Medicare

New & Noteworthy

What to Know About Pharmacy Benefit Managers and Federal Efforts at Regulation

The top three pharmacy benefit managers (PBMs) manage 79% of prescription drug claims on behalf of 270 million people. We look at the role PBMs play in influencing drug costs and access to medicines, as well as efforts to regulate them.

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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  • Cost-Related Problems Are Less Common Among Beneficiaries in Traditional Medicare Than in Medicare Advantage, Mainly Due to Supplemental Coverage

    Issue Brief

    This analysis examines health care cost-related problems among Medicare beneficiaries, comparing beneficiaries in traditional Medicare, including those with and without supplemental coverage, to those in Medicare Advantage, with a focus on racial equity. We compare rates of cost-related problems among White, Black, and Hispanic beneficiaries, those in fair or poor health, and those under age 65 with long-term disabilities. The measure of cost-related problems include problems getting care due to cost, delays seeking care due to cost, and problems paying medical bills among people with Medicare.

  • Public Opinion on Prescription Drugs and Their Prices

    Poll Finding

    This chart collection draws on recent KFF poll findings to provide an in-depth look at the public's attitudes toward prescription drugs and their prices. Results include Americans' opinions on drug affordability, pharmaceutical companies, and various potential measures that could lower prices, including the Inflation Reduction Act.

  • FDA’s Approval of Biogen’s New Alzheimer’s Drug Has Huge Cost Implications for Medicare and Beneficiaries

    Issue Brief

    The question of what would happen when a new, expensive prescription drug comes to market for a disease like Alzheimer’s that afflicts millions of people has loomed large in discussions over drug prices in the U.S. This brief analyzes the cost implications for Medicare and beneficiaries associated with Biogen's new FDA-approved Alzheimer's drug, which will cost $56,000 per year.

  • Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2021

    Issue Brief

    The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans, including stand-alone drug plans and Medicare Advantage drug plans. This analysis provides the latest data about Part D enrollment, premiums, and cost sharing in 2021 and trends over time.

  • Medicare and Telehealth: Coverage and Use During the COVID-19 Pandemic and Options for the Future

    Issue Brief

    This brief provides an overview of changes in coverage of telehealth under traditional Medicare before the coronavirus pandemic, and estimates changes in use of telehealth services using survey data from the Medicare Current Beneficiary Survey (MCBS) during the pandemic. The analysis also discusses issues and questions related to extending telehealth coverage under traditional Medicare beyond the public health emergency.

  • Medicare Advantage 2021 Spotlight: First Look

    Issue Brief

    For 2021, the average Medicare beneficiary has access to 33 Medicare Advantage plans, the largest number of options available in the last decade, and can choose from plans offered by eight firms. Among the majority of Medicare Advantage plans that cover prescription drugs, 54 percent will charge no premium in addition to the monthly Medicare Part B premium. As in previous years, the vast majority of Medicare Advantage plans will offer supplemental fitness, dental, vision, and hearing benefits. In addition, virtually all will also offer telehealth benefits in 2021.

  • Medicare Part D: A First Look at Medicare Prescription Drug Plans in 2021

    Issue Brief

    This issue brief provides an overview of the Medicare Part D prescription drug benefit plan landscape for 2021, with a focus on stand-alone drug plans. 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 drug plans available in 2021.

  • Medicare Advantage 2024 Spotlight: First Look

    Issue Brief

    For 2024, the average Medicare beneficiary has access to 43 Medicare Advantage plans and can choose from plans offered by 8 firms. Among the majority of Medicare Advantage plans that cover prescription drugs, 66 percent will charge no premium in addition to the monthly Medicare Part B premium. As in previous years, the vast majority of Medicare Advantage plans will offer supplemental benefits, including fitness, dental, vision, and hearing benefits.