Medicare

New & 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.

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.

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.

Related: FAQs on Medicare Financing and Trust Fund Solvency

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  • Prescription Drug Discount Cards: Current Programs and Issues

    Report

    As policymakers consider a range of approaches to providing prescription drug coverage to the Medicare population in today s tight budgetary environment, one proposal that has been put forth by the Bush Administration is that of a Medicare-endorsed prescription drug discount card program.

  • Health Reform and Medicare: Overview of Key Provisions Tutorial

    Interactive

    This tutorial was produced for kaiserEDU.org, a Kaiser Family Foundation website that ceased production in September 2013. The kaiserEDU.org tutorials are no longer being updated but have been made available on kff.org due to demand by professors who are using the tutorials in class assignments. You may search for other tutorials to view on kff.org.

  • Retiree Health Benefits At the Crossroads

    Report

    This issue brief reviews recent trends and developments in employer-sponsored retiree health coverage and examines the impact of recent legislation, such as the Medicare drug benefit and the Affordable Care Act (ACA) on retiree health coverage. The report describes leading strategies employers have been pursuing or considering to limit costs for retiree health benefits. In addition, the report considers the potential implications of proposals aimed at reducing federal spending for retiree health coverage and costs.

  • Medicare Beneficiaries Without Supplemental Coverage Are at Risk for Out-of-Pocket Costs Relating to COVID-19 Treatment

    Policy Watch

    Most Medicare Advantage enrollees are in plans that have waived cost sharing for COVID-19 treatment, and many other beneficiaries in traditional Medicare have their cost sharing covered by supplemental insurance. This blog post discusses the 6 million Medicare beneficiaries without supplemental coverage who would face out-of-pocket costs if they require treatment for COVID-19.

  • KFF Analysis: Number of Coronavirus Cases, Distribution of $30B in CARES Act funding and Medicare Advantage Penetration by State

    Fact Sheet

    Number of Coronavirus Cases, Distribution of $30B in CARES Act funding and Medicare Advantage Penetration by StateStateNumber ofCOVID-19 Cases on April 21, 2020Percent of Total COVID-19 CasesFirst Distribution of CARES Act PaymentsPercent of Total Money DistributedPercent of Medicare Beneficiaries in Medicare Advantage, 2020New York253,400.0032.1%$1,859,574,4346.2%40%New Jersey88,806.0011.3%$919,426,8013.1%29%Massachusetts39,643.005.0%$841,425,1202.8%23%Pennsylvania34,005.004.3%$1,246,250,0764.2%41%California33,866.004.3%$2,920,960,7339.7%40%Michigan32,000.004.1%$936,700,1393.1%42%Illinois31,508.004.0%$1,204,103,1804.0%25%Florida27,058.003.4%$2,220,563,1377.4%43%Louisiana24,523.003.1%$474,891,7351.6%38%Connecticut19,815.002.5%$377,981,2571.3%41%Texas20,087.002.5%$2,089,066,4527.0%37%Georgia19,398.002.5%$792,069,1602.6%37%Maryland14,193.001.8%$742,225,3062.5%11%Ohio12,919.001.6%$989,773,4173.3%39%Washington12,486.001.6%$553,838,8061.8%33%Indiana11,688.001.5%$668,604,6142.2%32%Colorado10,112.001.3%$360,905,4821.2%38%Virginia9,097.001.2%$814,360,4672.7%21%Tennessee7,238.000.9%$739,723,3472.5%38%North Carolina6,979.000.9%$919,171,0873.1%36%Missouri5,963.000.8%$618,601,1672.1%35%Rhode Island5,090.000.6%$90,459,8340.3%39%Arizona5,068.000.6%$707,587,4822.4%39%Alabama5,092.000.6%$449,481,9451.5%41%Mississippi4,512.000.6%$374,847,7901.2%20%Wisconsin4,541.000.6%$471,681,0771.6%42%South Carolina4,439.000.6%$518,022,4631.7%28%Nevada3,830.000.5%$241,471,8410.8%36%Utah3,213.000.4%$185,292,4220.6%36%Iowa3,159.000.4%$297,929,1711.0%22%Kentucky3,050.000.4%$452,761,1711.5%34%District of Columbia3,098.000.4%$84,989,0990.3%20%Delaware2,745.000.3%$154,114,1180.5%17%Oklahoma2,680.000.3%$489,853,9981.6%22%Minnesota2,470.000.3%$472,206,1221.6%43%Kansas2,070.000.3%$325,135,9501.1%19%Oregon1,956.000.2%$291,029,0251.0%42%Arkansas1,990.000.3%$326,536,0431.1%26%New Mexico1,971.000.2%$169,486,1320.6%35%South Dakota1,685.000.2%$107,650,2010.4%19%Idaho1,736.000.2%$135,028,0560.5%33%Nebraska1,648.000.2%$225,027,9120.8%17%New Hampshire1,447.000.2%$164,580,3860.5%19%Puerto Rico1,298.000.2%$41,889,8220.1%70%West Virginia908.000.1%$246,574,8510.8%31%Maine875.000.1%$145,763,8120.5%36%Vermont816.000.1%$54,457,8700.

  • President Trump’s Record on Health Care

    Issue Brief

    This issue brief provides a detailed overview of the Trump Administration’s record on health care issues relating to: the Administration’s response to the COVID-19 pandemic, the ACA and private insurance markets, Medicaid, Medicare, reducing prescription drug and other health care costs, sexual and reproductive health, mental health and substance use, immigration and health, long-term care, HIV/AIDS policy, and LGBTQ health.