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.

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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  • Changes to Medicare Part D in 2024 and 2025 Under the Inflation Reduction Act and How Enrollees Will Benefit

    Issue Brief

    The Inflation Reduction Act of 2022 includes several provisions to lower prescription drug costs for people with Medicare and reduce drug spending by the federal government, including a number of changes to the Medicare Part D drug benefit. This brief provides an overview of the Part D benefit design and Part D enrollee cost-sharing requirements in 2023 and changes coming in 2024 and 2025.

  • KFF News Release

    What is the Potential Impact of New Drugs for Obesity and Alzheimer’s Disease on Medicare Costs, Coverage and Beneficiaries? 

    News Release

    Two new KFF analyses examine the potential impact of Medicare coverage of new prescription drugs for obesity and Alzheimer’s disease on program spending and beneficiary out-of-pocket costs, as well as the role that the Inflation Reduction Act could play in mitigating these effects. Manufacturers of both types of drugs are lobbying for broad Medicare coverage of them, though they face different challenges. The availability of effective weight-loss drugs, including Novo Nordisk’s Ozempic and Wegovy (semaglutide)…

  • Deaths From COVID-19 Spiked Over The Summer, Especially Among People 65 and Older, Before Dipping Again in September

    News Release

    Although COVID-19 fatalities remain much lower than during the peak of last winter’s Omicron surge, deaths among people 65 and older spiked over the summer, more than doubling between April and July 2022, finds a new KFF analysis. The number of deaths topped more than 11,000 people 65 and older in both July and August. For people younger than 65, deaths have increased more slowly since April, rising by 52 percent to about 1,900 in…

  • Estoy inscrito en un plan Medicare Advantage, y recientemente hice planes para viajar por los Estados Unidos. ¿Mi plan brindará la misma cobertura en todos los estados que visite?

    FAQs

    No necesariamente. Deberá comunicarse con la compañía que ofrece su plan para averiguar si los beneficios están disponibles fuera del estado. Si su plan no ofrece cobertura fuera del estado, puede haber otro plan ofrecido por la misma empresa que sí lo haga, o un plan similar ofrecido por otra empresa en su área. Sin embargo, si decide cambiarse a un plan diferente, tenga en cuenta que deberá esperar hasta el Período de Inscripción abierta…

  • Decidí no inscribirme en un plan de medicamentos de la Parte D cuando califiqué por primera vez para Medicare al cumplir 65 el año pasado, pero ahora quiero inscribirme en un plan de medicamentos durant...

    FAQs

    Sí, puede inscribirse en un plan de la Parte D durante el Período de Inscripción abierta de Medicare. Sin embargo, es posible que también deba una multa por inscripción tardía porque no se inscribió en la cobertura de medicamentos de la Parte D cuando se volvió elegible por primera vez para Medicare. La multa es igual al 1% del monto de la prima promedio nacional por cada mes que no tuvo una cobertura tan buena…

  • Medicare Advantage Hospital Networks: How Much Do They Vary?

    Report

    This report takes an in-depth look at Medicare Advantage plans’ hospital networks. The analysis draws upon data from 409 Medicare Advantage plans serving beneficiaries in 20 diverse counties that together accounted for about one in seven (14%) Medicare Advantage enrollees nationwide in 2015. The report examines the size and composition of plans’ hospital networks, the variation across counties, the inclusion of Academic Medical Centers and NCI-Designated Cancer Centers, and the relationship between network size and…

  • What is Medicare’s Role in End-of-Life Care?

    News Release

    Medicare plays an integral role in end-of-life care, an issue that is emotionally-charged and easily politicized.  About three-quarters of the 2.5 million Americans who die each year are ages 65 and older, and covered by Medicare at the time of their death, yet policy issues related to Medicare and end-of-life care are often poorly understood. As policymakers consider whether and how Medicare should pay physicians and other health care professionals for talking to Medicare beneficiaries…

  • Insulin Costs and Coverage in Medicare Part D

    Issue Brief

    In light of heightened attention to insulin and the Trump Administration’s new Part D model to address out-of-pocket costs for insulin for Medicare beneficiaries, we analyzed out-of-pocket spending on insulin by beneficiaries enrolled in Part D drug plans, variation in Part D plan formulary coverage and tier placement of insulin products, and trends in prices for insulin.