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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  • Closing the Medicare Part D Coverage Gap: Trends, Recent Changes, and What’s Ahead

    Issue Brief

    This data note examines the latest data and trends in the Medicare Part D coverage gap, where enrollees must pay a greater share of their prescription drug costs. The note includes data about how many Part D enrollees reached the coverage gap, their average out-of-pocket spending, the value of manufacturer discounts, and recent and proposed changes affecting out-of-pocket costs for Part D enrollees who reach the gap.

  • In All But Four States, Seniors on Medicare Can Be Denied a Medigap Policy Due to Pre-existing Conditions, Except During Specified Windows of Opportunity

    News Release

    In all but four states, insurance companies can deny private Medigap insurance policies to seniors after their initial enrollment in Medicare because of a pre-existing medical condition, such as diabetes or heart disease, except under limited, qualifying circumstances, a Kaiser Family Foundation analysis finds. Medigap policies provide supplemental health insurance to help cover the deductibles and coinsurance for Medicare covered services. One in four people in traditional Medicare had a Medigap policy in 2015. This…

  • Summary of Recent and Proposed Changes to Medicare Prescription Drug Coverage and Reimbursement

    Issue Brief

    On February 9, 2018 the President signed into law the Bipartisan Budget Act of 2018, which included some provisions related to Medicare Part D prescription drug coverage. Shortly thereafter, the Office of Management and Budget released the President’s fiscal year (FY) 2019 budget, which also included several proposals related to Medicare Part D drug coverage and Part B drug reimbursement. This brief summarizes these recently enacted and proposed changes.

  • Medicare’s Income-Related Premiums Under Current Law and Changes for 2019

    Issue Brief

    Most people with Medicare pay the standard monthly premium for Part B and Part D coverage, which is set to cover 25 percent of per capita program costs, but a relatively small share of beneficiaries with higher incomes are required to pay higher premiums. This issue brief describes the legislative history of Medicare's income-related premiums and changes to these premiums that will take effect in 2019, based on a provision in the Bipartisan Budget Act…

  • Medicare Enrollment, 1966-2013

    Feature

    Medicare Enrollment, 1966-2013 Download Source Centers for Medicare & Medicaid Services, Medicare Enrollment: Hospital Insurance and/or Supplemental Medical Insurance Programs for Total, Fee-for-Service and Managed Care Enrollees as of July 1, 2011: Selected Calendar Years 1966-2011; 2012-2013, HHS Budget in Brief, FY2014.

  • Medicare Enrollment, 1970-2035

    Feature

    Medicare Enrollment, 1970-2035 Download Source 2013 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds.

  • The Affordable Care Act: Three Years Post-Enactment

    Issue Brief

    On March 23, 2010, the Affordable Care Act (ACA) was signed into law. Although the date for full implementation of most provisions of the law is January 1, 2014, the ACA has already led to progress toward expanded coverage of the uninsured; improved access and better care delivery models; broader access to community-based long-term care; and more integrated care and financing for beneficiaries who are dually eligible for Medicare and Medicaid. The brief provides an…