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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  • Quiero cambiarme de Medicare Advantage a Medicare tradicional, pero aún quiero cobertura de medicamentos. ¿Qué tengo que hacer?

    FAQs

    Si cambia de un plan Medicare Advantage al Medicare tradicional y desea cobertura de medicamentos, puede inscribirse durante el Período de Inscripción Abierta de Medicare para obtener un plan de medicamentos recetados independiente en su área. Su nueva cobertura entrará en vigencia el 1 de enero. También puede cambiarse de Medicare Advantage a Medicare tradicional durante el período de inscripción abierta de Medicare Advantage entre el 1 de enero y el 31 de marzo, cuando…

  • Estoy inscrito en un plan Medicare Advantage y estoy satisfecho con mi cobertura. ¿Debo hacer algo durante el Período de Inscripción Abierta de Medicare?

    FAQs

    No, no necesita hacer nada durante el Período de Inscripción Abierta de Medicare si le gusta su plan actual de Medicare Advantage, siempre que se siga ofreciendo el año próximo. Sin embargo, sigue siendo una buena idea comparar las opciones de su plan cada año, ya que los planes a menudo realizan cambios en sus beneficios, costos compartidos, primas y/o redes de proveedores de un año a otro. Al comparar su plan actual con otros…

  • Options to Make Medicare More Affordable For Beneficiaries Amid the COVID-19 Pandemic and Beyond

    Report

    Medicare provides significant health and financial protections to more than 60 million Americans, but there are gaps in coverage and high cost-sharing requirements that can make health care difficult to afford. This report analyzes several policy options that could help make health care more affordable for people covered by Medicare, especially beneficiaries with relatively low incomes: adding an out-of-pocket limit to traditional Medicare, adding a hard out-of-pocket cap to Part D, expanding financial assistance through…

  • 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,…

  • Analysis Examines the Affordable Care Act’s Impact on Nearly All Americans

    News Release

    A week after the 2020 elections, the Supreme Court is scheduled to hear arguments on a legal challenge, supported by the Trump administration, that seeks to overturn the Affordable Care Act, an outcome that would have major effects throughout the health care system as the law’s provisions have affected nearly all Americans in some way. A KFF analysis examines key provisions of the 2010 law that have changed the nation’s health care system, including what’s…

  • Health Spending for 60-64 Year Olds Would Be Lower Under Medicare Than Under Large Employer Plans

    Issue Brief

    During the presidential campaign, President Biden proposed to lower the age of Medicare eligibility from 65 to 60. This analysis uses claims data for covered medical services from both large employer plans and traditional Medicare to illustrate the potential spending effects of using Medicare payment rates in lieu of higher rates paid by employer plans for people 60-64 who shift from large employer plans to Medicare.