Medicare

New & Noteworthy

What to Know About Medicare Coverage of Telehealth

Congress has repeatedly extended pandemic-era flexibilities around Medicare coverage of telehealth, but most such flexibilities remain temporary. This brief answers key questions about the current scope of Medicare telehealth coverage, including both temporary and permanent changes adopted through legislation and regulation, and future policy considerations.

Examining the Potential Impact of Medicare’s New WISeR Model

A federal initiative to establish new prior authorization requirements in traditional Medicare, called the Wasteful and Inappropriate Service Reduction (WISeR) model, is likely to have only modest impact in its first year.

State Profiles for Dual-Eligible Individuals

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).

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.

Related: FAQs on Medicare Financing and Trust Fund Solvency

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  • Most Medicare Beneficiaries Lack Dental Coverage, and Many Go Without Needed Care

    News Release

    Almost two-thirds of Medicare beneficiaries (65%), or nearly 37 million people, do not have dental coverage and many go without needed care, according to a new KFF brief on dental coverage and costs for Medicare beneficiaries. Rates are even higher among black and Hispanic beneficiaries, and those with low incomes.

  • Medicare Advantage 2019 Spotlight: First Look

    Issue Brief

    In 2019, more than 20 million Medicare beneficiaries (34%) are enrolled in Medicare Advantage plans, which are mainly HMOs and PPOs offered by private insurers as an alternative to the traditional Medicare program. This issue brief provides an overview of the Medicare Advantage plans that will be available in 2019, including the variation in the number of plans available by county and plan type. The brief also examines the insurers entering the Medicare Advantage market for the first time and also examines the insurers exiting the market.

  • Medicare-for-All and Public Plan Buy-In Proposals: Overview and Key Issues

    Issue Brief

    This issue brief compares eight Medicare-for-All and public plan option bills that have been introduced in the 115th Congress. The brief describes the range of proposals on the table and raises key questions related to how these proposals could affect coverage, out-of-pocket costs, existing coverage, payments to providers, as well as overall costs and financing, and potential tradeoffs.

  • Implications of “Medicare for All” and “Public Plan” Strategies: New Brief and Interactive Tool Summarize Legislative Proposals and Key Issues

    News Release

    The idea of expanding the role of government programs such as Medicare and Medicaid has received renewed attention on Capitol Hill and on the campaign trail this year as policymakers consider ways to expand health insurance coverage and moderate health care costs. Lawmakers have introduced eight such proposals in the current Congress.

  • Medicare Part D: A First Look at Prescription Drug Plans in 2019

    Issue Brief

    This issue brief provides an overview of the Medicare Part D prescription drug benefit plan landscape, with a focus on stand-alone drug plans, the largest segment of the Part D market. 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 top ten Part D plans for 2019.