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.

Changes to the Medicare Advantage Program Enhance Some Consumer Protections But Roll Back Others

CMS recently finalized policies as part of the 2027 Medicare Advantage final rule that both enhance consumer protections and roll back changes to the Medicare Advantage program that were intended to protect consumers. These changes have gotten less attention than payment issues and changes to the star ratings system, which also affect plan payments, but could have implications for Medicare beneficiaries.

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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  • 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.…

  • Are covered benefits and cost-sharing requirements under Medicare Advantage plans the same? How can I compare?

    FAQs

    All Medicare Advantage plans cover the same services that are covered by traditional Medicare. However, not all Medicare Advantage plans have the same cost-sharing requirements. The deductibles, premiums, and cost sharing for services vary by plan. And plans may cover benefits not covered by traditional Medicare. For example, most Medicare Advantage plans offer coverage of dental, hearing, and vision services, although the scope of coverage varies. To compare the costs and benefits of different Medicare…

  • I am about to turn 65 and sign up for Medicare but I’m not sure what my options are for coverage. Where can I go for more information?

    FAQs

    To learn more about your coverage options under Medicare, including the Medicare Advantage plans, Part D prescription drug plans, and Medicare supplement policies (Medigap) available in your area, and how to enroll, you can go to the Medicare coverage comparison website, a searchable tool on the Medicare.gov website, or call 1-800-MEDICARE (1-800-633-4227). You can also contact the State Health Insurance Assistance Program (SHIP) in your state or the Social Security Administration. SHIPs offer local, personalized…

  • Is there a lifetime limit on the number of times a person can switch Medicare Advantage and Medicare Part D plans, or can I shop around and switch every year if I want to?

    FAQs

    You may switch Medicare Advantage and Part D plans every year during the annual Medicare Open Enrollment period (October 15 through December 7), and, if you are enrolled in a Medicare Advantage plan, you can also switch during the Medicare Advantage Open Enrollment period (January 1 through March 31). It is generally a good idea to compare your plan options every year, even if you are happy with your current coverage, since plans often make…

  • Analysis Finds End-of-Life Medicare Spending Declines With Age Among Seniors

    News Release

    Among beneficiaries who died in 2014, Medicare spent significantly more per person on medical services for seniors in their late sixties and early seventies than on older beneficiaries, according to a new data note from the Kaiser Family Foundation. The analysis comes at a time when physicians can now be reimbursed by Medicare for end-of-life care discussions with their patients. The analysis of Medicare claims data through 2014 finds that among those who died in…

  • Medicare And Medicaid At 50

    Poll Finding

    Medicare and Medicaid were signed into law by President Lyndon Johnson on July 30, 1965 in a bipartisan effort to provide health insurance coverage for low-income, disabled, and elderly Americans. In their 50 year history, each of these programs has come to play a key role in providing health coverage to millions of Americans today and make up a significant component of federal and state budgets. As major programs both in size and scope, their…

  • Private Contracts Between Doctors and Medicare Patients: Key Questions and Implications of Proposed Policy Changes

    Issue Brief

    Changes in Medicare’s private contracting laws could have significant implications for beneficiaries, doctors, and the Medicare program. This brief summarizes the three options that physicians and practitioners currently have for charging Medicare patients, explains how private contracting works in Medicare under current law, and reviews current proposals on changes to private contracting in Medicare, as well as their implications for patients, physicians, and the Medicare program.