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.

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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  • I am enrolled in a stand-alone Medicare Part D drug plan. Do I need to do anything during the Medicare Open Enrollment period?

    FAQs

    If you are happy with your current coverage and your plan will continue to be offered next year, you can keep it and do not need to do anything during the Medicare Open Enrollment period. Your enrollment will automatically continue. However, you might want to see how your current coverage compares to other plan options in your area to see if you can obtain better coverage by switching plans during the Medicare Open Enrollment period.…

  • I am currently enrolled in a Medicare Advantage plan, but I received a notice that my plan is not being offered next year. What do I need to do?

    FAQs

    If your current Medicare Advantage plan is not being offered next year and you do not choose another plan, you will be enrolled by default in traditional Medicare. In this case, if you do not receive Extra Help with your Part D drug costs, then you will need to select a Part D prescription drug plan (PDP) if you want Medicare drug coverage, unless you have drug coverage from another source of coverage (for example,…

  • Amid the Coronavirus Crisis, President Trump and Democratic Nominee Joe Biden Offer Widely Different Views on Health Care

    News Release

    President Trump and Democratic nominee Joe Biden hold widely divergent views on health issues, with the president’s record and response to the coronavirus pandemic likely to play a central role in November’s elections. A new KFF side-by-side comparison examines President Trump’s record and former Vice President Biden’s positions across a wide range of key health issues, including the response to the pandemic, the Affordable Care Act marketplace, Medicaid, Medicare, drug prices, reproductive health, HIV, mental…

  • Limiting Private Insurance Reimbursement to Medicare Rates Would Reduce Health Spending by About $350 Billion in 2021

    Issue Brief

    This analysis estimates the total annual reduction in health care spending by employers and privately insured individuals that would result from having private insurers reimburse hospitals and other health care providers at Medicare rates. In total, we estimate spending for the privately insured population would be an estimated $352 billion lower in 2021 if employers and other insurers reimbursed health care providers at Medicare rates.

  • Analysis Examines the Affordable Care Act’s Impact on Nearly All Americans

    News Release

    A week after the 2020 elections, the Supreme Court is scheduled to hear arguments on a legal challenge, supported by the Trump administration, that seeks to overturn the Affordable Care Act, an outcome that would have major effects throughout the health care system as the law’s provisions have affected nearly all Americans in some way. A KFF analysis examines key provisions of the 2010 law that have changed the nation’s health care system, including what’s…

  • Options to Make Medicare More Affordable For Beneficiaries Amid the COVID-19 Pandemic and Beyond

    Report

    Medicare provides significant health and financial protections to more than 60 million Americans, but there are gaps in coverage and high cost-sharing requirements that can make health care difficult to afford. This report analyzes several policy options that could help make health care more affordable for people covered by Medicare, especially beneficiaries with relatively low incomes: adding an out-of-pocket limit to traditional Medicare, adding a hard out-of-pocket cap to Part D, expanding financial assistance through…

  • Kaiser Health Tracking Poll – November 2017: The Politics of Health Insurance Coverage, ACA Open Enrollment

    Feature

    This month marks the start of the ACA's fifth open enrollment period and finds three in ten of the public saying they haven't heard anything at all about the current open enrollment period. Despite their overall views of the ACA, the majority of the public (61 percent) – including most Democrats (71 percent), independents (58 percent), and half of Republicans (52 percent) – say that because President Trump and Republicans in Congress are now in…

  • Testimony: Promoting Integrated and Coordinated Care for Medicare Beneficiaries

    Issue Brief

    Gretchen Jacobson, Associate Director of the Foundation's Program on Medicare Policy, testified on June 7, 2017 before the U.S. House Committee on Ways and Means, Subcommittee on Health. Her testimony focused on three approaches for integrating and coordinating care for Medicare beneficiaries, and the opportunities and challenges presented by these approaches.

  • Women and Medicare:  Making the Connection

    Other Post

    Women and Medicare: Making the Connection This briefing examines Medicare s role in meeting older women's health needs, the gaps in Medicare's benefits package for women, and the emerging debate over prescription drug coverage and Medicare reform.