 2011 and finds that, despite concerns about the effects of the 2010 health reform payment reductions on private Medicare Advantage plans, enrollment continued to rise this year. Additionally, Medicare Advantage enrollees are paying lower premiums, on average, than they did in 2010. Preferred Provider Organizations gained more enrollees than any other plan type, while enrollment in Private Fee-for-Service plans continued to decline. A companion…

  • Medigap Reform: Setting the Context for Understanding Recent Proposals

    Issue Brief

    This brief presents the most current data available on the Medicare supplemental insurance (Medigap) market, including enrollment and premiums by state and plan type, analyzes how many beneficiaries have first dollar coverage (particularly Plans C and F), and describes recent Medigap proposals that have emerged as part of efforts to reduce Medicare spending and the national debt.

  • Analysis of Medicare Prescription Drug Plans in 2011 and Key Trends Since 2006

    Report

    This report presents findings from an analysis of the Medicare Part D marketplace in 2011 and changes in drug coverage and costs since 2006. It presents key findings related to Medicare drug plan premiums, the subsidy for low-income beneficiaries, the coverage gap, benefit design and cost sharing, formularies, and utilization management, based on data from CMS for all plans participating in Part D. The analysis was conducted jointly by Jack Hoadley and Laura Summer of Georgetown…

  • Analysis of Medicare Prescription Drug Plans In 2012 And Key Trends Since 2006

    Report

    This report presents findings from an analysis of the Medicare Part D marketplace in 2012 and changes in drug coverage and costs since 2006. It presents key findings related to Medicare drug plan plan availability, premiums, cost-sharing, the coverage gap and availability for low-income beneficiaries, the coverage gap, benefit design and cost sharing, formularies, and utilization management, based on data from CMS for all plans participating in Part D. The analysis was conducted jointly by…

  • Health Care on the Brink of the Fiscal Cliff

    Event Date:
    Event

    The Alliance for Health Reform and the Kaiser Family Foundation present a November 16 briefing to discuss the components of this key policy crossroads with a particular emphasis on the implications for health programs and the health care industry. Automatic cuts would not apply to Medicaid, but Medicare providers would experience 2 percent payment cuts. The reductions would likely be larger for discretionary health programs, such as those funded as part of the National Institutes…

  • Visualizing Health Policy: Health Coverage Under the Affordable Care Act (ACA)

    Report

    Related Resources Study Highlights Role of Geography and Plan Shopping Under Medicare Premium Support System Medicare Part D: A First Look at Part D Plan Offerings in 2013 The Medicare Prescription Drug Benefit - An Updated Fact Sheet Online Consumer Guide to Medicare   The latest Visualizing Health Policy infographic is a flowchart illustrating the mechanisms by which people will get health coverage beginning in 2014. Medicare's Role and Future Challenges << Previous Visualizing Health…