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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  • What Do People with Medicare Think About the Role of Marketing, Shopping for Medicare Options, and Their Coverage?

    Report

    To capture Medicare beneficiaries’ views and experiences in choosing between traditional Medicare and private plans, and among private plans, and the factors that influence these decisions, KFF worked with PerryUndem to conduct focus groups with Medicare beneficiaries in the Fall of 2022, during the annual Medicare open enrollment period. This report summarizes first-hand accounts of participants’ reactions open enrollment advertising and factors that influence their decision-making around Medicare plan choice.

  • Probing the Legal Arguments in the Drug Industry’s Challenges to Medicare Drug Price Negotiations

    Event Date:
    Event

    With the Biden administration’s announcement of the first 10 drugs to be negotiated for Medicare as part of the Inflation Reduction Act (IRA), an array of legal challenges from the pharmaceutical industry is potentially the biggest obstacle to implementation. On Tuesday, September 12, two legal experts and a health policy expert joined Larry Levitt, executive vice president for health policy at KFF, for a 45-minute discussion about the legal issues underpinning these lawsuits and how they intersect with the policy goals of the legislation.

  • The 4 Arguments You Will Hear Against Drug Price Negotiation

    Perspective

    As the Biden administration begins the process of negotiation drug prices for Medicare as authorized in the Inflation Reduction Act, KFF's Larry Levitt probes some of the arguments against it and the policy and political implications of the debate in this New York Times op-ed column.

  • Medicare Advantage Enrollment, Plan Availability and Premiums in Rural Areas

    Issue Brief

    Medicare Advantage enrollment is lower, but has grown more rapidly in recent years in rural areas than in metropolitan areas. In 2023, nearly 40% of eligible Medicare beneficiaries in rural areas are in Medicare Advantage. Rural Medicare beneficiaries can choose from 27 Medicare Advantage plans on average and most are enrolled in a plan that charges no additional premium.

  • Medicare Part D in 2024: A First Look at Prescription Drug Plan Availability, Premiums, and Cost Sharing

    Issue Brief

    Medicare Part D prescription drug coverage is available for people with Medicare who enroll in private plans, either a stand-alone prescription drug plan (PDP) for people in traditional Medicare, or a Medicare Advantage plan that covers all Medicare benefits, including prescription drugs (MA-PD). This issue brief provides an overview of Part D plan availability and premiums in 2024 and key trends over time.

  • Medicare Advantage 2024 Spotlight: First Look

    Issue Brief

    For 2024, the average Medicare beneficiary has access to 43 Medicare Advantage plans and can choose from plans offered by 8 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.

  • Medicare Advantage Has Become More Popular Among the Shrinking Share of Employers That Offer Retiree Health Benefits

    Issue Brief

    This analysis examines the extent to which large private and non-federal public employers that offer retiree health benefits are turning to Medicare Advantage and why they are making this shift, using data from the 2024 Employer Health Benefits Survey. We find that slightly more than half (56%) of large employers offering retiree health benefits to Medicare-age retirees offer coverage to at least some retirees through a contract with a Medicare Advantage plan, more than double the share in 2017 (26%).