Medicare

Medicare Open Enrollment

Medicare Advantage Plan Availability Varies Widely by County for 2027

Medicare Advantage prescription drug plan (MA-PD) availability varies widely by county in 2027, with a modest reduction in the share of enrollees with more than 40 plans to choose from and some major insurers exiting many more counties than they are entering. 1 in 5 Medicare beneficiaries (20%) can choose from among more than 40 MA-PDs for 2027, down from 27% in 2026. 1% of all beneficiaries will have no plan option for 2027.

Medicare Open Enrollment and Coverage Options: Key Questions and Answers

Each year, Medicare beneficiaries have an opportunity to make changes to how they receive their Medicare coverage during the nearly 8-week annual open enrollment period, which runs from October 15 through December 7. This brief answers key questions about the Medicare open enrollment period and Medicare coverage options.

Medigap

Medigap Guaranteed Issue Requirements: An Overview of Federal and State Rules

This issue brief analyzes federal and state rules related to guaranteed issue requirements for Medigap policies and how they impact beneficiaries’ access to Medigap, including the implications for Medicare beneficiaries with pre-existing medical conditions and those under age 65 with long-term disabilities.

NEW AND NOTEWORTHY

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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  • Raising the Age of Medicare Eligibility: A Fresh Look Following Implementation of Health Reform

    Report

    Several major deficit-reduction and entitlement reform proposals include raising Medicare's age of eligibility from 65 to 67 as a way of improving Medicare's solvency. This Kaiser Family Foundation report estimates the expected effects of such a change on the federal budget, as well as on affected seniors' out-of-pocket costs, employers, Medicaid and others in light of the major changes in coverage enacted under the 2010 health reform law. The study estimates that raising Medicare’s eligibility…

  • Medicare Part D Spending on the EpiPen Increased More than 1000 Percent from 2007 to 2014

    News Release

    As policymakers in Washington scrutinize the rising cost of the EpiPen auto-injector, a new analysis from the Kaiser Family Foundation shows that Medicare Part D spending for the potentially life-saving device increased by more than 1000 percent between 2007, the year after the Part D drug benefit took effect, and 2014, the most recent year for which data are available. The higher spending partly results from more Part D enrollees using EpiPens during that period,…

  • How ACA Repeal and Replace Proposals Could Affect Coverage and Premiums for Older Adults and Have Spillover Effects for Medicare

    Issue Brief

    This brief explains the key AHCA provisions that would reshape the private market to more closely resemble the pre-Affordable Care Act period, and the effects of these changes on adults ages 50-64. The brief also discusses how changes to Medicaid could affect older, low-income adults, and how an increase in the number of uninsured older adults could have implications for the Medicare program in the future.

  • Revisiting ‘Skin in the Game’ Among Medicare Beneficiaries: An Updated Analysis of the Increasing Financial Burden of Health Care Spending From 1997 to 2005

    Issue Brief

    This issue brief presents an analysis of the financial burden of out-of-pocket health care spending for Medicare beneficiaries between 1997 and 2005. The analysis shows median out-of-pocket spending as a share of Medicare beneficiaries' income increased between 1997 and 2005, from 11.9 percent to 16.1 percent. For some beneficiaries, the spending burden was even greater, with 25 percent of people on Medicare spending nearly one-third or more of their income on health care.

  • Medicare Part D: A First Look at Prescription Drug Plans in 2017

    Issue Brief

    This issue brief provides an overview of the 2017 Medicare Part D stand-alone prescription drug plan marketplace, based on analysis of data from the Centers for Medicare & Medicaid Services. The brief focuses on data for 2017 and changes over time in plan availability, premiums, benefit design, cost sharing, and low-income subsidy plan availability.

  • Medicare Drug Plan Enrollees Would Face an Average 9 Percent Premium Increase Unless They Switch Plans During Open Enrollment, New Analysis Finds

    News Release

    Current enrollees in stand-alone Medicare Part D plans are projected to face an average 9 percent increase in premiums if they remain in their current plan for 2017, according to an analysis released today by the Kaiser Family Foundation. During Medicare’s 2017 open enrollment period, which runs from Oct. 15 through Dec. 7, Medicare beneficiaries in each state will have a choice of 22 stand-alone Part D drug plans (PDPs), on average. This is fewer…

  • Medicare Part D: A First Look at Prescription Drug Plans in 2018

    Issue Brief

    This issue brief provides an overview of the 2018 Medicare Part D stand-alone prescription drug plan landscape, the largest segment of the Part D marketplace, 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 top ten Part D plans in 2018.

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

    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 Part B and Part D program costs, but a relatively small share of beneficiaries are required to pay higher premiums. This issue brief describes current requirements with respect to Medicare's Part B and Part D income-related premiums and proposed changes under House legislation being considered in November 2017.

  • Web Briefing: The Future of Delivery System Reform in Medicare: Assessing the Evidence and Looking Ahead

    Event Date:
    Event

    On Nov. 28, 2017, KFF held a public web briefing on the topic of delivery system reform in Medicare. It explored the latest evidence on savings and quality among newer payments models (including ACOs, bundled payments and medical homes), and discussed future directions that the Centers for Medicare and Medicaid Services (CMS) may consider in its effort to lower costs and improve care in the coming years. Panelists: Tricia Neuman, senior vice president at the Kaiser…