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.

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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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  • The Impact of H.R. 1 on Two Medicaid Eligibility Rules

    Issue Brief

    This issue brief describes the impact of H.R.1's 10-year delay in implementing provisions in two Medicaid eligibility rules that would have reduced red tape. The delayed rules are projected to decrease federal spending and future Medicaid and CHIP enrollment and increase coverage loss.

  • A Profile of Dual-Eligible Individuals

    Issue Brief

    Approximately 12 million people are enrolled in both Medicare and Medicaid, referred to as dual-eligible individuals. This brief examines the demographic, socioeconomic, and health characteristics of dual-eligible individuals compared with Medicare beneficiaries without Medicaid.

  • 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.

  • Medigap May Be Elusive for Medicare Beneficiaries with Pre-Existing Conditions

    Issue Brief

    This issue brief analyzes federal and state guaranteed issue rules and how they impact beneficiaries’ access to Medigap, including the implications for Medicare beneficiaries with pre-existing conditions and those under age 65 with long-term disabilities. This brief also explores a recently finalized rule: Nondiscrimination in Health Programs and Activities regarding Section 1557 of the Affordable Care Act that may have implications for the Medigap market.

  • The Uncertain Future of Medicare’s Stand-Alone Prescription Drug Plan Market and Why It Matters

    Issue Brief

    This brief focuses on the stand-alone Medicare Part D prescription drug plan marketplace and its somewhat uncertain future, in light of recent trends in plan availability and the potential for another year of premium increases in 2026, in part depending on what the Trump administration decides to do with the temporary Part D premium stabilization demonstration. The brief explains why the stability of the PDP market matters, both for people in traditional Medicare who want…

  • Estoy inscrito en un plan de medicamentos independiente de la Parte D de Medicare. ¿Debo hacer algo durante el Período de Inscripción Abierta de Medicare?

    FAQs

    Si está satisfecho con su cobertura actual y su plan continuará ofreciéndose el próximo año, puede mantenerla y no necesita hacer nada durante el Período de Inscripción Abierta de Medicare. Su inscripción continuará automáticamente. Sin embargo, es posible que quiera comparar su cobertura actual con otras opciones de planes en su área para ver si puede obtener una mejor cobertura al cambiar de plan durante el Período de Inscripción Abierta de Medicare. Los planes de…

  • President Trump’s Record on Health Care

    Issue Brief

    This issue brief provides a detailed overview of the Trump Administration’s record on health care issues relating to: the Administration’s response to the COVID-19 pandemic, the ACA and private insurance markets, Medicaid, Medicare, reducing prescription drug and other health care costs, sexual and reproductive health, mental health and substance use, immigration and health, long-term care, HIV/AIDS policy, and LGBTQ health.

  • Medicare and Telehealth: Coverage and Use During the COVID-19 Pandemic and Options for the Future

    Issue Brief

    This brief provides an overview of changes in coverage of telehealth under traditional Medicare before the coronavirus pandemic, and estimates changes in use of telehealth services using survey data from the Medicare Current Beneficiary Survey (MCBS) during the pandemic. The analysis also discusses issues and questions related to extending telehealth coverage under traditional Medicare beyond the public health emergency.