Medicare

Medicare Open Enrollment

Medicare Advantage Plan Availability Varies Widely by County for 2027

Medicare Advantage prescription drug plan (MA-PD) availability varies widely by county in 2027, with a modest reduction in the share of enrollees with more than 40 plans to choose from and some major insurers exiting many more counties than they are entering. 1 in 5 Medicare beneficiaries (20%) can choose from among more than 40 MA-PDs for 2027, down from 27% in 2026. 1% of all beneficiaries will have no plan option for 2027.

Medicare Open Enrollment and Coverage Options: Key Questions and Answers

Each year, Medicare beneficiaries have an opportunity to make changes to how they receive their Medicare coverage during the nearly 8-week annual open enrollment period, which runs from October 15 through December 7. This brief answers key questions about the Medicare open enrollment period and Medicare coverage options.

Medigap

Medigap Guaranteed Issue Requirements: An Overview of Federal and State Rules

This issue brief analyzes federal and state rules related to guaranteed issue requirements for Medigap policies and how they impact beneficiaries’ access to Medigap, including the implications for Medicare beneficiaries with pre-existing medical conditions and those under age 65 with long-term disabilities.

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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  • The Role of Private Plans in Medicare

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    Event

    Enrollment in private health plans has grown sharply since the enactment of the Medicare Modernization Act in 2003, which created a Medicare drug benefit to be provided by private plans and created incentives for new private plans to enter the Medicare market. Today, virtually all Medicare beneficiaries--including those living in rural areas--have access to one or more private plans (known as Medicare Advantage plans), such as a Medicare HMO, PPO, special-needs plan or a private…

  • Medicaid Matters For Low Income Medicare Beneficiaries: A Video

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    In this video, Mildred Benham, a 68 year-old dual enrollee who lives in Bloomington, Illinois, describes the role Medicaid plays in providing services that Medicare does not, such as prescription drugs and personal care. Mildred is a typical dual enrollee in that she has multiple conditions, such as fibrosis of the lungs, rheumatoid arthritis, high blood pressure, and cataracts. To control her conditions, she takes 12 prescriptions a day. Because of her physical limitations, Medicaid…

  • Old and Poor: America’s Forgotten

    Video

    While the Census Bureau’s official poverty measure shows 9 percent of seniors nationally live in poverty, the share climbs to about one in seven seniors (15 percent) under the Bureau’s alternative Supplemental Poverty Measure, which takes into account out-of-pocket health expenses and geographic differences in the cost of living. Produced by the Kaiser Family Foundation, Old and Poor: America's Forgotten provides a portrait of seniors who are living in poverty, in both urban and rural…

  • What’s In and What’s Out? Medicare Advantage Market Entries and Exits for 2016

    Issue Brief

    This Issue Brief examines the availability of Medicare Advantage plans nationwide and by state in 2016, and tracks changes in plan availability since 2012. It documents the number and share of Medicare Advantage enrollees affected by plan withdrawals each year, the characteristics of plans that will be entering or exiting the market in 2016, and the potential implications of these changes for Medicare Advantage enrollees.

  • Primary Care Physicians Accepting Medicare: A Snapshot

    Issue Brief

    This Data Note presents findings on reported acceptance of Medicare patients among non-pediatric primary care physicians, based on data from the Kaiser Family Foundation/Commonwealth Fund 2015 National Survey of Primary Care Providers. In addition to comparing physicians’ acceptance of Medicare to private insurance and Medicaid, this Data Note also explores the characteristics of non-pediatric primary care physicians who accept new Medicare patients and who have greater shares of Medicare patients in their caseloads.

  • What’s in Store for Medicare’s Part B Premiums and Deductible in 2016, and Why?

    Issue Brief

    As a result of the recently-enacted Bipartisan Budget Act of 2015, the Medicare Part B monthly premium will be $121.80 in 2016 according to the Centers for Medicare and Medicaid Services, an increase of 16 percent over the 2015 amount for 30 percent of beneficiaries —far lower than the 52 percent increase initially projected by the Medicare actuaries. This Issue Brief reviews how Medicare Part B premiums and deductibles are affected by the recent budget…

  • Medicare Part D Spotlight: Part D Plan Availability in 2010 and Key Changes Since 2006

    Issue Brief

    This Medicare Part D data spotlight examines the stand-alone Medicare drug plan options that will be available to beneficiaries in 2010, including the number of available plans, premiums for those plans, and benefit designs. About two-thirds of the nearly 27 million Medicare beneficiaries who are enrolled in Part D plans get their coverage through stand-alone plans. The analysis is based on the 2010 Medicare drug plan information released by the Centers for Medicare & Medicaid Services…

  • Resources for Medicare & Medicaid’s 50th Anniversary

    News Release

    On July 30, 1965, President Lyndon Johnson signed the law creating the Medicare and Medicaid programs.  As the programs' 50th anniversary nears, the Kaiser Family Foundation offers several resources that look at the programs' past and future, including videos that are available to share at in-person events or with online communities: Six new articles authored by Foundation staff and published in the journal Generations reflecting on Medicare’s history, evolution and future, the Medicare and Medicaid…