Medicare

NEW AND 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. u003cbru003eu003cbru003eExplore 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.u003cbru003eu003cbru003eu003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022 data-type=u0022linku0022 data-id=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003eRelated:u003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003e FAQs on Medicare Financing and Trust Fund Solvencyu003c/au003eu003c/au003e

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  • Prescription Drug Coverage for Medicare Beneficiaries: A Side-by-Side Comparison

    Other Post

    This document, prepared by Health Policy Alternatives, Inc., provides a side-by-side comparison of five major federal proposals under consideration to provide outpatient prescription drug coverage to Medicare beneficiaries. It includes both a summary and a detailed comparison of the following major proposals: S. 357, The Medicare Preservation and Improvement Act of 2001 (Breaux/Frist I), S. 358, The Medicare Prescription Drug and Modernization Act of 2001 (Breaux-Frist II), H.R. 4680, The Medicare Rx 2000 Act (passed…

  • Medicare Prescription Drugs Through Private Drug-Only Plans: A Discussion with Actuaries

    Report

    Central to the current debate over Medicare prescription drug coverage is the role of private insurance plans in providing drug benefits to Medicare beneficiaries. This report offers views from health actuaries knowledgeable about the Medicare program and the prescription drug debate on key issues that emerge for potential plan sponsors, such as insurers and PBMs, in providing prescription drug benefits to Medicare beneficiaries through private, drug-only plans. The views of the actuaries were obtained through…

  • Medicare and Medicaid Personally Important To Majority Of Public

    Feature

    Medicare and Medicaid Personally Important To Majority Of Public Download Source Kaiser Family Foundation/Robert Wood Johnson Foundation/Harvard School of Public Health, The Public’s Health Care Agenda for the 113th Congress (conducted January 3-9, 2013)

  • How Much Has Medicare Spent on the EpiPen Since 2007?

    Issue Brief

    This data note examines the effects of rising EpiPen prices on Medicare and beneficiaries. We analyze EpiPen spending, in the aggregate and per user, in Medicare Part D between 2007 (the year after the Part D drug benefit took effect, and the year Mylan acquired the product) and 2014 (the most recent year of data available).

  • 7 in 10 Medicare Beneficiaries Report That They Did Not Compare Their Coverage Options During a Recent Open Enrollment Period

    News Release

    With the Medicare open enrollment period set to begin October 15, a new KFF analysis finds that 7 in 10 beneficiaries (71%) say that they didn’t compare their coverage options during a recent open enrollment season. Twenty-nine percent said they did compare Medicare plans. But not shopping around can have a big impact on enrollees’ coverage and costs. The Centers for Medicare & Medicaid Services (CMS) recommends that beneficiaries review and compare Medicare plans each…

  • I decided not to sign up for a Part D drug plan when I first qualified for Medicare when I turned 65 last year, but now I want to enroll in a drug plan during the Medicare Open Enrollment period. Can I...

    FAQs

    Yes, you can sign up for a Part D plan during the Medicare Open Enrollment period. However, you may also owe a late enrollment penalty because you didn’t sign up for Part D drug coverage when you first became eligible for Medicare. The penalty is equal to 1% of the national average premium amount for every month you didn't have coverage as good as the standard Part D benefit.

  • I’m turning 65 soon, but I like my current insurance. Do I have to enroll in Medicare? Will there be penalties if I don’t?

    FAQs

    It depends on how you are receiving your current insurance. If you are receiving employer-sponsored health insurance through either your or your spouse’s job when you turn 65, you may be able to keep your insurance until you (or your spouse) retire(s). You will need to contact your employer’s benefits representative to find out whether they will continue your coverage when you turn 65. Since Medicare Part A is premium-free for most beneficiaries, you may…

  • How can I compare my Medicare coverage options?

    FAQs

    You can compare your Medicare coverage options using an online searchable tool on the Medicare.gov website that allows users to compare Medicare coverage options, including Medicare Advantage plans, Medicare Part D plans, and Medigap supplemental policies. You can get information about the coverage, costs, and benefits of different plan options in your area using the Medicare coverage comparison website. You can also enroll in a Medicare Advantage plan or a Medicare Part D plan on…