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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  • Democrats Like Medicare-for-All, but Swing Voters Don’t

    From Drew Altman

    Medicare-for-all is popular with Democrats in battleground states, but not with swing voters. In this Axios column, Drew Altman discusses the implications of the KFF-Cook Political Report poll findings. 

  • Millions of Medicare Part D Enrollees Face Increases in Premiums and Other Costs in 2020 if They Do Not Switch Plans During Open Enrollment 

    News Release

    Millions of current enrollees in stand-alone Medicare Part D prescription drug plans will face premium and other cost increases next year unless they switch to lower-cost plans during the open enrollment period that began Oct. 15 and ends on Dec. 7, a new KFF analysis finds. This includes two-thirds of Part D stand-alone drug plan enrollees not receiving low-income subsidies—nine million enrollees—who will face higher monthly premiums if they keep their current plan in 2020.…

  • Medicare Part D: A First Look at Prescription Drug Plans in 2020

    Issue Brief

    This issue brief provides an overview of the Medicare Part D prescription drug benefit plan landscape for 2020, with a focus on stand-alone drug plans, the largest segment of the Part D market. It includes national and state-level data on plan availability, premiums, benefit design, cost sharing, information about premium-free plans for low-income beneficiaries, and information about the national Part D plans available in 2020.

  • Medicare-for-All’s Popularity May Have Peaked

    From Drew Altman

    In this Axios column, Drew Altman looks at the polling trend on support for Medicare-for-all suggesting it may have crested as criticism has mounted. He considers what it means for the Democratic primary and continued debate for Medicare-for-all and other expansion proposals.

  • Medicare Beneficiaries Spent an Average of $5,460 Out-of-Pocket for Health Care in 2016, With Some Groups Spending Substantially More 

    News Release

    The average person with traditional Medicare coverage paid $5,460 out of their own pocket for health care in 2016, according to a new KFF analysis and interactive tool. This $5,460 includes about $1,000 in out-of-pocket spending for long-term care facility services, averaged across all traditional Medicare beneficiaries.  Such services are used by only 5 percent of beneficiaries in traditional Medicare. For the 95 percent of beneficiaries living in the community, average out-of-pocket spending on health…

  • How Much Do Medicare Beneficiaries Spend Out of Pocket on Health Care?

    Issue Brief

    This analysis presents the most current data on out-of-pocket health care spending by Medicare beneficiaries, both overall and among different groups of beneficiaries. The analysis explores how much Medicare beneficiaries spend out of pocket in total on health care premiums and health-related services, on average; how much beneficiaries spend out of pocket on different types of health-related services; and what share of income beneficiaries spend on out-of-pocket health care costs.

  • Analysis Finds Record 3,148 Medicare Advantage Plans Will be Available in 2020

    News Release

    A record 3,148 Medicare Advantage plans will be available across the country as alternatives to traditional Medicare, a new KFF analysis finds. That’s up 15% from last year’s 2,734 plans and results in a typical beneficiary having 28 plans available to them in their local market for the 2020 Medicare open enrollment period, which began Oct. 15 and runs until Dec. 7. About 22 million Medicare beneficiaries - a third of all beneficiaries - are…

  • Medicare Advantage 2020 Spotlight: First Look

    Issue Brief

    In 2020, more than 22 million Medicare beneficiaries (34%) are enrolled in Medicare Advantage plans, which are mainly HMOs and PPOs offered by private insurers as an alternative to the traditional Medicare program. This data note provides an overview of the Medicare Advantage plans that will be available in 2020, including the variation in the number of plans available by county and plan type. The brief also examines the insurers entering the Medicare Advantage market…