Medicare

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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  • Betting on Private Insurers

    Perspective

    Just-released estimates of national health spending in 2010 by the Centers for Medicare and Medicaid Services (CMS) show that 45% of our health care spending is financed by the federal and state governments, primarily through the Medicare and Medicaid programs. This share has grown temporarily in recent years because of the economic downturn, as private insurance has declined and Medicaid has grown. It has also increased due to our demographic destiny: the growing cohort of baby…

  • 10 Key Facts About Women with Medicare

    Issue Brief

    This brief examines 10 key facts about women with Medicare and presents new statistics on the health, economic and functional status of women with Medicare.

  • 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.

  • I am covered by Medicare and my only income is $12,000 from Social Security. I have $1,000 in a savings account.  Do I qualify for any financial assistance with her Medicare coverage?

    FAQs

    Based on your current income and asset amounts, you may qualify for Medicaid. Under the current rules, Medicaid helps many low-income people on Medicare with their Medicare premiums and cost-sharing requirements and may also cover some benefits that are not covered by Medicare, such as dental services and long-term services and supports. You might also qualify for extra financial assistance to help with the cost of Medicare Part D prescription drug coverage. To find out…

  • 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).

  • Vice President Harris’ Proposal to Broaden Medicare Coverage of Home Care

    Issue Brief

    On October 8, 2024, Vice President Harris has proposed to expand Medicare to provide home care to help families who are struggling with the costs of long-term care. If enacted, this would be the first major expansion of Medicare since the Medicare Modernization Act of 2003 that added a prescription drug benefit to the program.

  • Pulling it Together: 2012: The ACA, and More

    From Drew Altman

    What is remarkable about 2012 (and the current era in health policy) is how many big health policy issues and marketplace changes will be in play at the same time: HEALTH REFORM: There is the implementation of a historic but fragile health reform law, with a Supreme Court decision pending and so much hanging in the balance. MEDICARE AND MEDICAID: There are continuing debates about potentially big changes in Medicare and Medicaid, driven by the…