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 Costs Break Through the Partisan Logjam

    From Drew Altman

    In this Axios column, Drew Altman analyzes new poll findings which show how one issue breaks through the gridlock between Democrats and Republicans in health – the high cost of prescription drugs.

  • Most Office-Based Physicians Accept New Patients, Including Patients With Medicare and Private Insurance

    Issue Brief

    This brief examines the share of non-pediatric office-based physicians accepting new patients with Medicare or private insurance and how these rates have changed over time and vary by physician specialties, geographic areas, and physician and practice characteristics across Medicare and private insurance. This analysis further examines the extent to which non-pediatric physicians are opting out of Medicare, by specialty and state.

  • Potential Savings for Medicare Part D Enrollees Under Proposals to Add a Hard Cap on Out-of-Pocket Spending

    Issue Brief

    Medicare Part D, the outpatient prescription drug benefit for Medicare beneficiaries, provides coverage above a catastrophic threshold for high out-of-pocket drug costs, but there is no cap on total out-of-pocket drug costs that beneficiaries pay each year. Recent legislative proposals would add a cap on out-of-pocket spending under Part D. This analysis focuses on the potential impact of different out-of-pocket spending caps in terms of how many beneficiaries would be affected and how much they…

  • Dental, Hearing, and Vision Costs and Coverage Among Medicare Beneficiaries in Traditional Medicare and Medicare Advantage

    Issue Brief

    This analysis builds on our prior work – Medicare and Dental Coverage: A Closer Look – by analyzing hearing and vision use, out-of-pocket spending and cost-related barriers to care among Medicare beneficiaries as well as hearing and vision benefits in Medicare Advantage plans. It also incorporates top-level findings from the analysis of dental services to provide a comprehensive profile of dental, hearing, and vision benefits in Medicare.

  • Key Facts About Medicare Part D Enrollment and Costs in 2022

    Issue Brief

    This analysis provides the latest data about Medicare Part D enrollment, premiums, and cost sharing in 2022 and trends over time, including information about stand-alone prescription drug plans (PDPs) and Medicare Advantage prescription drug plans.

  • Simulating the Impact of the Drug Price Negotiation Proposal in the Build Back Better Act

    Issue Brief

    The Build Back Better Act (BBBA) includes a range of health and other proposals supported by President Biden, including a proposal to allow the federal government to negotiate the price of some prescription drugs covered under Medicare Part B (administered by physicians) and Medicare Part D (retail outpatient drugs). This brief illustrates the potential scope of the drug price negotiation proposal in the BBBA. This analysis is designed to highlight the types of Medicare-covered drugs…

  • Medicare: An Overview

    Feature

    This slideshow explains key elements of the Medicare program, which now provides health coverage to 55 million people — including 46 million people age 65 and older and another 9 million younger adults with permanent disabilities.