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.

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 2025 Spotlight: A First Look at Plan Premiums and Benefits

    Issue Brief

    This brief provides an overview of premiums and benefits in Medicare Advantage plans that are available for 2025 and key trends over time. Two-thirds of all Medicare Advantage plans with Part D prescription drug coverage (MA-PDs) (67%) will charge no premium (other than the Part B premium) in 2025, similar to 2024 (66%). Nearly all Medicare Advantage plans (97% or more) are offering vision, dental and hearing, as they have in previous years. However, the…

  • A Primer on Medicare Financing

    Issue Brief

    As Congress and the Administration increasingly focus on the nation’s budget deficit, many policy experts and several bipartisan deficit reduction panels have proposed significant changes to Medicare to reduce federal spending and address rising health care costs. This primer provides an overview of Medicare spending trends, how the program is financed, and factors contributing to the growth in Medicare spending. Medicare now covers 47 million seniors and younger people with disabilities, with total expenditures of…

  • Medicare Advantage 2011 Data Spotlight: Plan Availability and Premiums

    Report

      This Medicare Advantage Data Spotlight provides an overview of recent changes made to the Medicare Advantage program and examines trends in plan participation, premiums and certain benefits. About 12 million people, or nearly a quarter of the Medicare population, are enrolled in Medicare Advantage, the privately administered plans that are an alternative to the traditional fee-for-service Medicare program. The analysis was conducted by a team researchers at Mathematica Policy Research, Inc. and the Kaiser…

  • Improving Prescription Drug Coverage: Opportunities and Challenges for Reform

    Event Date:
    Event

    Tricia Neuman, Vice President and Director of the Medicare Policy Project, testified before the Senate Finance Committee on prescription drug coverage under Medicare. The statement reviews existing sources of prescription drug coverage for Medicare beneficiaries and the importance of such coverage for this population. It reviews current approaches for improving prescription drug coverage, identifying significant areas of common ground, as well as the key decisions and challenges facing policymakers in designing a Medicare drug benefit.

  • Overall Satisfaction with Medicare is High, But Beneficiaries Under Age 65 With Disabilities Experience More Insurance Problems Than Older Beneficiaries

    Issue Brief

    This brief analyzes data from the 2023 KFF Survey of Consumer Experiences with Health Insurance to get a current understanding of how Medicare is working for older adults and younger people with disabilities. The analysis shows that people with Medicare who are under 65 with disabilities experience more problems using their Medicare coverage, including access and cost-related problems, than beneficiaries who are 65 and older.

  • There are a lot of Medicare Advantage plan options in my area. How do I decide which plan is best for me?

    FAQs

    In choosing among the many Medicare Advantage plans, it is useful to think about what’s most important to you in a health plan. If you feel strongly about getting care from specific doctors and hospitals, it would be a good idea to review the provider directories of each Medicare Advantage plan to be sure the hospitals, doctors, and other health professionals that matter most to you are in the plan network. If you are most…

  • I have Medicare Part A and Part B. I’ve heard about Part C and Part D, but I don’t know what those are. Do I need to sign up for those during the Medicare Open Enrollment period?

    FAQs

    Medicare Part C plans, also known as Medicare Advantage plans, are private health insurance plans, mainly HMOs and PPOs, for people enrolled in Medicare. If you enroll in a Medicare Advantage plan, you still have Medicare, but you get all of your Medicare-covered benefits through a private plan. Most Medicare Advantage plans also cover prescription drugs and most also cover other services, such as vision, dental, and hearing benefits. If you have Part A and…

  • State Profiles for Dual-Eligible Individuals

    Interactive

    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).

  • Views of the New Medicare Drug Law – Chartpack By Income Group

    Report

    This comprehensive survey of people on Medicare, conducted in June and July 2004, assesses their attitudes toward the new Medicare drug law. This chartpack, issued in September 2004, presents additional analysis on the survey data, looking at key findings broken down by income group. Chartpack (.pdf)